Wyoming Administrative Code
Agency 044 - Insurance Dept
Sub-Agency 0002 - General Agency, Board or Commission Rules
Chapter 49 - REGULATION TO IMPLEMENT THE SMALL EMPLOYER HEALTH INSURANCE AVAILABILITY ACT
Section 49-7 - Requirement to Insure Entire Groups

(i) That offers coverage to a small employer shall offer to provide coverage to each eligible employee and may offer coverage to each dependent of an eligible employee. Except as provided in paragraph (ii), the small employer carrier shall provide the same health benefit plan to each employee and eligible dependent(s);

(ii) May offer the employees the option of choosing among one or more health benefit plans, provided that each employee may choose any of the offered plans. The choice among benefit plans may not be limited, restricted or conditioned based upon the risk characteristics of the employees or their dependents, unless allowed by applicable federal or state law;

(iii) Shall require each small employer that applies for coverage, as part of the application process, to provide a complete list of eligible employees and dependents, if offered, as defined in applicable federal or state law. Employees who are listed as being in their waiting period, probationary period or other period with similar limitations of coverage must be identified, including the ending date for each employee's period of limitation. Any subsequent lists submitted to the carrier shall also contain the information required in this section. The carrier shall require the employer to provide appropriate supporting documentation to verify the information required under this paragraph;

(iv) Shall secure a waiver with respect to each eligible employee and eligible dependents if dependent coverage is offered who declines an offer of coverage. The waiver shall be signed by the eligible employee or by the employee on behalf of the eligible dependent(s). The waiver shall certify that the individual who declined coverage was informed of the availability of coverage under the health benefit plan. The waiver form shall include the reason for declining coverage ,a written warning of the penalties imposed on late enrollees and a statement informing of any special enrollment rights, as allowed by applicable federal or state law. Waivers shall be maintained by the carrier for a period of six (6) years;

(v) Shall not issue coverage to a small employer that refuses to provide the list required under subparagraph (iii) or a waiver required under subparagraph (iv);

(vi) Shall not issue coverage to a small employer if the carrier, or the carrier's producer, has reason to believe that the small employer has induced or pressured an eligible employee or eligible dependent, if dependent coverage is offered, to decline coverage due the individual's risk characteristics.

(vii) Shall offer new entrants to a small employer group an opportunity to enroll in the health benefit plan. A new entrant who does not exercise the opportunity to enroll in the health benefit plan within the period provided by the small employer carrier may be treated as a late enrollee by the carrier, provided that the period provided to enroll in the health benefit plan extends at least thirty (30) days after the date the new entrant is notified of his or her opportunity to enroll. If a small employer carrier has offered more than one health benefit plan to a small employer group pursuant to subsection (a)(ii), the new entrant shall be offered the same choice of health benefit plans as the other members of the group.

(viii) Shall not apply a waiting period, elimination period or other similar limitation of coverage unless allowed by applicable federal and state law.

(ix) Shall accept new entrants for coverage by the small employer carrier without any restrictions or limitations on coverage related to the risk characteristics of the employees or their dependents if dependent coverage is offered, except that a carrier may exclude coverage for preexisting medical conditions, if allowed by applicable federal or state law.

(x) May assess a risk load to the premium rate associated with a new entrant, consistent with the requirements of W.S. § 26-19-304. The risk load shall be the same risk load charged to the small employer group immediately prior to acceptance of the new entrant.

(i) Notify a small employer carrier, prior to submitting an application for coverage with the carrier on behalf of a small employer, of any circumstances that would indicate that the small employer has induced or pressured an eligible employee or eligible dependent, if dependent coverage is offered, to decline coverage due to the individual's risk characteristics.