(a)
Initial Filing. Prior to enrolling Eligible Small
Businesses or Eligible Individuals within a Health Benefit Plan, an
Intermediary is to file with the Commissioner a report that contains at least
the following information certified by an officer of the organization:
1. A narrative description of the
Intermediary;
2. A copy of the
basic organizational documents of the Intermediary, such as the articles of
incorporation, and amendments thereto;
3. A copy of the bylaws, rules, regulations
or other similar documents regulating the conduct of the internal affairs of
the Intermediary;
4. A copy of the
eligibility criteria for individuals or groups seeking to join the Intermediary
including, but not limited to, the forms that individuals or Members must
complete prior to enrollment in the Intermediary;
5. The number of Massachusetts Members in the
Intermediary who buy health insurance through the Intermediary, broken out by
Eligible Small Groups and Eligible Individuals;
6. A listing of the services, other than
health insurance, which the Intermediary offers to its members;
7. The fees paid by members to join or
maintain membership in the Intermediary;
8. A description of each Health Benefit Plan
offered by the Intermediary to the Intermediary's members who are Residents of
Massachusetts;
9. A statement
declaring that the Intermediary does not condition enrollment in a Health
Benefit Plan on health status, claims experience, Wellness Program usage,
tobacco usage, or duration of coverage since issue; and
10. A statement affirming that the
Intermediary was not formed for the purposes of obtaining insurance.
(b)
Annual
Filing. Every Intermediary which has met the filing requirements
of 211 CMR 66.12(3)(a)
must, on or before April
1st of each year, file a report that contains at
least the following information.
1. The number
of Massachusetts Members in the organization who buy health insurance through
the Intermediary, broken out by Eligible Small Groups and Eligible
Individuals;
2. A listing of the
services, other than health insurance, which the Intermediary offers to its
members;
3. The fees paid by
members to join or maintain membership in the Intermediary;
4. A description of each Health Benefit Plan
offered by the Intermediary to its members who are Residents of
Massachusetts;
5. A statement
declaring that the Intermediary does not condition enrollment in a Health
Benefit Plan on health status, claims experience, or duration of coverage since
issue; and
6. A statement affirming
that the Intermediary was not formed for the purposes of obtaining
insurance.