Rule 120-2-79-.14 - Areas of Service(1) As part of its application for a certificate of authority, a health plan purchasing cooperative shall file with the Commissioner a description of the entire service area of the health plan purchasing cooperative. All changes to a service area shall be filed for approval with the Commissioner at least sixty (60) days prior to such effective change.(2) A health plan purchasing cooperative serving any part of a single metropolitan statistical area in Georgia, as most recently defined and established by the U.S. Office of Management and Budget, shall serve every county which is either entirely or partially located within such single metropolitan statistical area. A health plan purchasing cooperative may serve contiguous counties outside of the single metropolitan statistical area; however:(a) If such contiguous county is located in another single metropolitan service area not served by the health plan purchasing cooperative (regardless of whether or not it is part of a consolidated metropolitan statistical area), the health plan purchasing cooperative may not serve such county unless it serves the entire single metropolitan statistical area in which it is located; and(b) If such contiguous county is partially located in the single metropolitan service area served by the health plan purchasing cooperative, and partially located in another single metropolitan service area not served by the health plan purchasing cooperative, the health plan purchasing cooperative may then serve only the entire contiguous county that is partially in each single metropolitan service area.(3) Nothing in this section shall prevent a health plan purchasing cooperative from serving a consolidated metropolitan statistical area in the state (as defined by the U.S. Office of Management and Budget), or two or more entire single metropolitan statistical areas.(4) All references to metropolitan statistical area in this Rule shall equally apply to a primary metropolitan statistical area as defined by the U.S. Office of Management and Budget.(5) A health plan purchasing cooperative may offer coverage in one or more counties in adjoining states contiguous to the borders of Georgia.Ga. Comp. R. & Regs. R. 120-2-79-.14
O.C.G.A. Secs. 33-2-9, 33-30A-5, 33-30A-9.
Original Rule entitled "Areas of Service" adopted. F. Feb. 23, 2000; eff. Mar. 14, 2000.