Guaranteed Issuer Must Issuer must accept for enrollment any state resident within the group Issue and Accept All 45 CFR to whom the plan is offered and within the carrier's service area and Continuity of Residents in §147.104(a); provide or assure the provision of all covered services regardless of Coverage Service Area RCW 48.43. age, sex, family structure, ethnicity, race, religion, national origin, 035(1) health condition, geographic location, employment status socioeconomic status, the presence of any sensory, mental, or physical handicap, other condition or situation, or actual or perceived status regarding HIV or Hepatitis C. Contract RCW 48.43.035(2) Plan must contain or incorporate by endorsement a guarantee of the Must Contain 45 C.F.R. continuity of coverage of the plan. Guarantee of §147.106 (a) A plan is "renewed" when it is continued beyond the earliest date Continuity upon at the carrier's sole option, the plan could have been terminated for other than nonpayment of premium. RCW When 48.43.035 Plan Plan may be canceled or nonrenewed for: May (3)(a) Be Nonpayment of premium; Nonrenewed RCW 48.43.035 Violation of published policies of the carrier approved by the (3)(b) commissioner; RCW 48.43.035 Covered persons entitled to become eligible for Medicare (3)(c) 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; RCW 48.43.035 Covered persons who fail to pay any deductible or copayment (3)(d) amount owed to the carrier and not the provider of health care services; (3)(e) Covered persons committing fraudulent acts as to the carrier; (3)(f) Covered persons who materially breach the health plan; or
Guaranteed Issue and Continuity of Coverage Issuer Must Accept All Residents in Service Area 45 CFR §147.104(a); RCW 48.43. 035(1) Issuer must accept for enrollment any state resident within the group to whom the plan is offered and within the carrier's service area and provide or assure the provision of all covered services regardless of age, sex, family structure, ethnicity, race, religion, national origin, health condition, geographic location, employment status socioeconomic status, the presence of any sensory, mental, or physical handicap, other condition or situation, or actual or perceived status regarding HIV or Hepatitis C. Contract Must Contain Guarantee of Continuity RCW 48.43.035(2) 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 at the carrier's sole option, the plan could have been terminated for other than nonpayment of premium. When Plan May Be Nonrenewed RCW 48.43.035 (3)(a) Plan may be canceled or nonrenewed for: Nonpayment of premium; RCW 48.43.035 (3)(b) Violation of published policies of the carrier approved by the commissioner; RCW 48.43.035 (3)(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; RCW 48.43.035 (3)(d) Covered persons who fail to pay any deductible or copayment amount owed to the carrier and not the provider of health care services; (3)(e) Covered persons committing fraudulent acts as to the carrier; (3)(f) Covered persons who materially breach the health plan; or
cl-forms-19-disability-sg-analyst-checklist.docx