40-3223. Open enrollment.
40-3223
40-3223. Open enrollment.(a) After a health maintenance organization has been in operationtwenty-four (24) months, it may have an annual open enrollment period of atleast one month during which it accepts enrollees up to the limits of itscapacity, as determined by the health maintenance organization, in theorder in which they apply for enrollment. A health maintenance organizationshall apply to the commissioner for authorization to impose suchunderwriting restrictions upon enrollment as may be deemed necessary by thehealth maintenance organization and the commissioner to preserve itsfinancial stability, to prevent excessive adverse selection by prospectiveenrollees, or to avoid unreasonably high charges for enrollee coverage forhealth care services. The commissioner shall approve or deny suchapplication within thirty (30) days of the receipt thereof from the healthmaintenance organization.
(b) Health maintenance organizations providing or arranging for servicesexclusively on a group contract basis may limit the open enrollmentprovided for in subsection (a) to all members of the group or groupscovered by such contracts.
History: L. 1974, ch. 181, § 23; July 1.