Notification of division required concerning unauthorized health insurance product--Review of division website--Stop loss insurers.

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58-33-98. Notification of division required concerning unauthorized health insurance product--Review of division website--Stop loss insurers.

A licensee shall notify the division MEWA contact if the licensee knows a product is, or is about to be, offered to the public in this state, and the licensee, based on the information known to the licensee, reasonably should know the product is unauthorized health insurance. A licensee meets the requirements of this section if that licensee reviews the division's website of admitted health insurers and either does not notify the division's MEWA contact if that insurer is listed as an admitted insurer or notifies the division's MEWA contact if that insurer is not listed as an admitted insurer. For the purposes of this section an insurer does not include a stop loss insurer but a stop loss insurer is a licensee under this section. Knowledge of a producer regarding an unrelated unauthorized health insurance arrangement is not imputed to licensed insurers represented by that producer. Circumstances where a licensee knows that a product is, or is about to be, offered to the public in this state, include if the licensee knows that any person is:

(1)Recruiting producers to solicit or offer, or is soliciting or offering, a health benefit plan generally to the public in this state; or

(2)Seeking an administrator for, or is administering a health benefit plan that is intended to be offered generally to the public in this state.

A licensee complies with this section if the licensee notifies the division within thirty days or a period reasonable under the circumstances, whichever is later.

Source: SL 2007, ch 292, §6.


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