La. Admin. Code tit. 37 § XIII-3107

Current through Register Vol. 50, No. 9, September 20, 2024

Section XIII-3107 - Pilot Plan in General

A. An authorized carrier under the LA Health Plan shall deliver coverage for the plan through a fully insured individual health insurance policy or health maintenance organization membership plan. Each authorized carrier shall design the plan to minimize the cost of delivery and administration of the plan and medical services for covered benefits.

B. An authorized carrier may provide coverage to individuals or their dependents or both. However, an authorized carrier may offer coverage for all adults or all children, or the individual's entire family.

C. An authorized carrier may accept partial payment for individuals enrolled under the LA Health Plan from such individual's employers; however, such payment shall not be considered to be part of that employer's group health insurance if the employer offers other health insurance. Furthermore, such payment by an employer shall not change the status of the coverage. It remains an individual policy.

D. Employers who agree to make partial payment for individuals enrolled under the LA Health Plan may be authorized by the enrolled employee to deduct insurance premiums for the plan. Such a payroll deduction shall not be construed to alter the plan's status as an individual insurance policy.

La. Admin. Code tit. 37, § XIII-3107

Promulgated by the Department of Insurance, Office of the Commissioner, LR 20:1012 (September 1994).

AUTHORITY NOTE: Promulgated in accordance with R.S. 22:244-247 of the Insurance Code.