58-50-115. Health benefit plans subject to Act.
(a) A health benefit plan is subject to this Act if it provides health benefits for small employers and if any of the following conditions are met:
(1) Any part of the premiums or benefits is paid by a small employer or any covered individual is reimbursed, whether through wage or adjustments or otherwise, by a small employer for any portion of the premium;
(2) The health benefit plan is treated by the employer as part of a plan or program for the purpose of sections 106, 125, or 162 of the United States Internal Revenue Code; or
(3) The small employer has permitted payroll deductions for the eligible enrollees for the health benefit plans.
(b) Repealed by Session Laws 1993, c. 529, s. 3.5, effective January 1, 1995.
(c) A health benefit plan is not subject to this Act if it provides health benefits for employers who are employer members of a Path 2 MEWA pursuant to Article 50A of this Chapter through a policy issued to the Path 2 MEWA. (1991, c. 630, s. 1; 1993, c. 529, s. 3.5; 2013-357, s. 2(c); 2019-202, s. 4(b); 2020-69, s. 3(d).)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 50 - General Accident and Health Insurance Regulations.
§ 58-50-1 - Waiver by insurer.
§ 58-50-15 - Conforming to statute.
§ 58-50-25 - Nurses' services.
§ 58-50-26 - Physician services provided by physician assistants.
§ 58-50-30 - Right to choose services of certain providers.
§ 58-50-35 - Notice of nonpayment of premium required before forfeiture.
§ 58-50-45 - Group health or life insurers to notify insurance fiduciaries of obligations.
§ 58-50-46 - Recodified as G.S108A-55.4 by Session Laws 2006-221, s9(a), effective January 1, 2007.
§ 58-50-56 - Insurers, preferred provider organizations, and preferred provider benefit plans.
§ 58-50-56.1 - Exclusive provider organizations, exclusive provider benefit plans.
§ 58-50-56.2 - Exclusive provider organization continuity of care.
§ 58-50-57 - Offsets against provider reimbursement for workers' compensation payments forbidden.
§ 58-50-61 - Utilization review.
§ 58-50-62 - Insurer grievance procedures.
§ 58-50-63 - Expired pursuant to Session Laws 2005-453, s3, effective July 1, 2005.
§ 58-50-65 - Certain policies of insurance not affected.
§ 58-50-70 - Punishment for violation.
§ 58-50-75 - Purpose, scope, and definitions.
§ 58-50-77 - Notice of right to external review.
§ 58-50-79 - Exhaustion of internal grievance process.
§ 58-50-80 - Standard external review.
§ 58-50-82 - Expedited external review.
§ 58-50-84 - Binding nature of external review decision.
§ 58-50-85 - Approval of independent review organizations.
§ 58-50-87 - Minimum qualifications for independent review organizations.
§ 58-50-89 - Hold harmless for Commissioner and independent review organizations.
§ 58-50-90 - External review reporting requirements.
§ 58-50-92 - Funding of external review.
§ 58-50-93 - Disclosure requirements.
§ 58-50-94 - Selection of independent review organizations.
§ 58-50-100 - Title and reference.
§ 58-50-105 - Purpose and intent.
§ 58-50-112 - Affiliated companies; HMOs.
§ 58-50-115 - Health benefit plans subject to Act.
§ 58-50-125 - Health care plans; formation; approval; offerings.
§ 58-50-130 - Required health care plan provisions.
§ 58-50-131 - Premium rates for health benefit plans; approval authority; hearing.
§ 58-50-149 - Limit on cessions to the Reinsurance Pool.
§ 58-50-150 - North Carolina Small Employer Health Reinsurance Pool.
§ 58-50-275 - Notice contact provisions.
§ 58-50-280 - Contract amendments.
§ 58-50-285 - Policies and procedures.
§ 58-50-292 - Dental provider networks; confidential business information.
§ 58-50-295 - Prohibited contract provisions related to reimbursement rates.