Statute 40-3223: Open enrollment.
(a) After a health maintenance organization has been in operation
twenty-four (24) months, it may have an annual open enrollment period of at
least one month during which it accepts enrollees up to the limits of its
capacity, as determined by the health maintenance organization, in the
order in which they apply for enrollment. A health maintenance organization
shall apply to the commissioner for authorization to impose such
underwriting restrictions upon enrollment as may be deemed necessary by the
health maintenance organization and the commissioner to preserve its
financial stability, to prevent excessive adverse selection by prospective
enrollees, or to avoid unreasonably high charges for enrollee coverage for
health care services. The commissioner shall approve or deny such
application within thirty (30) days of the receipt thereof from the health
maintenance organization.
(b) Health maintenance organizations providing or arranging for services
exclusively on a group contract basis may limit the open enrollment
provided for in subsection (a) to all members of the group or groups
covered by such contracts.
History: L. 1974, ch. 181, § 23; July 1.