Rules and Regulations of the State of Georgia
 

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  • 1. In the address bar, type about:config and press Enter.
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<xmp>.</xmp> <form name="form1" method="post" action="120-2-81?urlRedirected=yes&amp;data=admin&amp;lookingfor=120-2-81" id="form1"> <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="/wEPDwUKLTY5ODkwOTM2Nw8WAh4Ec3BhbQINFgJmD2QWAgIFDw8WAh4EVGV4dAUFNiArIDdkZGRCn6+c7Ekt+hjtcfGIwVGwgUXWCQ==" /> <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="EEBB6393" /> <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="/wEWCAL/vu+pAQLniKOhBALV5cpNAoa5iIEFAoznisYGAsrv5u0MAsrv4u0MAsrv3u0Ms+oZf5JsCNT03ak1bGUgu4j+RFc=" /> <div class='popup'> <div class='cnt223'> <div style="margin-bottom:6px;"> <img alt="Rules and Regulations of the State of Georgia" src="/images/new.gif"/> </div> <div class="header"> Terms and Conditions of Agreement for Access to Rules and Regulations of the State of Georgia Website </div> <div class="scroll"> <p>(Note: certain features of this site have been disabled for the general public to prevent digital piracy. If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree that you will not copy, print, or download anything from this website for any commercial use. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website.</p> <p> You agree that you will not sell, will not license, and will not otherwise make available in exchange for anything of value, anything that you download, print, or copy from this site.</p> <p> You agree that you will not copy, print, or download any portion of the regulations posted on this site exceeding a single chapter of regulations for sale, license, or other transfer to a third party, except that you may quote a reasonable portion of the regulations in the course of rendering professional advice.</p> <p> If you violate this agreement, or if you access or use this website in violation of this agreement, you agree that Lawriter will suffer damages of at least $20,000. </p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website. </p> <p> You agree that you will not sell or license anything that you download, print, or copy from this website.</p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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charset=UTF-16"> </HEAD> <div id="infobar"><a href="javascript:;" accesskey="r" Name="Route" title="Route" class="quickkey"><em class="mnemonic">R</em>oute </a>:<div class="searchtips" style="float:right;margin-right:10px;color: rgb(47, 79, 79);"> <a style="text-decoration:none;color: rgb(47, 79, 79);" title="search tips" name="searchtip" href="../help.aspx#searching" target="_blank"><em class="mnemonic">S</em>earch tips</a></div><ul class="breadcrumb"> <li><a href="/GAC" name="GAC" title="GAC">GA R&amp;R</a></li> <li>&raquo; <a href="/GAC/120" title="120">Department 120</a></li> <li>&raquo; <a href="/GAC/120-2" title="120-2">Chapter 120-2</a></li> <li>&raquo; Subject 120-2-81</li> </ul> </div> </div><div id="doc" class="container"> <div id="doc-content" class="content"> <h1><nllsubject>Subject 120-2-81 INDIVIDUAL HEALTH INSURANCE ASSIGNMENT SYSTEMS</nllsubject></h1> <h2><a href="/GAC/120-2-81-.01" name="120-2-81-.01" title="120-2-81-.01">Rule 120-2-81-.01 Authority</a></h2> <P>This Regulation Chapter is issued pursuant to the authority vested in the Commissioner of Insurance by O.C.G.A. §§ <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-2-9&amp;title=33#" target="_newtab">33-2-9</a> and <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><U>et seq.</U></P> <h2><a href="/GAC/120-2-81-.02" name="120-2-81-.02" title="120-2-81-.02">Rule 120-2-81-.02 Purpose</a></h2> <P>The purpose of this Regulation Chapter is to implement O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><U>et seq.</U> and related provisions of the federal Health Insurance Portability and Accountability Act of 1996.</P> <h2><a href="/GAC/120-2-81-.03" name="120-2-81-.03" title="120-2-81-.03">Rule 120-2-81-.03 Definitions</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> For the purpose of this Regulation Chapter, the following definitions shall apply: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Assignment System" shall mean the Georgia Health Insurance Assignment System (GHIAS) and the Georgia Health Benefits Assignment System (GHBAS) as established by O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><U>et seq.</U> and this Regulation Chapter.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Continuation Coverage" shall mean any coverage under the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA).</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Eligible Dependent" shall mean a dependent of a qualifying eligible individual, including a spouse, covered under the qualifying eligible individual's most recent group health plan, or continuation coverage thereof, who meets the requirements of subparagraphs (f)(1) through (6) below. Eligible dependents shall include any dependents who would otherwise not qualify for coverage because they have less than eighteen (18) months previous creditable coverage, provided: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(c)(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> they were born, adopted, or placed for adoption during coverage under the most recent group health plan or continuation coverage of the qualifying eligible individual; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(c)(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> were enrolled under such coverage within 31 days of birth, adoption, or placement for adoption.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Group Health Plan" shall mean creditable coverage under an employer sponsored health benefit arrangement which does not provide benefits through a group health insurance policy or contract, or a group health insurance policy or contract subject to the laws of another state and not required to issue conversion policies pursuant to O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-24-21.1&amp;title=33#" target="_newtab">33-24-21.1</a>.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Individual Health Insurance" or "Individual Health Benefits" shall mean any creditable coverage offered by a health insurer or managed care organization in the individual market as defined in Section 2791(e)(1) of the federal Public Health Service Act, issued or actively marketed to an individual in Georgia through a policy or certificate of coverage approved by the Commissioner or otherwise permitted by state law or the Rules and Regulations of the Office of Commissioner of Insurance, and as determined by the Commissioner pursuant to O.C.G.A. <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><I>et seq.</I> and Rule <a title="120-2-81-.17" href="120-2-81-.17">120-2-81-.17</a>, but, in any case, not including: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(e)(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> limited benefit insurance as defined in O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-24-21.1&amp;title=33#33-24-21.1(I)" target="_newtab">33-24-21.1(I)</a> or excepted benefits pursuant to <a href="https://links.casemakerlegal.com/states/us/books/Code_of_Federal_Regulations/browse?ci=25&amp;id=gasos&amp;codesec=148.220&amp;title=45#" target="_newtab">45 CFR 148.220</a>; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(e)(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> certificates issued to individuals through a true association as defined in O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-30-1&amp;title=33#33-30-1(b)" target="_newtab">33-30-1(b)</a>.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Qualifying Eligible Individual" shall mean any Georgia domiciliary who meets all of the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> As of the date on which the individual seeks coverage under this section, the aggregate period of previous creditable coverage is 18 months or more;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The individual's most recent coverage was under a group health plan, or continuation coverage thereof;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The individual's insurance under the group health plan has been terminated for any reason, including discontinuance of the group health plan in its entirety or with respect to a class, except for non-payment of premium contribution pertaining to the qualifying eligible individual;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> With regard to such an individual's coverage under a group health plan or continuation thereof, a qualifying event has occurred on or after October 30, 1997;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The individual is not eligible for, or has not declined, any of the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(5)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Coverage under a group health insurance policy or contract, or other group health plan, including continuation coverage under COBRA or O.C.G.A. §§ <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-24-21.1&amp;title=33#" target="_newtab">33-24-21.1</a> or <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-24-21.2&amp;title=33#" target="_newtab">33-24-21.2</a>;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(5)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Medicare;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(5)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The state plan under Medicaid or any successor program; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(5)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Enhanced conversion coverage offered in accordance with O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-24-21.1&amp;title=33#" target="_newtab">33-24-21.1</a> and the Rules and Regulations of the Office of Commissioner of Insurance;</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The individual is not enrolled in or covered under any other creditable health insurance coverage, including individual health insurance policies or blanket accident and sickness insurance pertaining to student health coverage; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The individual is one of the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(7)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A current or former employee, member, or enrollee covered under the group health plan or continuation coverage thereof, if applicable;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(7)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The surviving spouse, if any, of a deceased covered employee, member, or enrollee, with or without dependents;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(7)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The spouse, or a former spouse, with or without dependents, of a covered employee, member, or enrollee upon a qualifying event of the spouse while the employee, member, or enrollee remains insured under the group health plan or continuation thereof, by ceasing to be a qualified family member under the group health plan, such as a result of a valid decree of divorce; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(f)(7)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An otherwise eligible dependent upon reaching limiting age or otherwise losing dependent status under the group health plan or continuation thereof, or under coverage issued to another qualifying eligible individual in the assignment system.</td> </tr> </table> </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Qualifying Event" shall mean loss of creditable coverage resulting from either: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(g)(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Exhaustion of continuation coverage to the maximum extent eligible under federal law; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(g)(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Termination of coverage under a group health plan, in the event such a qualifying eligible individual is not eligible for continuation coverage.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(1)(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Schedule of Benefits" shall mean the outline of benefit levels for a policy or plan, including but not limited to the types of benefits covered and associated cost-sharing provisions.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.03(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All other terms shall have the same meaning as in O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><U>et seq.</U> and Section 2791 of the Federal Public Health Service Act.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.04" name="120-2-81-.04" title="120-2-81-.04">Rule 120-2-81-.04 Georgia Health Insurance Assignment System</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The standard benefit schedules developed by the Commissioner in accordance with O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-4&amp;title=33#" target="_newtab">33-29A-4</a> shall be designated as Plan A and Plan B respectively. The model policy form template for Plans A and B is designated as Form GHIAS-1 , and schedule of benefits for Plans A and B is designated as Form GHIAS-S .</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A health insurer who participates in the Georgia Health Insurance Assignment System (GHIAS) must file policy forms necessary for providing the coverage required by the GHIAS no later than thirty (30) days following either the effective date of this Regulation Chapter, or the date of notice from the Commissioner that the health insurer is subject to the provisions of O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><U>et seq.</U>, whichever is later. Coverage provided pursuant to assignment by the GHIAS that is effective prior to the approval of the policy form shall be subject to the requirements of this Regulation Chapter and shall be amended pursuant to any modifications required by the Commissioner for approval of the filing. Such coverage made effective prior to approval of filing shall not be in violation if the policy form is filed within thirty (30) days as required.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Methods of Filing. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(3)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A participating health insurer may file policy forms prepared in accordance with Form GHIAS-1 and the schedule of benefits in Form GHIAS-S . Such policy forms shall be deemed approved upon the date the Commissioner receives the filing, provided they conform to the template form; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(3)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A participating health insurer may file policy forms with contractual language substantially similar to the model policy form template for approval, but must include the same benefits prescribed in the model policy form template and the same schedule of benefits prescribed in Forms GHIAS-1 and GHIAS-S . Such filings must include a description which specifically outlines the variances in language between the model policy form template and the filed form. A policy form filing with variances from the model policy form template prescribed in Form GHIAS-1 may not contain any provisions which are less beneficial than the relevant template provisions with regard to qualifying eligible individuals or eligible dependents.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Special Rules for Preferred Provider Arrangements. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A participating health insurer which issues health insurance policies with preferred provider arrangements in this state as approved by the Commissioner may offer standard policies with preferred provider arrangements. The out-of-network benefit levels must be at least as comprehensive as the schedule of benefits prescribed in Form GHIAS-S for Plans A and B.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Health insurers may offer preferred provider arrangements with gatekeeper provisions if such provisions are typically included in health insurance policies approved by the Commissioner and issued by the health insurer in this state outside of the assignment system.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Policy forms including preferred provider arrangements may be filed utilizing the model policy form template for preferred provider arrangements described in Form GHIAS-2 . Such policy forms shall be deemed approved upon the date the Commissioner receives the filings, provided they conform to the template form. Otherwise, the health insurer must file for approval a policy form that is substantially similar to the preferred provider model policy form template. The health insurer may submit a revised schedule of benefits for approval which reflects in-network and out-of-network benefit levels for Plans A and B.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(4)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A policy form filing with variances from the model policy form template prescribed in Form GHIAS-1 may not contain any provisions which are less beneficial than the relevant template provisions with regard to qualifying eligible individuals or eligible dependents.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.04(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A health insurer shall file with the Commissioner for approval any and all materials used to offer coverage to a qualifying eligible individual and eligible dependents through the GHIAS. These materials include enrollment forms, forms describing or soliciting an election of benefit options, disclosures regarding coverage under standard and optional policies, and any other documentation issued to qualifying eligible individuals for enrollment in standard or optional policies offered by the health insurer.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.05" name="120-2-81-.05" title="120-2-81-.05">Rule 120-2-81-.05 Georgia Health Benefits Assignment System</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.05(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The standard health benefit plans developed by the Commissioner in accordance with O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-5&amp;title=33#" target="_newtab">33-29A-5</a> shall be designated as Plan C and Plan D respectively. The model policy form template for Plans C and D are designated as Form GHBAS-1 , and the schedule of benefits for Plans C and D is designated as Form GHBAS-S .</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.05(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A managed care organization who participates in the Georgia Health Benefits Assignment System (GHBAS) must file policy forms necessary for providing the coverage required by the GHBAS no later than thirty (30) days following either the effective date of this Regulation Chapter, or the date of notice from the Commissioner that the managed care organization is subject to the provisions of O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><U>et seq.</U>, whichever is later. Coverage provided pursuant to assignment by the GHBAS that is effective prior to the approval of the policy form shall be subject to the requirements of this Regulation Chapter and shall be amended pursuant to any modifications required by the Commissioner for approval of the filing. Such coverage made effective prior to approval of filing shall not be in violation if the policy form is filed within thirty (30) days as required.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.05(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Methods of Filing. <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.05(3)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A participating managed care organization may file policy forms prepared in accordance with Form GHBAS-1 and the schedule of benefits in Form GHBAS-S . Such policy forms shall be deemed approved upon the date the Commissioner receives the filing, provided they conform to the template form; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.05(3)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A participating managed care organization may file policy forms with contractual language substantially similar to the model policy form template for approval, but must include the same benefits prescribed in the model policy form template and the same schedule of benefits prescribed in Forms GHBAS-1 and GHBAS-S . Such filings must include a description which specifically outlines the variances in language between the model policy form template and the filed form. A policy form filing with variances from the model policy form template prescribed in Form GHIAS-1 may not contain any provisions which are less beneficial than the relevant template provisions with regard to qualifying eligible individuals or eligible dependents.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.05(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A managed care organization shall file with the Commissioner for approval any and all materials used to offer coverage to a qualifying eligible individual and eligible dependents through the GHBAS. These materials include enrollment forms, forms describing or soliciting an election of benefit options, disclosures regarding coverage under standard and optional plans, and any other documentation issued to qualifying eligible individuals for enrollment in standard or optional plans offered by the managed care organization.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.06" name="120-2-81-.06" title="120-2-81-.06">Rule 120-2-81-.06 Optional Policies or Plans</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.06(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A health insurer or managed care organization may offer, in addition to the standard policies or plans, other additional individual health insurance policies or plans approved by the Commissioner for use in this state. A health insurer or managed care organization may also offer additional policies or plans with benefit options based on the standard plans but with different benefit schedules, provided such policies are filed with the Commissioner for approval. In the event a health insurer or managed care organization elects to offer such optional plans to qualifying eligible individuals and eligible dependents, the health insurer or managed care organization must assure that: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.06(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> both the standard and optional policies or plans are presented in a written offer of coverage and there is no unfair inducement to persuade the applicant in his or her selection;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.06(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all optional policies or plans are made available to all qualifying eligible individuals and eligible dependents applying for coverage under the assignment system and assigned to the health insurer or managed care organization;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.06(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all optional policies or plans comply with Rules <a title="120-2-81-.11" href="120-2-81-.11">120-2-81-.11</a>, <a href="https://links.casemakerlegal.com/states/ga/books/Rules and Regulations/browse?ci=25&amp;id=gasos&amp;codesec=120-2-81-.12&amp;title=120#" target="_newtab">.12</a>, <a href="https://links.casemakerlegal.com/states/ga/books/Rules and Regulations/browse?ci=25&amp;id=gasos&amp;codesec=120-2-81-.13&amp;title=120#" target="_newtab">.13</a>, <a href="https://links.casemakerlegal.com/states/ga/books/Rules and Regulations/browse?ci=25&amp;id=gasos&amp;codesec=120-2-81-.14&amp;title=120#" target="_newtab">.14</a>, <a href="https://links.casemakerlegal.com/states/ga/books/Rules and Regulations/browse?ci=25&amp;id=gasos&amp;codesec=120-2-81-.15&amp;title=120#" target="_newtab">.15</a>, <a href="https://links.casemakerlegal.com/states/ga/books/Rules and Regulations/browse?ci=25&amp;id=gasos&amp;codesec=120-2-81-.18&amp;title=120#" target="_newtab">.18</a>, and <a href="https://links.casemakerlegal.com/states/ga/books/Rules and Regulations/browse?ci=25&amp;id=gasos&amp;codesec=120-2-81-.19&amp;title=120#" target="_newtab">.19</a>; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.06(1)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> all optional policies or plans are accompanied by a certification from the health insurer or managed care organization which asserts the following: <P>"This policy option is not a standard plan developed by the Commissioner of Insurance of the State of Georgia. Unlike the standard plans, it may not contain maximum rate limitations and benefits as guaranteed by state law and regulation. Should you have questions regarding any differences between this policy and the standard plan, you may contact [name of health insurer or managed care organization] at [phone number]".</P> </td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/120-2-81-.07" name="120-2-81-.07" title="120-2-81-.07">Rule 120-2-81-.07 Premium Rates for Standard Policies or Plans</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.07(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Maximum premium rates are specified in Form GHIAS-R for Plans A and B, and in Form GHBAS-R for Plans C and D. All premium rates utilized by the health insurer or managed care organization for standard policies or plans must be filed for approval and shall include premium modes available. All participating health insurers and managed care organizations shall offer a monthly premium mode and may offer additional, less frequent, modes.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.07(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Actual premiums charged to any eligible individual may not exceed the maximum premium rates specified in Forms GHIAS-R and GHBAS-R . If premium modes that are less frequent than monthly are offered, the actual premiums charged through such modes may not exceed the maximum premium rates specified in Forms GHIAS-R and GHBAS-R discounted by the modal factors that the health insurer or managed care organization would typically apply to other policies for that premium mode.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.07(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If a health insurer offers standard policies with preferred provider arrangements as permitted by this Regulation Chapter, the maximum rate charged may not exceed the maximum premium rates specified in Form GHIAS-R for Plans A and B discounted by the same factor that the health insurer would typically apply to other policies with preferred provider arrangements.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.07(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Premium rates shall reflect, at a minimum, single male and female rating tiers and one family tier for any number of dependents. The Commissioner may prescribe additional tiers on Forms GHIAS-R and GHBAS-R if deemed necessary for the effective maintenance of the GHIAS and GHBAS.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.08" name="120-2-81-.08" title="120-2-81-.08">Rule 120-2-81-.08 Individual Applications and Assignments</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Applications for coverage must be submitted to the Commissioner, or to a designated administrator appointed by the Commissioner, prior to assignment to a participating health insurer or managed care organization. Certificates of creditable coverage sufficient to establish status as a qualified eligible individual shall be submitted with the application if available.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Qualifying eligible individuals must use application forms for assignment included in Form APP-ASSIGN . The Commissioner, or the Commissioner's designated administrator, shall furnish such applications to licensed insurance agents or to other individuals upon request.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An application form may be completed and submitted either by a licensed insurance agent or directly by the applicant. If the application for coverage in GHIAS or GHBAS using Form APP-ASSIGN is prepared and submitted by a licensed insurance agent, the participating health insurer or managed care organization to which the applicant is assigned and who issues a health insurance policy or benefit plan as a result of that assignment shall compensate that agent only for the procurement, preparation, and submission of such application at a commission rate of not less than 3 percent of the premiums received by the issuing health insurer or managed care organization for coverage issued to the applicant.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> After initial review, the Commissioner, or the designated administrator, shall enter the application into either the GHIAS or the GHBAS as appears appropriate.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An applicant entered into the GHIAS will be assigned to a participating health insurer using a randomized assignment selection process established and maintained by the Commissioner, or an alternate method as deemed necessary by the Commissioner, that is based on the pro rata premium volume of individual health insurance business done in Georgia by each such health insurer. Assignments shall become final, and credited to the health insurer's share, upon final determination of eligibility and payment of the initial premium.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An applicant entered into the GHBAS will be assigned to a participating managed care organization using a randomized assignment selection process established and maintained by the Commissioner, or an alternate method as deemed necessary by the Commissioner, that is based on the pro rata premium volume of individual health benefits business done in Georgia by each such managed care organization. Assignments shall become final, and credited to the health insurer's share, upon final determination of eligibility and payment of the initial premium. If the applicant does not reside within a geographic area normally served by a participating managed care organization to which the applicant is initially assigned, the assignment selection process shall be repeated until a participating managed care organization is selected that serves the area in which the applicant resides. If no participating managed care organization serves the area in which the applicant resides, the applicant will be entered into the GHIAS and assigned to a participating health insurer.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Commissioner or designated administrator shall notify the participating health insurer or managed care organization of an assignment and shall deliver the application to the assigned participating health insurer or managed care organization. The participating health insurer or managed care organization to which the applicant is assigned shall be responsible for verification of the information contained in the application and determining whether the applicant is an eligible individual. Upon determination that the applicant is an eligible individual, the participating health insurer or managed care organization to which the applicant is assigned shall, in writing, promptly offer the applicant a choice of the standard policies or plans (and optional policies or plans, if applicable). A participating health insurer or managed care organization shall make such determination and written offer no later than ten (10) business days after the health insurer or managed care organization is notified by the Commissioner of such assignment.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> If the participating health insurer or managed care organization determines that the applicant is not an eligible individual, the determination, along with a detailed explanation for the decision, must be furnished to the applicant, and to the Commissioner or the designated administrator, no later than ten business (10) days after the health insurer or managed care organization is notified by the Commissioner of such assignment.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The written offer of coverage by a participating health insurer or managed care organization to an assigned applicant shall include copies of the appropriate schedule of benefits for each standard policy or plan as indicated on Form GHIAS-S or GHBAS-S , as well as a premium rate table for each policy or plan, as found in Forms GHIAS-R or GHBAS-R . The health insurer or managed care organization shall use the enrollment form prescribed in Form GHIAS-E or GHBAS-E for enrolling the applicant. The applicant must select the desired policy or plan and pay the initial premium within thirty (30) days of receiving such offer. Upon selection by the applicant and payment of the initial premium, the policy or plan shall be promptly issued and shall be made effective on the date specified by this Regulation Chapter.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.08(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Upon issuance of each health insurance policy or benefit plan, the participating health insurer or managed care organization shall notify the Commissioner, or the designated administrator, in writing and provide a copy of the completed enrollment form. Assignments will then be adjusted as policies are actually issued to assure that no participating health insurer or managed care organization issues coverage to a significantly disproportionate share of assigned applicants. Failure to promptly process applications, issue policies or benefit plans, and notify the Commissioner, could result in a disproportionate share of applicants being assigned to the participating health insurer or managed care organization. The participating health insurer or managed care organization shall promptly notify the Commissioner when it is determined that no policy or benefit plan will be purchased by the applicant.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.09" name="120-2-81-.09" title="120-2-81-.09">Rule 120-2-81-.09 Administration</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.09(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Commissioner shall administer the GHIAS and the GHBAS or may designate an administrator to perform any specific tasks necessary for the administration of the GHIAS and the GHBAS.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.09(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Commissioner may require that costs associated with administration of the GHIAS and the GHBAS be reimbursed by the participating health insurers and managed care organizations. The amount of such reimbursement and method of payment shall be specified by the Commissioner and may be included as a share of premium payments made to health insurers or managed care organizations participating in GHIAS or GHBAS.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.10" name="120-2-81-.10" title="120-2-81-.10">Rule 120-2-81-.10 Eligibility for Benefits; Time Limit for Application</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.10(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Coverage issued through the assignment system shall cover the qualifying eligible individual and any eligible dependents if coverage for all such individuals is elected pursuant to application as provided for in this Regulation Chapter.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.10(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A qualifying eligible individual or a spouse or former spouse who is an eligible dependent shall have a choice of individual coverage or family coverage to include any or all eligible dependents.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.10(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An election of assignment system coverage by a qualifying eligible individual shall be deemed to be an election on behalf of any eligible dependents covered under the qualifying eligible individual's continuation coverage, unless the application indicates an election of the qualifying eligible individual otherwise. Election shall not be contingent on identical election of any other family member with regard to individual or family coverage.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.10(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Commissioner or administrator may at any time request additional information from the applicant for initial review of eligibility, and may delegate any part of the eligibility review and solicitation of additional information to health insurers and managed care organizations participating in GHIAS or GHBAS. The qualifying eligible individual must comply with a request for additional information and verification of eligibility to the fullest extent possible. Health insurers and managed care organizations are subject to the provisions of the Rules and Regulations of the Office of Commissioner of Insurance § <a title="120-2-67" href="120-2-67">120-2-67</a>-.12 with regard to accepting attestations and other evidence of coverage during verification if a certification of creditable coverage is not available.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.10(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A substantially completed application for coverage under the assignment system shall be filed with the Commissioner or the delegated administrator not later than sixty-three (63) consecutive days after a qualifying event. Such filing shall toll the sixty-three (63) consecutive day election period for the qualifying eligible individual and all other eligible dependents for whom coverage is elected, provided that eligibility is ultimately verified and initial premium is paid.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.10(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Notwithstanding paragraph (5), qualified eligible individuals with qualifying events on or after October 30, 1997, but before January 1, 1998, may file a substantially completed application no later than March 3, 1998.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.11" name="120-2-81-.11" title="120-2-81-.11">Rule 120-2-81-.11 Effective Date of Coverage</a></h2> <P>All coverage issued through the assignment system, upon application and payment of premium, shall become effective on the date of a qualifying event. In no case shall a participating health insurer or managed care organization be required to make such coverage effective prior to January 1, 1998.</P> <h2><a href="/GAC/120-2-81-.12" name="120-2-81-.12" title="120-2-81-.12">Rule 120-2-81-.12 Initial Premium</a></h2> <P>A participating health insurer or managed care organization may require payment for any retroactive periods of coverage commencing with the date of a qualifying event as part of the initial premium in order to effectuate coverage. However, such initial premium shall not exceed the sum total of such retroactive payment, a pro-rated premium for the remaining month, and the next full calendar month if a monthly payment mode is selected.</P> <h2><a href="/GAC/120-2-81-.13" name="120-2-81-.13" title="120-2-81-.13">Rule 120-2-81-.13 Preexisting Conditions and Health Status</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.13(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All policies or plans issued through the assignment system shall not exclude any preexisting condition or maintain any preexisting condition limitation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.13(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Health insurers or managed care organizations participating in the assignment system may not take into account health status related factors, claims experience, or evidence of insurability with regard to eligibility for coverage or benefit choices in the assignment system.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.14" name="120-2-81-.14" title="120-2-81-.14">Rule 120-2-81-.14 Reduction of Coverage</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.14(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any assignment system policy or plan may provide for a reduction or coordination of coverage on any person upon eligibility for coverage under Medicare.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.14(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> No assignment system policy or plan may provide for a reduction or coordination of coverage based upon a person's eligibility for coverage under the Medicaid program of the State of Georgia.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.14(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The benefits under the assignment system policy or plan shall be secondary to any group or blanket accident and sickness contract covering any person insured under the assignment system policy.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.14(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The assignment system policy or plan may provide that any hospital, surgical or medical benefits payable thereunder may be reduced by the amount of any such benefits payable under the continuation coverage after the termination of the individual's insurance thereunder.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.14(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A health insurer or managed care organization may request information in advance of any premium due date of such policy or plan of any person covered thereunder only as to whether: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.14(5)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The insured is covered for similar benefits under any arrangement of coverage for individuals in a group, whether on an insured or uninsured basis; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.14(5)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Similar benefits are provided for or available to such person, pursuant to or in accordance with the requirements of Medicare.</td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/120-2-81-.15" name="120-2-81-.15" title="120-2-81-.15">Rule 120-2-81-.15 Renewability</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.15(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All assignment system policies and plans must provide that the health insurer or managed care organization may refuse to renew the coverage of any person insured thereunder only as permitted in the Rules and Regulations of the Office of Commissioner of Insurance § <a title="120-2-67" href="120-2-67">120-2-67</a>-.10(b)(1), (2), (3), and (5) with regard to renewability of individual health insurance policies or contracts.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.15(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any refusal to renew shall be without prejudice to any valid claim commencing while the policy or plan is in force.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.16" name="120-2-81-.16" title="120-2-81-.16">Rule 120-2-81-.16 Notification</a></h2> <P>All insurers issuing accident and sickness insurance coverage in this state, managed care organizations, and third party administrators licensed by the Commissioner and engaged in the business of health insurance in this state may issue any notices or other information regarding coverage under the assignment system produced by the Commissioner for Georgia citizens to employers and employer sponsored health benefit arrangements for whom administrative services are rendered. The Commissioner may require any or all such insurers, managed care organizations, or third party administrators to distribute such notices or information to agents and other individuals for dissemination to potential eligible individuals.</P> <h2><a href="/GAC/120-2-81-.17" name="120-2-81-.17" title="120-2-81-.17">Rule 120-2-81-.17 Maintenance</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> As deemed necessary, the Commissioner may survey all insurers and managed care organizations issuing or renewing accident and sickness coverage in this state to determine the health insurers and managed care organizations eligible to participate in GHIAS and GHBAS, the pro-rata volume of business in the individual health insurance market issued by each health insurer and managed care organization for the purpose of making fair and equitable assignments, and for any other purpose necessary for the continued implementation and maintenance of GHIAS and GHBAS. The Commissioner may use all authority granted to him or her by law to enforce disclosure of information solicited by this survey. The survey may require disclosure of information pertaining to the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Premium volume under individual health insurance coverage issued in this state;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Premium rates charged;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Information regarding the marketing activity of insurers and managed care organizations in the individual health insurance market in this state;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(1)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Policy form, benefit, and enrollment data for individual health insurance coverage sold or renewed in this state; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(1)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any other information deemed appropriate by the Commissioner for the continued implementation and maintenance of O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><U>et seq.</U></td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> In lieu of a survey, the Commissioner may require all insurers and managed care organizations issuing or renewing accident and sickness insurance coverage (pursuant to annual reporting data formally collected by the Commissioner) to submit to the Commissioner a supplement to the annual report, designed by the Commissioner, which requires disclosure of certain information for purposes of determining participation in the assignment system.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Commissioner may periodically revise and update the standardized policy forms, benefit schedules, and rate tables used for the assignment system based on data collected from insurers and managed care organizations issuing or renewing individual health insurance coverage in this state. The Commissioner shall have discretion in determining fair and equitable methodologies for such revisions in compliance with O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=33-29A-1&amp;title=33&amp;getbrowsepage=yes#" target="_newtab">33-29A-1</a><U>et seq.</U> Additionally, the Commissioner may establish periods for which revisions shall take place and notify participating health insurers and managed care organizations of such revisions.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.17(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The assignment selection methodology for assigning qualifying eligible individuals to the GHIAS and GHBAS shall be determined by the Commissioner, shall provide for a reasonable randomized order of assignments based on market share, and shall be revised periodically to assure fair and equitable distribution of assignments among participating health insurers or managed care organizations based on data collected pursuant to this Rule.</td> </tr> </table> <h2><a href="/GAC/120-2-81-.18" name="120-2-81-.18" title="120-2-81-.18">Rule 120-2-81-.18 Subsequent Optional Choices</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.18(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any qualifying eligible individual shall have the option of switching from Plan B to Plan A, or from Plan D to Plan C, or to any other optional policy or plan offered by the participating health insurer or managed care organization after enrolling and purchasing coverage under Plan B or Plan D in the assignment system. The participating health insurer or managed care organization shall also permit the privilege of switching form Plan A or Plan C to any other optional policy or plan offer under this Rule after the qualifying eligible individual enrolls for coverage. The participating health insurer or managed care organization may limit such choice to the following events: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.18(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Once a year within 31 days of the policy anniversary date, with coverage becoming effective on the policy anniversary date;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.18(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Upon notification of premium increase, with coverage becoming effective on the effective date of the premium increase; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="120-2-81-.18(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Within 31 days of divorce or marriage, with coverage becoming effective on the first day of the following calendar month.</td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/120-2-81-.19" name="120-2-81-.19" title="120-2-81-.19">Rule 120-2-81-.19 Penalties</a></h2> <P>Any health insurer or managed care organization failing to comply with the requirements of this Regulation Chapter shall be subject to penalties and other enforcement actions as may by appropriate under the insurance laws of this State.</P> <h2><a href="/GAC/120-2-81-.20" name="120-2-81-.20" title="120-2-81-.20">Rule 120-2-81-.20 Severability</a></h2> <P>If any provision of this Regulation Chapter or the application thereof to any person or circumstance is for any reason held to be invalid by a court of competent jurisdiction, the remainder of the Regulation Chapter or the applicability of such provision to other persons or circumstances shall not be affected.</P> </div> </div> </HTML> </div> <div id="toc" class="sidebar noprint"> <ul id="toc-children" class="children"><li><a href="/GAC/120-2-81-.01" name="120-2-81-.01" title="120-2-81-.01">Rule 120-2-81-.01 Authority</a></li><li><a href="/GAC/120-2-81-.02" name="120-2-81-.02" title="120-2-81-.02">Rule 120-2-81-.02 Purpose</a></li><li><a href="/GAC/120-2-81-.03" name="120-2-81-.03" title="120-2-81-.03">Rule 120-2-81-.03 Definitions</a></li><li><a href="/GAC/120-2-81-.04" name="120-2-81-.04" title="120-2-81-.04">Rule 120-2-81-.04 Georgia Health Insurance Assignment System</a></li><li><a href="/GAC/120-2-81-.05" name="120-2-81-.05" title="120-2-81-.05">Rule 120-2-81-.05 Georgia Health Benefits Assignment System</a></li><li><a href="/GAC/120-2-81-.06" name="120-2-81-.06" title="120-2-81-.06">Rule 120-2-81-.06 Optional Policies or Plans</a></li><li><a href="/GAC/120-2-81-.07" name="120-2-81-.07" title="120-2-81-.07">Rule 120-2-81-.07 Premium Rates for Standard Policies or Plans</a></li><li><a href="/GAC/120-2-81-.08" name="120-2-81-.08" title="120-2-81-.08">Rule 120-2-81-.08 Individual Applications and Assignments</a></li><li><a href="/GAC/120-2-81-.09" name="120-2-81-.09" title="120-2-81-.09">Rule 120-2-81-.09 Administration</a></li><li><a href="/GAC/120-2-81-.10" name="120-2-81-.10" title="120-2-81-.10">Rule 120-2-81-.10 Eligibility for Benefits; Time Limit for Application</a></li><li><a href="/GAC/120-2-81-.11" name="120-2-81-.11" title="120-2-81-.11">Rule 120-2-81-.11 Effective Date of Coverage</a></li><li><a href="/GAC/120-2-81-.12" name="120-2-81-.12" title="120-2-81-.12">Rule 120-2-81-.12 Initial Premium</a></li><li><a href="/GAC/120-2-81-.13" name="120-2-81-.13" title="120-2-81-.13">Rule 120-2-81-.13 Preexisting Conditions and Health Status</a></li><li><a href="/GAC/120-2-81-.14" name="120-2-81-.14" title="120-2-81-.14">Rule 120-2-81-.14 Reduction of Coverage</a></li><li><a href="/GAC/120-2-81-.15" name="120-2-81-.15" title="120-2-81-.15">Rule 120-2-81-.15 Renewability</a></li><li><a href="/GAC/120-2-81-.16" name="120-2-81-.16" title="120-2-81-.16">Rule 120-2-81-.16 Notification</a></li><li><a href="/GAC/120-2-81-.17" name="120-2-81-.17" title="120-2-81-.17">Rule 120-2-81-.17 Maintenance</a></li><li><a href="/GAC/120-2-81-.18" name="120-2-81-.18" title="120-2-81-.18">Rule 120-2-81-.18 Subsequent Optional Choices</a></li><li><a href="/GAC/120-2-81-.19" name="120-2-81-.19" title="120-2-81-.19">Rule 120-2-81-.19 Penalties</a></li><li><a href="/GAC/120-2-81-.20" name="120-2-81-.20" title="120-2-81-.20">Rule 120-2-81-.20 Severability</a></li></ul> </div> </div> <!--content ends here--> <div id="footer" class="noprint"><span class="footer">Copyright &copy; 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