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Terms Used In Kansas Statutes 40-2209e

  • Carrier: means an insurance company, medical or hospital service corporation, medical and hospital service corporation or health maintenance organization which holds a valid certificate of authority from the insurance commissioner. See Kansas Statutes 40-2239
  • Health benefit plan: means a contract for group medical, surgical, hospital or any other remedial care recognized by state law and related services and supplies. See Kansas Statutes 40-2239
  • Premium: means the monthly or other periodic charge for a health benefit plan. See Kansas Statutes 40-2239

(a) Any individual or group health benefit plan issued to a group authorized by Kan. Stat. Ann. § 40-2209(a), and amendments thereto, shall be subject to the provisions of this act if it provides health care benefits covering employees of a small employer and if it meets any one of the following conditions:

(1) Any portion of the premium is paid by a small employer, or any covered individual, whether through wage adjustments, reimbursement, withholding or otherwise;

(2) the health benefit plan is treated by the employer or any of the covered individuals as part of a plan or program for the purposes of section 106 or section 162 of the United States internal revenue code; or

(3) with the permission of the board, the carrier elects to renew or continue a health benefit plan covering employees of an employer who no longer meets the definition of a “small employer.”

(b) Except as expressly provided in this act, no health benefit plan offered to a small employer shall be subject to:

(1) Any law that would inhibit any carrier from contracting with providers or groups of providers with respect to health care services or benefits;

(2) any law that would impose any restriction on the ability to negotiate with providers regarding the level or method of reimbursing care or services provided under the health benefit plan.

(c) Individual policies of accident and sickness insurance issued to individuals and their dependents totally independent of any group, association or trust arrangement permitted under Kan. Stat. Ann. § 40-2209, and amendments thereto, shall not be subject to the provisions of this act.