Renewal of health benefit plan at option of small employer; exceptions; right of carrier to cease to renew all plans under a class of business; restrictions; application of section to carrier operating in single geographic area

1. Law
2. Mississippi Code
3. Insurance
4. Small Employer Health Benefit Plans
5. Renewal of health benefit plan at option of small employer; exceptions; right of carrier to cease to renew all plans under a class of business; restrictions; application of section to carrier operating in single geographic area

1. A health benefit plan subject to this chapter shall be renewable with respect to all eligible employees and dependents, at the option of the small employer, except in any of the following cases:
   1. Nonpayment of the required premiums;
   2. Fraud or misrepresentation of the small employer, or with respect to coverage of individual insureds, the insureds or their representatives;
   3. Noncompliance with the carrier's minimum participation requirements;
   4. Noncompliance with the carrier's employer contribution requirements;
   5. Repeated misuse of a provider network provision; or
   6. The commissioner finds that the continuation of the coverage would:
      1. Not be in the best interests of the policyholders or certificate holders; or
      2. Impair the carrier's ability to meet its contractual obligations.

      In such instance the commissioner shall assist affected small employers in finding replacement coverage.

2. A small employer carrier may cease to renew all plans under a class of business. The carrier shall provide notice to all affected health benefit plans and to the Commissioner of Insurance in each state in which an affected insured individual is known to reside at least one hundred eighty (180) days prior to termination of coverage. A carrier which exercises its rights to cease to renew all plans in a class of business shall not:
   1. Establish a new class of business for a period of five (5) years after the nonrenewal of the plans without prior approval of the Commissioner of Insurance; or
   2. Transfer or otherwise provide coverage to any of the employers from the nonrenewed class of business unless the carrier offers to transfer or provide coverage to all affected employers and eligible employees and dependents without regard to case characteristics, claim experience, health status or duration of coverage.
3. In the case of a small employer carrier doing business in one (1) established geographic service area of the state, the rules set forth in this section shall apply only to the carrier's operations in such service area.

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