P.R. Laws tit. 26, § 9130
(a) Issuers interested in offering and marketing, or who wish to continue offering and marketing the health plans authorized under this chapter, or any other designed for PYMES employers in Puerto Rico, shall comply with the following:
(1) As a transition measure, and while the provisions of this chapter are implemented entirely, it is hereby provided that any issuer that is offering, marketing, or administering any health plan for one or more PYMES employers at the time of the approval of this act may continue to do so.
(2) The preceding clause notwithstanding, such issuer shall provide, within a term of thirty (30) days, a notice to the Commissioner stating:
(A) The date on which it began offering, marketing or administering health plans for PYMES employers.
(B) the number of health plan models available for PYMES employers, classified as marketed, exclusive or administered, and if the latter has any stop loss coverage;
(C) the number of PYMES employers and enrollees that are enrolled by type of health plan, following the aforementioned classification;
(D) rate or rates for these health plans and the basis to determine the same, as well as those used and underwritten;
(E) a table itemizing the covered benefits, exclusions, and limitations, applicable deductible, copayments and coinsurance, eligible employees and dependents, and premiums applicable for individuals, family groups, the employee and one dependent (partner), for optional dependents or collaterals, as such terms and practices are commonly accepted and defined in the health insurance market, and
(F) any other information that may be necessary to achieve the purposes of this chapter.
(b) It is hereby further provided, that every issuer that, at the time of the approval of this chapter has underwritten any health plan for a PYMES employer, may continue to renovate the same, as provided in the applicable federal regulations, codified under 45 C.F.R. Section 146.152 (Guaranteed renewability of coverage for employers in the group market) and 147.140 (Preservation of right to maintain existing coverage), promulgated pursuant to Public Law 111-148, known as the Patient Protection and Affordable Care Act, and Public Law 111-152, known as the Health Care and Education Reconciliation Act.
History —Aug. 29, 2011, No. 194, § 8.100, eff. 180 days after Aug. 29, 2011; July 10, 2013, No. 55, § 19, eff. 30 days after July 10, 2013.