Rule 120-2-10-.12 - Small Group Health Insurance Access and Pooling(1) Definitions. The terms used in this Rule are defined as follows: (a) "Anticipated Group Premium" shall mean the premium expected to be generated on each new and existing group over a period of the next twelve (12) months including only deviations permitted pursuant to subparagraphs (b), (d), (e) and (f) of paragraph (5) of this Rule.(b) "Anticipated Pool Premium" shall mean the total amount of premium expected to be generated on all new or existing groups over a period of the next twelve (12) months. The anticipated pool premium shall equal the sum of all anticipated group premiums for all small groups in an insurer's pool.(c) "Dependent" shall mean any dependent of an employee, member, or enrollee, including children, adopted children, and non-custodial children, as permitted in O.C.G.A. §§ 33-24-28(b) and 33-30-4(3) and (4), or a spouse, or other family member eligible for coverage under the terms of the group health insurance policy or contract because of that person's dependency on the employee, member, or enrollee.(d) "Eligible employees, members or enrollees" shall mean persons who are actively employed with a small group and are eligible for coverage under the employment rules of the small group or who are otherwise, except for dependents, eligible for coverage under a group health insurance policy, without regard to claims experience or any health status related factor.(e) "Existing Group" shall mean a small group that is insured by an insurer and part of that insurer's small group pool.(f) "Group Health Insurance" shall mean any major medical insurance, medical expense coverage, hospital expense coverage, comprehensive health benefit plan, or managed health care plan issued by an insurer to small groups, other than a blanket accident and sickness policy, a health insurance policy written as part of workers' compensation equivalent coverage or supplemental to a liability policy, a credit insurance policy, or any limited benefit insurance policy as defined in O.C.G.A. § 33-30-12(e)(4). Group health insurance shall include all types of policies, contracts, or certificates, as applicable, or other comparable group-type coverage as specified in Rule 120-2-10-.10(2), actively marketed or issued in this state to small groups, including the following: 1. Group health insurance policies or certificates issued pursuant to group insurance contracts;2. Group health insurance policies issued or marketed to association groups or trusts, except bona fide associations as defined in O.C.G.A. § 33-30-1(b) and as specified in subparagraph (10) of this Rule;3. Group health insurance policies issued to multiple employer trusts established in or out of this state; and4. Except for policies excluded under O.C.G.A. § 33-30-12(e), individual health insurance policies which provide as a minimum primary or basic medical or hospital expense benefits and are spon- sored in any manner by an employer or other group insurance policyholder.(g) "Insured" shall mean any employee, member, enrollee, or dependent of an employee, member or enrollee insured under group health insurance issued to a small group.(h) "New Entrant" shall mean an eligible employee, member, enrollee or dependent not previously covered by the existing group insurance contract or policy and who is either a late enrollee or does not have previous creditable coverage as defined by O.C.G.A. § 33-30-15(a)(2). A New Entrant shall not include the following individuals:
1. a "newly eligible employee" as defined by O.C.G.A. § 33-30-15(a)(4);2. an insured covered under the group's prior group health insurance contract or policy, provided that such contract or policy constitutes previous creditable coverage; or3. newborn children or newly adopted children enrolled as permitted in O.C.G.A. § 33-30-15(e) and Rule Chapter 120-2-67.(i) "New Group" shall mean a small group that is not currently insured by an insurer or any affiliated insurer.(j) "Policyholder" shall mean, with respect to group health insurance coverage, the small group to which a group health insurance policy or contract is issued in accordance with O.C.G.A. § 33-30-1, including, but not limited to, an employer or employer groups issued certificates of coverage through a multiple employer trust.(k) "Pool Rate" shall mean the average rate for employees, members, and enrollees, or dependents of such individuals, in all small groups within an insurer's small group health insurance pool, to be determined and used over a period of the next twelve months and adjusted for benefit design but unadjusted for factors specified in paragraph (5). In determining pool rates, the insurer must take into account all actual and anticipated experience data of the entire pool itself as well as other experience data of the insurer or data available generally, and must apply recognized actuarial practices as to credibility, trend factors, expense factors, and margins. Insurers shall use pool rates to determine premiums for new and existing groups.(l) "Small Employer" shall mean any employer that employed an average of at least two but not more than 50 employees on business days during the preceding calendar year and that employs at least two employees on the first day of the rating period. All employers treated as a single employer under subsection (b), (c), (m), or (o) of Section 414 of the Internal Revenue Code of 1986 shall be treated as one employer. Subsequent to the issuance of a health insurance policy or contract to a small employer and for the purpose of determining continued eligibility, the size of a small employer shall be determined annually. Except as otherwise specifically provided, provisions of this Act that apply to a small employer shall continue to apply at least until the final day of the rating period following the date the small employer no longer meets the requirements of this definition. In the case of an employer which was not in existence throughout the preceding calendar year, the determination of whether or not an employer is a small employer shall be based on the average number of employees that it is reasonably expected that the employer will employ on business days in the current calendar year. Each small employer shall be considered a small group.(m) "Small Group" shall mean, as defined in O.C.G.A. § 33-30-12(a), a group which is a single employer, including a Small Employer, firm, corporation, partnership, sole proprietor, or other legitimate group as specified in O.C.G.A. § 33-30-1(a) with at least two and no more than fifty (50) total eligible employees, members or enrollees (not including dependents) on the initial application date and on average during the calendar quarter preceding application. In determining the number of eligible employees, members, or enrollees, companies that are affiliated companies, are eligible to file a combined tax return for purposes of taxation by this state, or are subsidiaries of another company and covered under the parent company's group health insurance contract or policy, shall be considered one group. Subsequent to the issuance of a health insurance policy or contract to a small group and for the purpose of determining continued eligibility, the size of a small group shall be determined annually. Except as otherwise specifically provided, provisions of this Rule shall continue to apply at least until the renewal date following the date the small group no longer meets the requirements of this definition. Such small groups include sole proprietors or employer members of a trust or an association which does not meet the definition in O.C.G.A. § 33-30-1(b). For the purposes of applying this Rule, a small group shall be subject to this Rule if:1. the majority of insured employees, members, or enrollees in the group are employed or reside in this state; or2. if no state contains a majority of the insured employees, members, or enrollees in a group, the primary business location of the employer is in this state. If an employer which constitutes a small group meets subparagraphs 1. or 2. of this definition, it shall not be considered to be an employer in another state as specified in O.C.G.A. § 33-30-1.1.(n) "True Association" shall mean an association which meets the requirements of O.C.G.A. § 33-30-1(b) and any applicable Rules and Regulations issued by the Commissioner.(2) Each insurer shall maintain only one small group health insurance experience pool for all types of group health insurance insuring small groups in Georgia as defined in paragraph (l)(m) and subject to O.C.G.A. § 33-30-12, regardless of where the group health insurance policy or contract is issued. Each insurer's small group health insurance pool shall consist of each insurer's total claims experience produced by all small groups in this state, regardless of the marketing mechanism or distribution system utilized.(3) Prohibitions. The following practices by an insurer are prohibited with regard to small groups and the small group health insurance pool:(a) Durational rating which increases premiums for any small group based solely on the length of time the small group has been insured;(b) Except as permitted under O.C.G.A. § 33-30-12(d) and paragraph (5)(e), tier rating which increases rates directly related to the tier within which any one small group's claims experience falls;(c) Cancellation or termination of any small group or any insured individual in a small group, provided that insurers may refuse to re- new coverage only for those reasons permitted by the Rules and Regulations of the Office of Commissioner of Insurance Chapter 120-2-67;(d) Waivers for one or more preexisting conditions, except that insurers may use preexisting condition exclusions pursuant to O.C.G.A. § 33-30-15;(e) Declination of any small employer for coverage, or refusal to offer to insure, make insurance available or make a quote or offer of coverage to any small employer, or engagement in practices directly or through agents or representatives which prevent, discourage, delay or impede the availability or marketing of group health insurance to any small employer, under all policies or contracts offered or actively made available by an insurer to small employers in the state or service area, except that an insurer may decline a small employer for coverage if any of the following applies:1. minimum participation or contribution rules are not satisfied by the small employer;2. with regard to policies offered only through a true association of employers, a small employer is not a member of the association;3. none of the eligible employees, members, or enrollees live, work, or reside in the service area of the network if the policy or contract is offered by a health maintenance organization or a provider- sponsored health care corporation;4. a health maintenance organization or provider-sponsored health care corporation has demonstrated, to the satisfaction of the Commissioner, and based on current documentary evidence, that it does not have the service capacity to adequately provide medical services to new small employers through network providers in a particular service area because of its obligations to existing groups in the service area, provided that:(i) all declinations apply uniformly to all small employers in the service area without regard to claims experience or any health status- related factors; and(ii) the health maintenance organization or provider-sponsored health care corporation includes in such filing a certification from the President, Executive Director, or Chief Financial Officer which purports to claim such service capacity limits; and(iii) the Commissioner has not determined that such a claim is not warranted within 90 days of filing documentary evidence.5. an insurer has demonstrated, to the satisfaction of the Commissioner, and based on its most recent quarterly financial report, examination, or any other more current documentary evidence, that it does not have sufficient financial capacity to underwrite additional coverage under any and all policy forms available to small employers in the state, provided that: (i) all declinations apply uniformly to all small employers in the state without regard to claims experience or any health status-related factors; and(ii) the insurer includes in such filing a certification from the President, Executive Director, or Chief Financial Officer which purports to claim such financial capacity limits; and(iii) the Commissioner has not determined that such a claim is unwarranted within 90 days of filing documentary evidence.(f) Issuing coverage under any and all policies or contracts in the small employer market in the state (or a particular service area if applicable) after satisfactorily demonstrating to the Commissioner the conditions described in subparagraphs (e)4. or (e)5., unless at least 180 days have elapsed since the date coverage was declined and the Commissioner has approved such resumption of issue based on documentary evidence that conditions have changed.(g) Discriminatory rating practices which result in premium rate differentials for an individual employee, member, enrollee, or dependent of such employee, member, or enrollee, within a small group based solely on any health status-related factor or claims experience in relation to that individual in the small group, or premium rate differentials for classes of employees, members, or enrollees within a small group subdivided solely on the basis of any health status-related factor or claims experience. Rate adjustments for demographic underwriting factors, differences in benefit designs or network arrangements, premium differentials based on family or dependent coverage, or other rate differentials permitted by this Rule do not constitute discriminatory rating practices.(4) Eligibility. (a) Eligible employees, members, or enrollees in a small group who apply when first eligible for coverage under group health insurance during the most recent continuing period of employment, and dependents of such employees, members, and enrollees who apply when first eligible for coverage, are deemed to be insurable and must be accepted for enrollment. No insurer may subdivide any small group for benefit eligibility under a group insurance policy or contract solely on the basis of any health status-related factor or claims experience.(b) An insurer may establish, either as a provision applying to all small groups insured by the insurer, or at the option of a particular small group policyholder, terms of coverage which govern acceptance of late enrollees to a small group. Once established, such terms may not be changed within a contract period or the entire effective term of the policy for a small group policy or contract in such a way as to discriminate against late enrollees on the basis of health status. Such terms, and any changes thereto, must be disclosed within each policy and all certificates, and may only be changed either for all small groups insured by the insurer, or at the option of each small group policyholder.(5) Rating. (a) Rating Period and Rate Guarantee. 1. The initial or renewal rate for any small group shall be based on the pool rate adjusted for benefit design and the factors permitted by this Rule section. The rating period for any small group shall be not less than twelve (12) months. An insurer may not modify rates during this period except for any benefit alteration elected by a small group during this period or as otherwise permitted by this paragraph. The rates in effect at the beginning of the rating period, or on the effective date of any benefit alteration during such period, shall be used for adjusting small group premiums as a result of new or terminating employees, members, enrollees, or dependents. For small groups not rated on a composite basis, an insurer may further adjust small group rates for a newly eligible employee, New Entrant, or the dependent of either using only demographic underwriting factors as permitted by this Rule.2. If a New Entrant enters an existing group at any time during the rating period other than on the small group's renewal date, and such a New Entrant elects coverage when first eligible, an insurer may impose a waiting period on such a New Entrant not to extend beyond the next renewal date, with coverage becoming effective for the New Entrant on the effective date of the next rating period. Imposition of such a waiting period must be applied consistently for all New Entrants, without regard to any health status-related factor, and any preexisting condition exclusion must run concurrently with the waiting period.3. If an insurer does not elect to choose the New Entrant waiting period, it must enroll a New Entrant under the terms of the group health insurance policy or contract during the rating period without assessing any substandard rating.4. An insurer electing the New Entrant waiting period must disclose this method within each policy and to all small group policyholders prior to use or issue. An insurer may require such a method for all small groups insured by it, or may elect to use it at the option of the small group policyholder.(b) Permitted Demographic Underwriting Factors. An insurer may set rates using pool rates adjusted for age, group size (provided that the group size factor may not vary by more than 15% from a base factor of 1.0), family size or composition, sex, area, industry, occupational, and avocational factors (including, but not limited to, tobacco usage). Demographic underwriting factors used by the insurer must be applied consistently with respect to all small groups in the insurer's pool, except that area factors may vary between policies or contracts with different network reimbursement provisions. These demographic underwriting factors may be adjusted:1. on a composite basis for any small group,2. on a composite basis for all small groups in an insurer's pool, or3. on an individual, family, or other tier basis as used by the insurer for all insureds in any small group. Methods 1. and 3. of adjusting demographic underwriting factors may both be used in an insurer's small group pool provided that group size is the only determining factor and such methods are applied consistently within the insurer's small group pool. An insurer may use the demographic underwriting factors in renewal rating of such a small group where changes in these underwriting factors have occurred.
(c) Use of Claims Experience under Previous Insurance Coverage Prohibited. Previous claims experience of a new group under any other group health insurance prior to its entry into a pool is deemed not to be credible and such previous claims experience may not be considered in the initial rating of any small group. This paragraph shall not be construed to prevent insurers from using the health status of individuals in the small group for the purposes of substandard rating or determining group experience factors at initial rating as permitted under this Rule.(d) Rate Changes Based on Trend. The pool rate change for the next twelve months shall be based on the experience trend for the entire pool and shall be applied uniformly to the current pool rate for each small group's upcoming rating period. Trend factors may vary during a small group's rating period or between small groups to account for changes to or differences in benefit design or network requirements only. Trend factors may not be based on the demographic characteristics, experience, or any health status-related factor of a small group or any insureds in a small group. Nothing in this paragraph shall prevent an insurer from applying the annual trend factor on a graduated basis in an equitable, consistent, and uniform manner to small groups according to the month, quarter, or semi-annual period in which a small group was issued its policy or contract.(e) Group Experience Factor. 1. Except as prohibited in subparagraph (c), the actual claims experience produced by a small group may be used to deviate the premium from the pool rate applicable for that group. The group experience factor must be applied uniformly, consistently, and equitably to the rates charged for all employees, members, enrollees, and dependents in the small group and may not exceed plus or minus twenty-five percent (25%) of the pool rate. The change in premium resulting directly from select or substandard ratings applied to any group following recognized underwriting practices and the provisions of this Rule shall not be considered a deviation from the pool rate only for the purposes of determining the group experience factor. A group experience factor may be adjusted upon renewal.2. The percent change in the group experience factor at renewal shall not exceed 15% from one rating period to the next.(f) Select and Substandard Ratings.1. General Application. Select and substandard ratings resulting from the health status of one or more New Entrants must only be applied to an existing group or new group as set forth in O.C.G.A. § 33-30-12(d) and this Rule.2. Applicability of Substandard Ratings. (i) An insurer may not, with regard to a new group or existing group, use substandard rating for, nor adjust any individual or group premium by way of a substandard rating as a result of the health status of anyone who is not a New Entrant as defined in this Rule. An insurer may not assess a substandard rate on any small group or small group member because of the health status of dependents with previous creditable coverage who enroll when first eligible or during special enrollment in accordance with O.C.G.A. § 33-30-15(a)(4)(A) and (e).(ii) Substandard rating may only be determined and assessed as a result of the health status of New Entrants to an existing group or New Entrants in a new group, relative to what may be considered a standard health risk by the insurer using recognized underwriting practices. Substandard ratings assessed as the result of New Entrants to an existing group may be imposed only at the beginning of the first rating period after the New Entrant waiting period permitted in subparagraph (b)2.3. Compliant Methods of Applying Select and Substandard Rating. No insurer may bill or charge select or substandard rating adjustments allowed in this subparagraph to individual employees, members, enrollees, or dependents because of health status-related factors for which the adjustments are applied. Select or substandard rating assessed as a result of the health status of a New Entrant must be applied uniformly, consistently, and equitably to the rates charged for all employees, members, enrollees, and dependents in the small group. For example, select or substandard ratings may be assessed to all insureds in a small group on a composite basis as a uniform factor derived from the total select or substandard rating for all New Entrants insured through the small group; or, select or substandard ratings may be assessed as a lump-sum quantity divided equally among all insured employees, members, or enrollees.4. Rating Parameters. Effective for all rating periods commencing on or after May 1st, 1998, and all subsequent rating periods, the differential resulting from applying select or substandard ratings as permitted in this subparagraph onto group premiums may not be greater than plus or minus twenty percent of the total premium for a small group determined using pool rates as adjusted for permitted demographic underwriting factors, group experience factors, and rate changes based on trend. The Commissioner may adjust these permitted select and substandard rating parameters at any time in the interest of ensuring affordable coverage and access in the small group health insurance market after such due notice and hearing as may be required by law. The effective date of any such adjustments shall be a reasonable period of time as determined by the Commissioner not to exceed one year after the date such adjustments have been promulgated by the Commissioner.5. Other Prohibitions on Assessing Substandard Ratings:(i) Insurers may not add, assess, use, or continue to use substandard ratings for an insured in replacing group health insurance where the replacing insurer is affiliated with the prior insurer, nor may an insurer add, assess, use, or continue to use substandard ratings when discontinuing a policy form and offering coverage under another policy form; and(ii) Insurers may not add, assess, or increase a substandard rating at any time other than during initial underwriting of a New Entrant to a new or existing group as permitted by this Rule.6. Removal. Insurers may remove substandard ratings at any time with a corresponding reduction in the group's premium. When an insured with a substandard rating leaves a small group, the insurer must remove the substandard rating from the small group premium within thirty (30) days of the date on which the insured is no longer eligible for coverage or continuation of coverage under the group.(g) Deviations Resulting From Rating Factors. In setting premiums to be charged each small group, insurers must determine upward and downward premium deviations from the pool rate resulting from application of each small group's demographic underwriting factors as specified in subparagraph (b), the group experience factor as specified in subparagraph (e), rate changes based on trend as specified in subparagraph (d), and select or substandard ratings permitted in subparagraph (f), in such a manner that the anticipated total of the upward deviations for all small groups in an insurer's pool is offset by the anticipated total of downward deviations. The total of all anticipated group premiums, which include all deviations resulting from factor adjustments described in this subparagraph (g), must equal the total anticipated pool premium.(h) Other Permissible Methodologies. Insurers may use a rating methodology which establishes a lowest possible base rate charged by an insurer for all small groups in lieu of a pool rate, and adjusts the rate upward for all factors permitted in this Rule, provided that:(i) the group experience factor applied to the lowest possible base rate is no greater than 1.67;(ii) the select and substandard rating is applied as permitted in subparagraph (f)4. and is limited to a factor no greater than 1.20 as applied to the small group's total premium based on the lowest possible base rate adjusted for demographic underwriting factors, group experience factors, and rate changes based on trend as permitted in this Rule;(iii) the midpoint of all rates for all small groups in an insurer's pool is equivalent to the pool rate which would be determined in accordance with this Rule, such that all anticipated rate deviations below the midpoint are offset by all anticipated rate deviations above the midpoint; and(iv) the methodology otherwise complies with all the requirements of this Rule.(i) The rating provisions of this Rule section shall apply to all rating periods commencing on or after November 1, 2002.(6) Documentation. (a) All insurers must determine pool rates annually or more frequently and document their rate and deviation determinations.(b) All insurers must disclose at the initial sale of a small group case the degree to which rates may vary within allowable +/-25% range around the pool rate.(c) All insurers must provide to each small group upon request at each rating period, the pool rate compared to the proposed rate for the small group to demonstrate where the rate for the small group lies in comparison to the pool rate, and shall be required to document to each small group the benefit design, demographic factors, group experience factor, select or substandard or other permitted adjustments from the pool rate and percentage change in the base pool rate, demographic and group experience factors since the pool rate utilized in the small group's previous rating period. In addition, reference must be made to legal and regulatory citations that relate to changes in rating factors. Each small group policy must contain a notice to the insured that this information is available upon request. If such information is requested, the insurer must respond to such request within ten (10) business days of the request for information.(d) Rating documentation shall be maintained at the insurer's home or principal office for a period of five years and insurers shall furnish this information to the Commissioner of Insurance or insurance department examiners upon request.(7) On or before March 1 each year, an insurer writing small group health insurance in this State shall provide for the preceding calendar year a certification by a responsible officer of the insurer as follows: "I (name of officer), hereby certify that the rates charged small groups in the State of Georgia by the (name of insurer) are in compliance with all the requirements of § 120-2-10-.12 of the Rules and Regulations of the Georgia Insurance Department.
I further certify and affirm that my company will provide prior, written notice to the Commissioner and to each small group in my company's small group health insurance pool within the State of Georgia at least 180 days before my company withdraws from the small group health insurance market in Georgia. Such written notice to the Commissioner will include a report or other substantial documentation of the extent of coverage, including identification of policy forms, certificates, and the number of insureds covered at the time of any notice of proposed withdrawal from this small group market in Georgia. I understand and agree to submit such other documentation as the Commissioner may reasonably require at that time. Additionally, I further certify and affirm that my company will comply with all other provisions in the Official Code of Georgia, Annotated, or in the Rules and Regulations of the Georgia Insurance Department, pertaining to withdrawal or discontinuation of coverage in the small group market.
(Date) ____________________________
(Signature of Officer)" ___________________________________
(8) One-life Groups. (a) Insurers may issue small group health insurance policies or contracts actively marketed to small groups, or certificates from such policies or contracts, to sole proprietors or other employers with only one employee, member, or enrollee (not counting dependents). In order for such coverage to qualify as group coverage, it must meet all rating and eligibility requirements of this Rule except those applicable only to small employers. At such time as the one life group acquires one or more additional employees, members, or enrollees, the exceptions shall not apply. Such one-life groups shall include sole proprietors offered coverage under a group health insurance policy or contract issued through a trust or association which does not meet the definition of O.C.G.A. § 33-30-1(b), provided that such group health insurance policy or contract covers other small groups as defined by this Rule. One-life groups may also include other such arrangements as provided for in the Rules and Regulations of the Office of Commissioner of Insurance or at the discretion of the Commissioner.(b) All policies or certificates issued to one-life groups as permitted by this Rule shall comply with the requirements of O.C.G.A. Title 33, including Chapter 30.(c) All policies or certificates issued to one-life groups in this state on or before June 30, 1997, shall be deemed one-life groups and shall be subject to the provisions of this Rule, as well as all the requirements of O.C.G.A. Title 33, including Chapter 30.(d) Insurers may not issue multiple one-life group policies or certificates to a single employer with more than one employee.(9) Minimum participation rules for small groups.(a) Minimum participation rules for a particular group health insurance policy shall apply uniformly and consistently to all small groups.(b) An insurer shall not require a minimum participation level for small groups greater than: 1. One hundred percent (100%) of eligible employees, members, or enrollees with three (3) or less employees; and2. Seventy-five percent (75%) of eligible employees, members, or enrollees with more than three (3) employees but not more than fifty (50) employees.(c) An insurer shall not modify such minimum participation rules applicable to a small group at any time after the small group has obtained coverage, except that an insurer may relax such rules prospectively upon notification to all existing groups, and must apply such relaxed rules to all new groups. Relaxation of such rules means that such rules are made more favorable to the insured than what is required in subparagraph (b).(d) In applying minimum participation rules with respect to a small group as permitted in (b), an insurer may not count eligible employees, members, or enrollees who have other group health insurance coverage from an unaffiliated insurer as a spouse or dependent in determining whether the applicable minimum participation level is met.(10) Associations. Only the provisions of paragraph (3) shall apply to true associations.Ga. Comp. R. & Regs. R. 120-2-10-.12
O.C.G.A. Secs. 33-2-9, 33-24-21.1, 33-27-8, 33-27-9, 33-30-1, 33-30-1.1, 33-30-12, 33-30-15.
Original Rule entitled "Penalties" adopted. F. Apr. 11, 1980; eff. July 1, 1980, as specified by the Agency.Repealed: Rule reserved. F. July 24, 1986; eff. September 1, 1986, as specified by the Agency.Amended: New Rule entitled "Group Premium Rate Increase Notice and Experience Rating for Mulitple Employer Trusts or Arrangements" adopted. F. Aug. 24, 1989; eff. Jan. 1, 1990, as specified by the Agency.Repealed: F. May 9, 1990; eff. June 15, 1990, as specified by the Agency.Amended: New Rule entitled "Small Group Pooling" adopted. F. Sept. 6, 1990; eff. Oct. 1, 1990, as specified by the Agency.Repealed: New Rule entitled "Small Group Health Insurance Access and Pooling" adopted. F. Mar. 25, 1998; eff. Apr. 14, 1998.Repealed: New Rule of same title adopted. F. May 23, 2002; eff. November 1, 2002, as specified by the Agency.Repealed: New Rule of same title adopted. F. Aug. 15, 2002; eff. Nov. 1, 2002. as specified by the Agency.Amended: F. Oct. 20, 2009; eff. Nov. 9, 2009.