Insurance - Digest of Bills

Digest of Bills - 1999

INSURANCE
S.B. 99-6 Continuing care - return to home. On and after January 1, 2000, requires health insurance carriers, including medicare supplement carriers, to pay for continuing care services provided by an out-of-network provider if:

The service is one that the carrier would be liable for if provided by an in-network provider;
The enrollee is returning to the same location where the enrollee resided prior to hospitalization;
The enrollee has a continuing care contract or rental agreement with the facility at that location;
The level of care that the enrollee needs may be provided by the continuing care provider and the continuing care provider is licensed as a skilled nursing facility; and
The provider agrees to abide by the same terms and condition as an in-network provider.

Requires the carrier to pay the provider the same amount for the same services as it would an in-network provider. Establishes a private cause of action for a carrier's violation of the requirements concerning provision of continuing care services.

APPROVED by Governor June 1, 1999
EFFECTIVE June 1, 1999

S.B. 99-31 Employee leasing companies - employer benefit plans. Under the "Colorado Employment Security Act" and the "Colorado Health Care Coverage Act", authorizes professional employer organizations that meet the requirements of the definition of "employee leasing companies" to offer fully insured employee benefit plans, including employee welfare benefit plans such as health coverage, to employees to the full extent afforded employers by law.

Specifies that a health plan sponsored by an employee leasing company with an aggregate of more than 50 employees shall comply with all provisions of Colorado law that apply to large employer health plans, including consumer and provider protections, mandated benefits, nondiscrimination and fair marketing rules, preexisting limitations, and other required health plan policy provisions.

Requires employee leasing companies to certify annually in an independent opinion of counsel to the department of labor and employment that it is in compliance with this act. Authorizes the department of labor and employment to require documentation supporting compliance with this act. Requires employee leasing companies to make annual certifications available to insurance carriers upon request. Repeals provisions in the health insurance laws that restrict the ability of small employer group health insurers to provide coverage to employees covered under policies issued to employee leasing companies.

APPROVED by Governor March 25, 1999
EFFECTIVE March 25, 1999

S.B. 99-69 Health insurance - business groups of one. Permits carriers to require covered persons to submit certain information to verify eligibility for business group of one health care coverage. Permits health care coverage carriers offering health benefit plans to business groups of one to establish annual open enrollment periods. With the approval of the commissioner of insurance, provides a procedure for small employer health carriers not to offer coverage to business groups of one if offering such coverage would place the small employer carrier in a financially impaired condition.

APPROVED by Governor April 5, 1999
EFFECTIVE August 4, 1999
NOTE: This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

S.B. 99-114 Health insurance - small employer groups - removal of cafeteria requirement. Eliminates the applicability of the small employer group health insurance laws for health benefit plans when the plan is a cafeteria plan, as defined by federal income tax law, when the employer does not sponsor a health benefit plan, and the employer does not pay for any portion of the premium for the health benefit plan.

APPROVED by Governor April 15, 1999
EFFECTIVE April 15, 1999

S.B. 99-123 No-fault automobile insurance - payment of claims to 3rd persons. In cases where a health care provider receives an assignment from an insured under a motor vehicle insurance policy, specifies that, when the health care provider bills the insurer, the health care provider shall notify the insurer of the assignment. Requires the insurer to honor the assignment the same as if a copy of the assignment had actually been received by the insurer. Provides that only upon the insurer's request shall a health care provider have to provide a copy of the assignment to the insurer.

Specifies that it is not an unfair practice in the business of insurance for an insurer to attempt to settle any claim by an insured by paying a 3rd person so long as the insurer believes in good faith that the 3rd person holds a written assignment from the insured. Provides that an insurer shall remain responsible to the insured for such amounts pursuant to the terms of the applicable policy in the event the insurer pays a 3rd person that did not hold a written assignment and did not provide services or goods to the insured at the insured's request.

APPROVED by Governor April 15, 1999
EFFECTIVE August 4, 1999
NOTE: This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

S.B. 99-124 Health insurance - small employer groups - study - effectiveness - affordability. Finds that the "Small Employer Health Insurance Availability Program Act" introduced broad and ambitious reform of small employer group health insurance. Further finds that affordable access to small employer group health insurance is important and was important in the enactment of the "Small Employer Health Insurance Availability Program Act". Declares that an evaluation should be conducted to determine if health insurance is readily available to small employers, including the business group of one, and if the insurance is adequate and affordable. States that evaluating how small employer's health insurance needs are being met is important and that all interested parties should participate in the dialogue.

Requires the university of northern Colorado to conduct a study of small employer health insurance needs and availability. Authorizes the president of the university of northern Colorado to solicit and disburse grants, gifts, and donations from private entities for the purposes of this study. Requires the president of the university of northern Colorado to deposit moneys collected into the grants and contracts fund established for the university of northern Colorado's research corporation. Allows the president to discontinue work on the study if resources are not committed and made available by August 15, 1999.

Requires the president of the university of northern Colorado to convene a meeting of all interested parties, including, but not limited to, providers and consumers of small employer group health insurance, the division of insurance, and any entities or persons affected by small employer group health insurance, no later than June 15, 1999, to discuss the resources available for this study. Requires the university of northern Colorado to submit a report of the findings from the study to leadership within the general assembly by December 1, 1999.

Includes specific questions to be answered by the study. Lists the information that should be collected as a part of the study. Repeals statutory provisions authorizing the study on July 1, 2000.

APPROVED by Governor May 20, 1999
EFFECTIVE May 20, 1999

S.B. 99-135 Advisory committee on continuing education requirements - repeal. Eliminates provisions concerning the continuing education advisory committee, scheduled for repeal effective July 1, 1999.

APPROVED by Governor March 24, 1999
EFFECTIVE March 24, 1999

S.B. 99-141 Health insurance - standing referral to a specialist - notice of second opinion. Finds that efficient and easy access to health care providers for 2nd opinions is important for residents. Further finds that a standing referral to a specialist for ongoing treatment for an insured is in the best interests of Colorado residents.

Requires a carrier's contract with a covered person include a provision, along with the health benefit description form, that informs the covered person when the health benefit policy provides coverage for a 2nd opinion for any diagnosis, procedure, or treatment for any condition that such 2nd opinion coverage exists within policy limits.

Requires health insurers providing coverage through managed care plans to allow for a standing referral to an appropriate specialist by a primary care provider for a covered person when the covered person, primary care provider, and specialist agree a standing referral is necessary. Requires the specialist to refer the insured back to the primary care provider for primary care.

Prohibits primary care providers and specialists from being penalized by the carrier with actions that include, but are not limited to, disaffiliation or disincentives when prescribing a standing referral for a covered person.

APPROVED by Governor April 15, 1999
EFFECTIVE July 1, 1999

S.B. 99-210 Certificate of self-insurance - taxis - acceptable proof. Requires the commissioner of insurance to accept a surety bond in an amount determined by the commissioner as proof that a self-insured taxi or other motor vehicle for hire has the ability to pay all judgments that might be entered against the person.

APPROVED by Governor May 17, 1999
EFFECTIVE August 4, 1999
NOTE: This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

S.B. 99-217 Sale of insurance by financial institutions - definition. Deletes bank holding companies as defined under federal law from the definition of "financial institution" under the Colorado insurance anti-affiliation law, thereby enabling a nonbank subsidiary of a bank holding company to underwrite insurance in Colorado.

APPROVED by Governor May 17, 1999
EFFECTIVE May 17, 1999

S.B. 99-224 Nonprofit hospital, medical-surgical, and health service corporations - conversion to stock insurance company - limitation on ownership interest - repeal. Repeals a 3-year limitation on the permissible combined voting power that an entity or person may own in a stock insurance company that results from the conversion of a nonprofit hospital, medical-surgical, and health service corporation.

APPROVED by Governor May 29, 1999
EFFECTIVE May 29, 1999

H.B. 99-1057 Title insurance documents - time period for retention. Decreases the period for which a title insurance company or agent must retain evidence of insurability of a title for which a policy or contract of title insurance was issued from 15 years to 7 years. Increases the period for which a licensed agent of a title insurance company must retain closing and settlement services files and escrow files from 5 years to 7 years.

APPROVED by Governor March 10, 1999
EFFECTIVE August 4, 1999
NOTE: This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

H.B. 99-1088 Health insurance - medically necessary therapy - children up to five years of age. Clarifies that with the exception of cleft lip and cleft palate coverage, insurance benefits available to newborn children in their first 31 days of life shall include the coverage of all medically necessary care and treatment of medically diagnosed congenital defects and birth abnormalities, notwithstanding policy limitations and exclusions that are applicable to other conditions or procedures covered by the policy.

Clarifies that copayment, deductible, and aggregate dollar policy maximums for coverage of an infant diagnosed with congenital defects and birth abnormalities in the first 31 days of life shall be no higher than generally applicable under the policy to all other sicknesses, diseases, and conditions otherwise covered by the policy.

Specifies that there shall be no age limit on benefits for children born with cleft lip or cleft palate, or both. Specifies that health care service plans may provide that the benefits required by law for newborn children and cleft lip or cleft palate children shall be covered benefits only if the services are rendered by a provider who is designated by and affiliated with the health maintenance organization.

Requires each individual and group health plan to provide medically necessary physical, occupational, and speech therapy for the care and treatment of a child's congenital defects and birth abnormalities up to 5 years of age. Specifies that the level of such therapy benefits shall be the greater of the number of visits allowable under the policy or plan for any other illness or condition or 20 therapy visits per year each for physical, occupational, and speech therapy. Such visits shall be distributed, as medically appropriate, throughout the yearly term of the policy or enrollee coverage contract, without regard to whether the condition is acute or chronic or whether the therapy is to maintain or to improve functional capacity. Provides that therapy benefits are subject to certain existing statutory provisions on waiver of affiliation periods applicable to a preexisting condition. Provides that a health care service plan may require that the physical, occupational, and speech therapy services for congenital defects and birth abnormalities be rendered by a provider who is designated by and affiliated with the health maintenance organization in order for such services to be considered covered benefits.

Specifies that the act applies to health care policies and contracts issued, modified, or renewed on or after January 1, 2000.

APPROVED by Governor June 1, 1999
EFFECTIVE January 1, 2000

H.B. 99-1130 No-fault automobile insurance - basic PIP coverage - qualifying income guidelines. Establishes new guidelines for determining income levels required to qualify for a basic personal injury protection policy at 185% of the federal nonfarm income poverty guidelines adjusted for family size. Requires the commissioner of the division of insurance to establish the eligibility levels on or before January 1 of each year.

APPROVED by Governor March 15, 1999
EFFECTIVE March 15, 1999

H.B. 99-1141 Licensees - appointment of producers - filing requirement - elimination. Repeals provisions requiring that formal appointments of insurance producers be filed with the commissioner of insurance. Deletes the requirement that certain fees be paid by insurers to the commissioner of insurance for the appointment of insurance producers. Replaces repealed provisions with a requirement that insurers maintain a current list of producers authorized to accept applications on behalf of the insurer and make such list available to the commissioner for investigative and enforcement purposes.

APPROVED by Governor May 18, 1999
EFFECTIVE January 1, 2000
NOTE: This act shall take effect January 1, 2000, unless a referendum petition is filed during the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution. If such a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

H.B. 99-1143 Health care coverage - small group coverage - ceding of risk - continuation of coverage - notice to employee. Eliminates the current requirement that small group health insurance carriers retain at least 50% of their small group risk under ceding arrangements with other carriers.

Clarifies and strengthens provisions relating to replacement of health coverage by:

Specifying that such provisions apply to group contracts;
Requiring the prior carrier to continue benefits for covered persons until release from an in-patient facility; and
Eliminating current provisions that limit the level of benefits applicable to preexisting conditions.

Requires employers to give explicit, written notice to employees of their right to continue health coverage upon termination of employment. Allows an employee to pay any necessary premiums and continue coverage within 30 days if the employer gives the specified notice or within 60 days if the employer fails to give the specified notice.

Clarifies provisions dealing with guaranteed renewal of health benefit plans to specify that discontinuance, in addition to nonrenewal, is an option in cases of nonpayment of premium or other events listed as bases for ending coverage.

APPROVED by Governor March 31, 1999
EFFECTIVE January 1, 2000

H.B. 99-1201 Colorado insurance guaranty association - authority. In the definition of "covered claim" in the "Colorado Insurance Guaranty Association Act", clarifies that the definition includes 1st party claims for damage to property with a permanent location in this state. Specifies that the act does not apply to any person with a net worth in excess of $10 million. Authorizes the Colorado insurance guaranty association to intervene as a party before any court in Colorado that has jurisdiction over an insolvent insurer. Augments the association's authority to recover the amount of covered claims paid on behalf of certain types of persons or entities.

APPROVED by Governor March 23, 1999
EFFECTIVE August 4, 1999
NOTE: This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

H.B. 99-1231 No-fault automobile insurance - limitation on medical treatment - children under 13. Creates an exception to the 5-year limitation period on medical treatment in the automobile no-fault insurance law. Provides that a reasonable and necessary surgical or reconstructive procedure performed after an automobile accident shall be covered even if it occurs after the 5-year limitation period if the patient is less than 13 years of age at the time of the accident and the surgical or reconstructive procedure cannot be performed because of such patient's lack of physical maturity.

States that, within 5 years after an accident, a licensed physician or dentist may issue a written opinion that reasonable and necessary surgery cannot be performed until after the 5-year period because of a lack of physical maturity, based on a reasonable degree of medical probability and supported by objective evidence. Makes benefit payments for such surgery are subject to the provisions of the policy at the time of the accident, including managed care arrangements. Requires that the treatment be provided before the individual attains 18 years of age.

Requires the claimant or the provider to notify the insurer in writing 90 days before the future surgery or reconstructive procedure. Includes items that must be included in such notice.

States that benefits provided after the 5-year limitation period shall be in addition to benefits paid within such period, subject to coverage limits. Includes record-keeping requirements.

Makes the act applicable to benefits arising out of motor vehicle accidents occurring on or after January 1, 2000.

H.B. 99-1239 Automobile "no-fault" insurance - permissible use. Defines "converter", for purposes of exclusions under "no-fault" insurance laws, as a person other than a named insured or resident relative who uses a motor vehicle in a manner reasonably determined to be unauthorized or beyond the scope of permission given by a named insured or resident relative. Sets forth 3 factors to be considered when determining whether a person is a converter.

APPROVED by Governor April 30, 1999
EFFECTIVE April 30, 1999

H.B. 99-1250 Health insurance - claims - prompt payment requirements. Declares that unnecessary delays in the payment of routine and uncontested claims for reimbursement from patients and health care providers represents an unwarranted drain on health care providers' resources and costs patients time and money.

Requires health insurance entities to pay "clean" claims (i.e., those filed on the insurer's standard form and containing all necessary information) within 30 days after electronic filing and 45 days after paper filing. Where additional information is needed for processing, allows 30 days for receipt of such information. Requires investigation and payment or settlement of disputed claims within 90 days, absent fraud. Imposes penalties and interest on late payments.

Provides that these provisions are not applicable to "no-fault" automobile insurance coverage.

APPROVED by Governor June 2, 1999
EFFECTIVE January 1, 2000

H.B. 99-1275 Health maintenance organizations - powers. Changes the authority of a health maintenance organization ("HMO") to allow an HMO to offer indemnity benefits that do not exceed 20% of the total benefits incurred by the HMO on an annual basis. Clarifies a provision that allows such indemnity benefits to be provided through insurers or nonprofit hospital, medical-surgical, and health service corporations on an unlimited basis.

Increases the minimum amount of surplus an HMO must have before the commissioner of insurance ("commissioner") issues a certificate of authority to $1,500,000 and requires an HMO to maintain a minimum surplus of $1,000,000 thereafter. Allows the commissioner to reduce the initial minimum surplus up to $500,000 if the HMO establishes that it has sufficient administrative infrastructure.

Authorizes the commissioner to promulgate rules to establish standards consistent with the risk-based capital models applicable to managed care organizations developed or adopted by the national association of insurance commissioners to require an HMO to maintain a greater minimum level of surplus than the specified dollar minimums. Establishes a procedure for an HMO that meets the necessary criteria to request a phase-in of any increase in the surplus minimum over a period of 3 years. Allows a hearing before the denial of an HMO's phase-in request.

Increases the amount of an HMO's minimum deposit based upon the number of people enrolled in the HMO. Establishes a procedure for an HMO that meets the necessary criteria to request a phase-in of any increase in the minimum deposit over a period of 3 years. Allows a hearing before the denial of an HMO's phase-in request.

Makes regulation of insurance holding company systems applicable to HMOs. Changes and eliminates some reporting requirements of HMOs to the commissioner.

APPROVED by Governor March 23, 1999
EFFECTIVE July 1, 1999

H.B. 99-1306 Health insurance - external review when benefits are denied - appropriation. Excludes insurance for workers' compensation injuries, medical and rehabilitation benefits from no-fault automobile insurance, and mandatory self-insurance from independent external review of health care coverage denials. Requires a 3-tiered appeals process for the denial of health benefit insurance coverage. Allows the first 2 tiers to be conducted internally by the insurer. Requires the 3rd tier to be the independent external review.

Declares that covered individuals should have access to independent external review of health care coverage decisions. Defines "covered individual requesting an independent external review" as someone who was denied coverage who has complied with internal appeal decisions. Defines "expert reviewer" as a licensed health care professional who is an expert in the covered person's illness. Defines "expedited review" and sets forth specific deadlines for accomplishing an expedited review. Defines "independent review entity" as an entity that conducts independent external reviews of determinations by health benefit plans. Requires such entities to be certified by the commissioner of insurance. Makes the commissioner of insurance responsible for coordinating the external review process. Requires the disclosure of the ownership and management of the independent external review entity. Forbids conflicts of interest between the reviewer and the plan, the health care providers, and the covered person.

Requires plans to provide external review processes, to notify the covered person of the availability of the process, and to pay the costs of such reviews. Requires the plan to notify persons who have been denied coverage of the availability of independent external review and specifies the contents of that notification. Limits the availability of independent external review to within 60 days after the initial coverage decision.

Sets forth deadlines for the provision of information to the reviewer and for the reviewer to make a determination. Requires the determination to be in writing. Sets forth the required elements of the determination. Makes the reviewer's determination binding on the plan. Specifies that the plan is not required to cover services not included in the contract. Absolves the entity and reviewer from liability for determinations, except for those made in bad faith or involving gross negligence.

Specifies that a violation of these provisions is an unfair method of competition and an unfair or deceptive act or practice in the business of insurance.

Appropriates $17,500 from the division of insurance cash fund to the division of insurance for the implementation of independent external review.

APPROVED by Governor June 1, 1999
EFFECTIVE June 1, 2000 (except appropriation section which is effective July 1, 1999)

H.B. 99-1310 Property and casualty insurance - commercial insureds - exemption for insurers from filing rate and form requirements with the division of insurance. Makes legislative findings that:

An exempt commercial policyholder, employing personnel specializing in insurance practices and risk management, is a sophisticated consumer and does not need the state to regulate rates or form certification for casualty and property insurance for such consumer's benefits; and
Not regulating rate or form certification requirements for insurers selling to exempt commercial policyholders will allow competitive underwriting.

Requires the division of insurance in the department of regulatory agencies to promulgate rules defining an exempt commercial policyholder. Recommends that the division receive suggestions from risk management professionals, insurance managers or buyers, insurer representatives, qualified insurance consultants, and consumers in creating rules defining exempt commercial policyholders. Allows the commissioner to promulgate other rules as necessary to administer the new provisions.

Exempts insurers selling property and casualty coverage to exempt commercial policyholders from rate regulation and approval requirements and form certification requirements of the division of insurance. Provides for review and regulation by the commissioner of insurance for insurers charging anticompetitive rates as defined in Colorado law.

Requires that policies sold to exempt commercial policyholders contain a conspicuous disclaimer that the policy is exempt from rate filing and form certification with the division of insurance and that rate information is available from the insurer upon reasonable request by the commissioner of insurance or the insured.

APPROVED by Governor April 22, 1999
EFFECTIVE January 15, 2000
NOTE: This act shall take effect January 15, 2000, unless a referendum petition is filed during the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution. If such a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

H.B. 99-1344 Life insurance - interest on proceeds. Makes the interest rate on life insurance proceeds paid to beneficiaries within the first 30 days after the date of death and receipt of a request for payout the rate of interest for proceeds left on deposit with the insurer and subject to withdrawal on demand.

For claims paid after such 30-day period, makes the rate of interest 2% above the federal discount rate. Specifies that, if a claim is denied and subsequent legal action results in a judgment against the insurer, the rate of interest shall be 4% above the federal discount rate from the date the legal action was filed until payment of the claim, except for situations where proceeds are deposited with the court in an interpleader action. Provides that in all other situations life insurance policy benefits shall accrue interest at 2% above the federal discount rate when such benefits are not paid more than 30 days after the insurer receives a request for payment. Specifies that such rates shall be determined using a weighted average of the rates in effect during the applicable period based upon the number of days the rate was in effect.

For variable life insurance policies, specifies that, if a policyholder exercises the right to return the policy for a refund within 15 days of its delivery, the amount refunded shall be the account value calculated as of the date the policy is returned plus any policy fee or charge deducted from the policy.

APPROVED by Governor May 29, 1999
EFFECTIVE August 4, 1999
NOTE: This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

H.B. 99-1371 Health insurance - individual plans for business groups of one - disclosures. Requires any health insurance carrier doing business in both the individual and small group markets, and declining individual coverage to a business group of one self-employed person, to notify the applicant of the availability of coverage in the small group market, both through that carrier and other carriers offering small group coverage.

Requires the disclosure forms that must be given to a business group of one self-employed person purchasing an individual health benefit plan to briefly describe the factors used to set rates for the individual policy being purchased in comparison with the factors used to set rates for a business group of one small group policy. Requires the health insurance carrier to provide the applicant a copy of the health benefit plan description form for the Colorado standard health benefit plan in addition to the description form for the individual plan being marketed, and requires the division of insurance to make available a standard plan description form to individual carriers upon request.

Eliminates the requirement that every application for an individual business group of one policy must include a statement that the sale must comply with the business group of one statutes governing the sale of individual coverage to a business group of one. Deletes the requirement that the signor must certify that, if the sale does not comply with the business group of one statutes, the plan may be regulated as a small group health plan.