Compilation of Rules and Regulations of the State of Georgia
Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER
Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE
Subject 120-2-101 - CHILD ONLY INDIVIDUAL HEALTH COVERAGE
Rule 120-2-101-.06 - Child-Only Program Reporting due in 2014

Current through Rules and Regulations filed through September 23, 2024

Insurers that are active in the individual health insurance market in Georgia in 2013 and comply with requirements to make child-only health products available shall report as required in O.C.G.A. §33-29B-7 by March 1, 2014.

The report submitted on March 1, 2014 for the child-only 2013 coverage program shall include this information and follow this reporting format:

2013 Georgia Child-Only Individual Health Insurance Program Report

Name of Insurer: ________________________ NAIC# ___________

Total Number of Applicants that applied during Open Enrollment Period

Number of Applicants that enrolled during Open Enrollment Period

Number of Applicants that were declined during Open Enrollment Period

Reason(s) for Denial of Applicants

(Include limited identifying details for each applicant case so denied, respecting potential privacy concerns)

Contact Person preparing this Report: _______________________Ph: _______________

Email: ___________________________

Certification by Responsible Officer of the Insurer:

I hereby affirm that the information included in this report of 2013 activities of the company is correct and complete.

Signed: _________________________________

Printed Name: ___________________________ Title: : ________________________

Date: __________________________________

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