Kansas Statutes
Article 22 - Uniform Policy Provisions
40-2209m Same; marketing of coverage; prohibited activities; agents and brokers; written denial of coverage; third-party administrators; treatment of affiliated carriers.

40-2209m. Same; marketing of coverage; prohibited activities; agents and brokers; written denial of coverage; third-party administrators; treatment of affiliated carriers. (a) Each small employer carrier shall actively market health benefit plan coverage to eligible small employers in the state.
(b) (1) Except as provided in paragraph (2), no small employer carrier, agent or broker shall, directly or indirectly, engage in the following activities:
(A) Encouraging or directing small employers to refrain from filing an application for coverage with the small employer carrier because of the health status, claims experience, industry, occupation or geographic location of the small employer;
(B) encouraging or directing small employers to seek coverage from another carrier because of the health status, claims experience, industry, occupation or geographic location of the small employer.
(2) The provisions of paragraph (1) shall not apply with respect to information provided by a small employer carrier or producer to a small employer regarding the established geographic service area or a restricted network provision of a small employer carrier.
(c) (1) Except as provided in paragraph (2), no small employer carrier shall, directly or indirectly, enter into any contract, agreement or arrangement with an agent or broker that provides for or results in the compensation paid to such person for the sale of a health benefit plan to be varied because of the health status, claims experience, industry, occupation or geographic location of the small employer.
(2) Paragraph (1) shall not apply with respect to a compensation arrangement that provides compensation to an agent or broker on the basis of percentage of premium, provided that the percentage shall not vary because of the health status, claims experience, industry, occupation or geographic area of the small employer.
(d) No small employer carrier shall terminate, fail to renew or limit its contract or agreement of representation with an agent or broker for any reason related to the health status, claims experience, occupation, or geographic location of the small employers placed by the agent or broker with the small employer carrier.
(e) No small employer carrier, agent or broker shall induce or otherwise encourage a small employer to separate or otherwise exclude an employee from health coverage or benefits provided in connection with the employee's employment.
(f) Denial by a small employer carrier of an application for coverage from a small employer shall be in writing and shall state the reason or reasons for the denial.
(g) The commissioner may adopt rules and regulations setting forth additional standards to provide for the fair marketing and broad availability of health benefit plans to small employers in this state.
(h) If a small employer carrier enters into a contract, agreement or other arrangement with a third-party administrator to provide administrative, marketing or other services related to the offering of health benefit plans to small employers in this state, the third-party administrator shall be subject to this section as if it were a small employer carrier.
(i) Except as provided in paragraph (l) [(j)], for the purposes of this act, carriers that are affiliated companies or that are eligible to file a consolidated tax return shall be treated as one carrier and any restrictions or limitations imposed by this act shall apply as if all health benefit plans issued to small employers in this state by such affiliated carriers were issued by one carrier.
(j) An affiliated carrier that is a health maintenance organization having a certificate of authority under K.S.A. 40-3201 et seq., and amendments thereto, may be considered to be a separate carrier for the purpose of this act.
History: L. 1992, ch. 200, § 12; L. 1998, ch. 174, § 10; L. 2000, ch. 34, § 3; July 1.

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Structure Kansas Statutes

Kansas Statutes

Chapter 40 - Insurance

Article 22 - Uniform Policy Provisions

40-2201 Accident and sickness policy; definition.

40-2202 Same; form of policy; policies issued to nonresidents.

40-2203 Uniform policy provisions; rules and regulations for filing or submission of policies.

40-2204 Conforming to statute; construction of policies in conflict.

40-2205 Statements made in application for policy; effect.

40-2206 Notice acknowledged by insurer not waiver of rights.

40-2207 Age; limit; misstatement by insured.

40-2208 Nonapplication to certain policies.

40-2209 Group sickness and accident insurance; eligibility for coverage; open enrollment; late enrollment; special enrollment; preexisting conditions; exclusions; renewal or continuation of benefits, exceptions; factors for eligibility; participation...

40-2209a Applicability of 1978 amendments to K.S.A. 40-1805, 40-1905 and 40-2209.

40-2209b Small employer healthcare plans; citation; purpose of act.

40-2209c Same; application of act; construction of 40-2209.

40-2209d Same; definitions.

40-2209e Same; plans subject to act; certain laws inapplicable to plans; individual policies not subject to act.

40-2209f Same; preexisting conditions exclusion, waiver; late enrollee exclusion; underwriting and rating; waiting periods; uniform employer coverage eligibility requirements; minimum participation and contribution requirements.

40-2209g Same; establishment of business classes by carrier; limitation.

40-2209h Same; rating; transfer of small employer from one business class to another, limitations; suspension of business class and rate limitations.

40-2209i Same; carrier sales solicitations, disclosures required.

40-2209j Same; actuarial certification of underwriting and rating compliance.

40-2209m Same; marketing of coverage; prohibited activities; agents and brokers; written denial of coverage; third-party administrators; treatment of affiliated carriers.

40-2209n Same; rules and regulations.

40-2209o Same; violations, penalties.

40-2209p Same; required coverage for all applying small employers; medical service enrollment, limitations; denial of coverage, when; definitions.

40-2210 Blanket sickness and accident insurance; payments, when blanket disability income policy is integrated with social security benefits.

40-2211 Workmen's compensation; insolvency of insured.

40-2212 Same; notice of injury or death; jurisdiction; lien of employee; payment to employee, agent or dependents.

40-2213 Prior policy, rider or endorsement.

40-2215 Forms and premium rates, filing, duties of commissioner; procedure; rules and regulations, violations, penalties.

40-2216 Purpose of act.

40-2217 Definitions.

40-2218 Establishment of benefit standards for accident and sickness policies or subscriber contracts; delivery or issuance of policy or contract not meeting standards prohibited, exceptions; identification of policies and contracts.

40-2219 Outline of coverage to accompany policy at issuance or to be delivered at time of application; format and contents of outline.

40-2220 Coverage of loss from pre-existing conditions required, when.

40-2221 Medicare supplement policies; rules and regulations to establish standards; denial of coverage prohibited, when.

40-2221a Same; notice required prior to termination; reinstatement.

40-2221b Same; when provisions of 40-2221a not applicable.

40-2222 Health coverage; jurisdiction of commissioner; exceptions.

40-2222a Same; associations not subject to jurisdiction of commissioner to provide applicants with written notice of nature of coverage.

40-2222b Same; premium tax, rate, computation, return and payment.

40-2223 Same; examination; subject to insurance laws.

40-2224 Same; disclosure to purchaser required.

40-2225 Long-term care insurance; name and citation of act.

40-2226 Same; application and construction of act.

40-2227 Same; definitions.

40-2228 Same; rules and regulations; prohibitions; preexisting condition provisions; delivery of outline of coverage upon application required.

40-2228a Long-term care policies and certificates; reinstatement of lapsed policies or certificates due to cognitive impairment or loss of functional capacity.

40-2228b Same; notice of lapse or termination; designation of person in addition to applicant to receive notice, waiver; change of designation.

40-2228c Same; payment of premiums through payroll or pension deduction plan; requirements under 40-2228b; application or enrollment form.

40-2228d Same; lapse or termination of policy or certificate; requirements; notice.

40-2228e Same; reinstatement, conditions.

40-2228f Long-term care insurance prompt payment act; effective date.

40-2228g Same; definitions.

40-2228h Same; claims; procedures; rules and regulations.

40-2229 Mammogram and pap smear coverage; policies to which mandated coverage applicable.

40-2230 Same; when reimbursement or indemnification required; deductibles, coinsurance and other limitations permissible.

40-2231 Continuing care contracts; definitions.

40-2232 Same; provider's annual disclosure statement; contents; requirement to furnish.

40-2233 Same; annual disclosure statement, contract and annual audit; filing with commissioner.

40-2234 Same; providing form to commissioner; contents and attachments.

40-2235 Same; certificate of registration, application, fee, renewal.

40-2237 Same; change of ownership or management of provider or home.

40-2238 Same; rules and regulations.

40-2239 Small employer health benefit plans; definitions.

40-2240 Same; establishment; assistance by commissioner.

40-2241 Same; contracts with carriers; coverage options; application of 40-2209 and 40-2215.

40-2242 Same; qualification for employer participation.

40-2243 Same; employee and employer contributions; employee's enrollment in multiple options; enrollment not required, when; payroll deductions.

40-2246 Same; employer income tax credit for corporations, computation of amount, reduction of deductions, election to claim, refunds; no inclusion of employer expenses in employee income; application date.

40-2247 Same; exemption from insurance premium tax.

40-2248 Mandated health benefits; impact report to be submitted prior to legislative consideration.

40-2249 Same; contents.

40-2249a Same; state employee group pilot project for new mandated health benefits.

40-2250 Insurance coverage to include reimbursement for services performed by advanced practice registered nurses.

40-2251 Statistical plan for recording and reporting premiums and loss and expense experience by accident and health insurers; compilation and dissemination; department of health and environment to serve as statistical agent; assessments; penalties...

40-2252 Same; rules and regulations.

40-2253 Universal accident and sickness insurance claim forms, design and use; acceptance of claims by insurer; uniform electronic data interchange formats and standards.

40-2254 Group accident and sickness insurance; extension of payment of benefits.

40-2255 Accident and sickness insurance; closing block of business, when.

40-2256 Health benefit plan.

40-2257 Individual policies; renewal or continuation of coverage; exceptions; discontinuance of policy; definitions.

40-2258 Group policies; mental illness, alcoholism, drug abuse or substance use disorder; limitations; exceptions; definitions.

40-2259 Genetic screening or testing; prohibiting the use of; exceptions; restrictions.

40-2260 Group health benefit plan option to establish premium only cafeteria plan.

40-2261 Employer providing certain health insurance coverage may offer cafeteria plan; employer not restricted in providing such benefits or coverage; definitions.