presence of any sensory, mental, or physical handicap, other condition or situation, or actual or perceived status regarding HIV or Hepatitis C. When Plan RCW Plan must contain or incorporate by endorsement a guarantee of the May Be 48.43.038(1) continuity of coverage of the plan. Nonrenewed 45 C.F.R. A plan is "renewed" when it is continued beyond the earliest date upon §147.106 (a) which, at the carrier's sole option, the plan could have been terminated for other than nonpayment of premium. RCW 48.43.038 Plan may still be canceled or nonrenewed for: (2)(a) Nonpayment of premium; RCW Violation of published policies of the carrier approved by the 48.43.038(2)(b) commissioner; RCW 48.43.038 Covered persons entitled to become eligible for Medicare benefits by (2)(c) reason of age who fail to apply for a Medicare supplement plan or Medicare cost, risk, or other plan offered by the carrier pursuant to federal laws and regulations; 48.43.038 Covered persons who fail to pay any deductible or copayment (2)(d) amount owed to the carrier and not the provider of health care services; (2)(e) Covered persons committing fraudulent acts as to the carrier; (2)(f) Covered persons who materially breach the health plan; or 48.43.038 Change or implementation of federal or state laws that no longer (2)(g) permit the continued offering of such coverage. RCW 48.43.038 Guaranteed Guaranteed renewability is not required where: (3)(a) Renewability An issuer has zero enrollment on a product; 48.43.038 Not Required An issuer withdraws from part or all of a service area due to (3)(b) When demonstrated lack of clinical, financial, or administrative capacity; RCW 48.43.038 Issuer provides a 90 day discontinuation notice to each enrollee, (3)(c) offers each the option to enroll in any of the issuer’s other individual
presence of any sensory, mental, or physical handicap, other condition or situation, or actual or perceived status regarding HIV or Hepatitis C. When Plan May Be Nonrenewed RCW 48.43.038(1) 45 C.F.R. §147.106 (a) Plan must contain or incorporate by endorsement a guarantee of the continuity of coverage of the plan. A plan is "renewed" when it is continued beyond the earliest date upon which, at the carrier's sole option, the plan could have been terminated for other than nonpayment of premium. RCW 48.43.038 (2)(a) Plan may still be canceled or nonrenewed for: Nonpayment of premium; RCW 48.43.038(2)(b) Violation of published policies of the carrier approved by the commissioner; RCW 48.43.038 (2)(c) Covered persons entitled to become eligible for Medicare benefits by reason of age who fail to apply for a Medicare supplement plan or Medicare cost, risk, or other plan offered by the carrier pursuant to federal laws and regulations; 48.43.038 (2)(d) Covered persons who fail to pay any deductible or copayment amount owed to the carrier and not the provider of health care services; (2)(e) Covered persons committing fraudulent acts as to the carrier; (2)(f) Covered persons who materially breach the health plan; or 48.43.038 (2)(g) Change or implementation of federal or state laws that no longer permit the continued offering of such coverage. Guaranteed Renewability Not Required When RCW 48.43.038 (3)(a) Guaranteed renewability is not required where: An issuer has zero enrollment on a product; 48.43.038 (3)(b) An issuer withdraws from part or all of a service area due to demonstrated lack of clinical, financial, or administrative capacity; RCW 48.43.038 (3)(c) Issuer provides a 90 day discontinuation notice to each enrollee, offers each the option to enroll in any of the issuer’s other individual
checklist-forms-2018-hmo-individual-analyst-checklist.docx