96-08: Association Groups

* This bulletin was repealed by 08-05

To:           All Insurance Companies Providing Health Insurance

From:      Jay Angoff, Director

Re:          Association Groups

Date:       November 19, 1996

It has recently come to the attention of the Missouri Department of Insurance that some small employer carriers have failed to rate small employers in association groups in accordance with the requirements of the Small Employer Health Insurance Availability Act ("the Small Employer Act"). This has resulted in unequal treatment between associations.

Pursuant to the authority vested in him under the Small Employer Act, the Director has determined to take the following actions to enhance the efficiency and fairness of the marketplace for small employer insurance:

Small employer carriers are reminded that the above suspension of the index rating restrictions does not exempt them from the requirement of Section 379.940.2(5)(a) that they accept or reject a small employer as a group, nor does it exempt them from the requirement of Section 379.952.1 that they offer the Basic and Standard Plans to each small employer that is rejected for any other small employer plan. Small employer carriers should also be aware that the guarantee issue requirement currently applicable to only the Basic and Standard Plans under Missouri's Small Employer Act will extend to all health insurance coverage offered in the small group market effective July 1, 1997, pursuant to the newly enacted, federal Health Insurance Portability and Accountability Act of 1996 (H.R. 3103 -- Kassebaum/Kennedy).