North Carolina Administrative Code
Title 11 - INSURANCE
Chapter 12 - LIFE AND HEALTH DIVISION
Section .1300 - SMALL EMPLOYER GROUP HEALTH COVERAGE
Section 12 .1305 - PROHIBITED ACTS
Current through Register Vol. 39, No. 6, September 16, 2024
(a) A carrier shall not unilaterally change a small employer group from one health benefit plan to another. A carrier shall not require an in-force health benefit plan risk to replace existing coverage with the basic or standard health care plans.
(b) No carrier, its agents or field representatives, a broker, nor a small employer shall discourage any employee or dependent from applying for coverage so that the small employer can be issued a more favorable premium rate or benefit package.
(c) No carrier shall set classes of employees in such a way as to exclude any employees who are eligible for insurance by definition. This Paragraph does not prevent a carrier from classifying ineligible employees or "extra-eligibles".
Authority
G.S.
58-2-40(1);
58-50-125(d);
58-50-130(a)(3);
Temporary Adoption Eff. December 21, 1992 for a period of 180 days or until the
permanent rule becomes effective, whichever is sooner;
Eff. April
1, 1993;
Pursuant to
G.S.
150B-21.3A, rule is necessary without
substantive public interest Eff. May 1, 2018.
