Insurance Dept.

General Agency, Board or Commission Rules

Chapter 41: Scope of Pool Coverage & Schedule of Benefits by WY Health Insurance Pool

Effective Date: 12/09/2016 to Current

Rule Type: Current Rules & Regulations

Reference Number: 044.0002.41.12092016

Chapter 41

SCOPE OF POOL COVERAGE AND SCHEDULE OF BENEFITS OFFERED BY WYOMING HEALTH INSURANCE POOL

Section 1. Authority

This regulation is issued pursuant to the authority vested in the Wyoming Insurance Commissioner under W.S. §§ 26-2-110, 26-43-106 and 16-3-101, et seq.

Section 2. Eligibility

(a) A 'resident' of the state for purposes of eligibility for pool coverage shall mean:

(i) Any individual person who occupies a dwelling in this state and has a present intent to make this state his home.

(ii) The pool administrator shall consider the following factors as indicating intent to remain in this state:

(A) Whether the applicant (or his custodial parent in the case of a minor) is registered to vote in this state;

(B) Whether the applicant (or his custodial parent in the case of a minor) has applied for or received a Wyoming driver's license;

(C) Whether the minor children of the applicant are enrolled to attend school in this state;

(D) If the applicant is of school age, then whether the applicant is enrolled to attend school in this state; and

(E) Whether the applicant (or his custodial parent in the case of a minor) has applied for or currently receives service in his name from any public utility at a dwelling within this state.

(iii) Any applicant currently occupying a dwelling in this state and meeting any two or more of the above-listed criteria shall be considered a resident eligible for pool coverage.

(iv) Any applicant denied pool coverage due to the administrator's determination of resident status shall have a right to appeal the administrator's determination in the manner set forth in the Plan of Operation for the pool.

Section 3. Pool Coverage and Schedule of Benefits

The general benefit features for an insured of the pool are set forth in the Wyoming Health Insurance Pool Summary of Benefit Features, located at http://doi.wyo.gov.

Section 4. Effective Date

This regulation shall become effective upon filing with the Secretary of State.