Eligibility for small employer and individual market.

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  • (1)
    • (a) A small employer carrier shall accept a small employer that applies for small group coverage as set forth in the Health Insurance Portability and Accountability Act, Sec. 2701(f) and 2711(a), and PPACA, Sec. 2702.
    • (b) An individual carrier shall accept an individual that applies for individual coverage as set forth in PPACA, Sec. 2702.
  • (2)
    • (a) A small employer carrier shall offer to accept all eligible employees and their dependents at the same level of benefits under any health benefit plan provided to a small employer.
    • (b) A small employer carrier may:
      • (i) request a small employer to submit a copy of the small employer's quarterly income tax withholdings to determine whether the employees for whom coverage is provided or requested are bona fide employees of the small employer; and
      • (ii) deny or terminate coverage if the small employer refuses to provide documentation requested under Subsection (2)(b)(i).






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