33-22-525. Guaranteed renewability in multiple employer welfare arrangements. A group health plan that is a multiple employer welfare arrangement, as defined by 29 U.S.C. § 1002, may not deny an employer whose employees are covered under the group health plan continued access to the same or different coverage under the terms of the group health plan other than:

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Terms Used In Montana Code 33-22-525

  • Fraud: Intentional deception resulting in injury to another.
  • Group health plan: means an employee welfare benefit plan, as defined in 29 U. See Montana Code 33-22-140
  • Network plan: means health insurance coverage offered by a health insurance issuer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the issuer. See Montana Code 33-22-140

(1)for nonpayment of contributions;

(2)for fraud or other intentional misrepresentation of material fact by the employer;

(3)for noncompliance with material plan provisions;

(4)because the group health plan is ceasing to offer any coverage in a geographic area;

(5)in the case of a group health plan that offers benefits through a network plan, because there is no longer any individual enrolled through the employer who lives, resides, or works in the service area of the network plan and the group health plan applies to this section uniformly without regard to the claims experience of employers or any health status-related factor of those individuals or their dependents; or

(6)for failure to meet the terms of an applicable collective bargaining agreement, to renew a collective bargaining or other agreement requiring or authorizing contributions to the group health plan, or to employ employees covered by the agreement.