Current through September 21, 2024
(a) Application Contents. Prior to the sale
of out-of-state health insurance policies in Wyoming, the insurer must file an
application as prescribed by the Wyoming insurance commissioner and are subject
to the applicable SERFF filing fees. The application must include at a minimum
the following:
(i) Proof of current approval
and product line authority in domicile state including health policy form
number and date approved in the domicile state;
(ii) Proof of authorization to transact
insurance in Wyoming;
(iii) The
price of the health policy as sold in the domicile state and whether the health
policy will be at the same price or at a Wyoming specific price;
(iv) A network provider directory that must,
at a minimum, include providers specialties, locations of providers, acceptance
of new patient status, the total unduplicated providers, and the total number
of essential community providers in the provider network; and
(v) A description of the relationship between
the insurer making the filing and the affiliate insurer, if any, which
currently has approval for the issuance of health insurance policies in another
state, the original state where the proposed product was approved, and the date
of such approval.
(b)
Policy Filing Requirements
(i) All health
insurance policies offered or intended to be sold pursuant to
W.S.
26-18-301, et seq. shall be filed for prior
review and approval and are subject to the applicable SERFF filing and policy
form filing fees.
(ii) For each
out-of-state health insurance policy sold or intended to be sold in Wyoming,
the insurer must file an outline of coverage with the health policy form
filings and are subject to the applicable SERFF filing fees. The outline of
coverage must have a section defining the benefits the health insurance policy
provides. The outline of coverage must state whether the policy offers any
Wyoming mandated benefits, and, if so, what Wyoming mandated benefits the
policy offers. The Wyoming insurance commissioner can require additional
information be disclosed in the outline of coverage.
(c) Agreement Between Carrier and
Commissioner
(i) Pursuant to W.S.
W.S.
26-18-302(a)(iv) the insurer
seeking to offer out-of-state health insurance policies in Wyoming must agree
that the Wyoming insurance commissioner may enforce the provisions of the
insurance policy and resolve disputes between the insurer and the
policyholder.
(ii) The agreement
will be a written agreement signed by the insurer. The agreement shall be on a
form as prescribed by the Wyoming insurance commissioner.
(d) Should the insurer fail to comply with
the application and filing procedures as prescribed by this regulation and as
otherwise prescribed by the Wyoming insurance commissioner pursuant to Wyoming
law, the insurers application may be rejected and the insurer may be denied the
authority to issue out-of-state health insurance policies.
