Rule 120-2-67-.06. Affiliation Periods

A group health insurance policy offered by a health maintenance organization may impose an affiliation period to employees, enrollees, or group members in lieu of any and all pre-existing condition exclusions or limitations only if the following are satisfied:

1. (a) The affiliation period is applied uniformly to all employees, enrollees, or members of the group, without regard to any health status related factor;
2. (b) The affiliation period does not exceed two months for newly eligible employees, group members and dependents, or three months for late enrollees;
3. (c) The affiliation period begins on the first day of any waiting period, or on the first day of employment, whichever is earlier, and runs concurrently with any waiting period;
4. (d) No premium is charged for the affiliation period; and
5. (e) A health maintenance organization electing to use an affiliation period in their group health policies or contracts must fully disclose the terms of such affiliation period in all policies or contracts and certificates.

Authority: O.C.G.A. Secs. 33-2-9, 33-30-15.

History. Original Rule entitled "Liabilities and Duties of Prior Insurers" adopted. F. Feb. 29, 1996; eff. Mar. 20, 1996.

Amended: ER 120-2-67-0.7 adopted. F. and eff. November 10, 1997, to remain in effect for 120 days or until the effective date of a permanent Rule covering the Same subject matter superseding this ER is adopted, as specified by the Agency.

Repealed: Permanent Rule entitled "Affiliation Periods" adopted. F. Feb. 17, 1998; eff. Mar. 9, 1998.