reglab/housing_qa huggingface dataset:
WY Stat § 26-19-202 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 2 - Group Coverage Replacement Act|Section 26-19-202 - Definitions.

26-19-202. Definitions.| (a) As used in this article:  (i) "Carrier" means an insurance company, nonprofit service corporation, trust, association or other arrangement subject to the jurisdiction of the insurance department;  (ii) "Group-type basis" means a benefit plan which meets the following conditions:  (A) Coverage is provided through insurance policies or subscriber contracts to classes of employees or members defined in terms of conditions pertaining to employment or membership or any other arrangement subject to the jurisdiction of the insurance department;  (B) The coverage is not available to the general public and can be obtained and maintained only because of the covered person's membership in connection with the particular organization or group;  (C) There are arrangements for bulk payment of premiums or subscription charges to the insurer, nonprofit service corporation, association or trust;  (D) There is sponsorship of the plan by the employer, union, association, trust or organization; and  (E) Individually underwritten and issued guaranteed renewable policies shall not be considered "group-type basis" under this paragraph even though purchased through payroll deduction.
WY Stat § 26-19-203 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 2 - Group Coverage Replacement Act|Section 26-19-203 - Continuance of Coverage Where One Carrier's Contract Replaces a Plan of Similar Benefits of Another Carrier.

26-19-203. Continuance of coverage where one carrier's contract replaces a plan of similar benefits of another carrier.| (a) In those instances in which one (1) carrier's contract replaces a plan of similar benefits of another carrier:  (i) The prior carrier remains liable only to the extent of its accrued liabilities and extensions of benefits. The position of the prior carrier shall be the same whether the group policy holder or other entity secures replacement coverage from a new carrier, self-insures or foregoes the provision of coverage;  (ii) The succeeding carrier is liable under the following circumstances:  (A) Each person covered under the prior carrier's plan shall be eligible for complete coverage in accordance with the succeeding carrier's plan of benefits, which shall include coverage for ninety (90) days for any complication caused as a result of a condition for which benefits were paid under the prior plan within ninety (90) days prior to termination of that plan. Copayment and deductible levels for coverage required under this subparagraph may be applied in a manner consistent with those provided by the succeeding carrier's plan;  (B) In the case of a preexisting conditions limitation included in the succeeding carrier's plan, the level of benefits applicable to preexisting conditions of persons becoming covered by the succeeding carrier's plan in accordance with this paragraph during the period of time this limitation applies under the new plan shall be the lesser of:  (I) The benefits of the new plan determined without application of the preexisting conditions limitations; or  (II) The benefits of the prior plan.  (C) In any situation where a determination of the prior carrier's benefit is required by the succeeding carrier, at the succeeding carrier's request the prior carrier shall furnish a statement of the benefits available or pertinent information, sufficient to permit verification of the benefit determination or the determination itself by the succeeding carrier. For the purposes of this section, benefits of the prior plan will be determined in accordance with all of the definitions, conditions and covered expense provisions of the prior plan rather than those of the succeeding plan. The benefit determination will be made as if coverage had not been replaced by the succeeding carrier.
WY Stat § 26-19-204 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 2 - Group Coverage Replacement Act|Section 26-19-204 - Violations; Penalty.

26-19-204. Violations; penalty.| Any person who violates any of the provisions of this article shall be subject to the penalties provided by W.S. 26-1-107.
WY Stat § 26-19-301 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 3 - Small Employer Health Insurance Availability|Section 26-19-301 - Short Title.

26-19-301. Short title.| This act shall be known and may be cited as the "Small Employer Health Insurance Availability Act."
WY Stat § 26-19-303 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 3 - Small Employer Health Insurance Availability|Section 26-19-303 - Applicability and Scope.

26-19-303. Applicability and scope.| (a) This act shall apply to any health benefit plan which provides coverage to two (2) or more employees of a small employer in this state if:  (i) Any portion of the premium or benefits is paid by a small employer or if an eligible employee or dependent is reimbursed, whether through wage adjustments or otherwise, by a small employer for any portion of the premium; or  (ii) The health benefit plan is treated by the employer or any of the eligible employees or dependents as part of a plan or program for the purposes of section 162, section 125 or section 106 existing as of the effective date of this act or similar sections subsequently enacted of the United States Internal Revenue Code.  (b) Notwithstanding subsection (a) of this section, W.S. 26-19-305(a) and (c) and 26-19-304(a) shall not apply to individual health benefit policies sold to small employers which are subject to approval for policy form by the commissioner.  (c) A Taft-Hartley trust, or a carrier with the written authorization of a Taft-Hartley trust may make a written request to the commissioner for a waiver from the application of any of the provisions of W.S. 26-19-304(a) with respect to a health benefit plan provided to the trust. The commissioner may grant the waiver if he finds that application of W.S. 26-19-304(a) with respect to the trust would have a substantial adverse effect on the participants and beneficiaries of the trust, and would require significant modifications to one (1) or more collectively bargained arrangement for which the trust is established or maintained. A waiver granted under this subsection shall not apply to an individual if the person participates in the trust as an associate member of an employee organization.  (d) This act shall apply to multiple employer welfare arrangements, consistent with W.S. 26-19-115.
WY Stat § 26-19-305 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 3 - Small Employer Health Insurance Availability|Section 26-19-305 - Renewability of Coverage.

26-19-305. Renewability of coverage.| (a) A health benefit plan subject to this act shall be renewable with respect to all eligible employees or dependents at the option of the employer except in the following cases:  (i) Nonpayment of the required premiums;  (ii) Fraud or misrepresentation of the employer or, with respect to coverage of individual insureds, the insureds or their representatives;  (iii) Noncompliance with the carrier's minimum participation requirements;  (iv) Noncompliance with the carrier's employer contribution requirements;  (v) Repeated misuse of a provider network provision;  (vi) The carrier elects not to renew all of its health benefit plans issued to small employers in this state. In such a case, the carrier shall:  (A) Provide advanced notice of its decision under this paragraph to the commissioner in each state in which it is licensed; and  (B) Provide notice of the decision not to renew coverage to all affected health benefit plans and to the commissioner in each state in which an affected insured individual is known to reside at least one hundred eighty (180) days prior to the nonrenewal of any health benefit plans by the carrier. Notice to the commissioner under this subparagraph shall be provided at least three (3) working days prior to the notice to the affected health plans.  (vii) The commissioner finds that the continuation of the coverage would:  (A) Not be in the best interests of the policyholders or certificate holders; or  (B) Impair the carrier's ability to meet its contractual obligations.  (b) If the commissioner finds that the carrier may elect not to renew coverage under paragraph (vii) of subsection (a) of this section he shall assist affected small employers in finding replacement coverage.  (c) A carrier that elects not to renew a health benefit plan under paragraph (vi) of subsection (a) of this section shall be prohibited from writing new business in the small employer market for a period of five (5) years from the date of notice to the commissioner.  (d) In the case of a health maintenance organization doing business in the small employer market in one (1) established geographic service area of the state, the provisions set forth in this section shall apply to the health maintenance organization's operations in that service area.
WY Stat § 26-19-308 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 3 - Small Employer Health Insurance Availability|Section 26-19-308 - Health Benefit Plan Committee.

26-19-308. Health benefit plan committee.| (a) The commissioner shall appoint a health benefit plan committee. The committee shall be composed of seven (7) members, which shall include:  (i) The commissioner;  (ii) Three (3) representatives of participating carriers; and  (iii) One (1) representative each of a small employer, an employee of a small employer and a health care provider.  (b) The committee shall recommend the form and level of coverages to be made available by small employer carriers pursuant to W.S. 26-19-306.  (c) The committee shall recommend benefit levels, cost sharing factors, exclusions and limitations for the basic health benefit plan and the standard health benefit plan. One (1) basic health benefit plan and one (1) standard health care plan shall contain benefit and cost sharing levels that are consistent with the basic method of operation and the benefit plans of health maintenance organizations, including any restrictions imposed by federal law:  (i) The plans recommended by the committee may include cost containment features such as, but not limited to:  (A) Utilization review of health care services, including review of medical necessity of hospital and physician services;  (B) Case management benefit alternatives;  (C) Reasonable benefit differentials applicable to participating and nonparticipating providers; and  (D) Other managed care provisions.  (ii) The committee shall submit the plans to the commissioner for approval within one hundred eighty (180) days after the appointment of the committee pursuant to this section. If the commissioner disapproves of the plans in whole or in part he shall submit alternative interim plans to the committee for its approval.  (d) Members of the committee shall be reimbursed from the assets of the program for expenses incurred by them as members of the committee but shall not otherwise be compensated by the program for their services.
WY Stat § 26-19-309 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 3 - Small Employer Health Insurance Availability|Section 26-19-309 - Periodic Market Evaluation.

26-19-309. Periodic market evaluation.| The board shall study and report at least every three (3) years to the commissioner on the effectiveness of this act. The report shall analyze the effectiveness of this act in promoting rate stability, product availability and affordability of coverage and may contain recommendations for actions to improve the overall effectiveness, efficiency and fairness of the small group health insurance marketplace. The report also shall address whether carriers and producers are fairly and actively marketing or issuing health benefit plans to small employers in fulfillment of the purposes of this act and may contain recommendations for market conduct or other regulatory standards or action.
WY Stat § 26-19-310 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 3 - Small Employer Health Insurance Availability|Section 26-19-310 - Administrative Procedures.

26-19-310. Administrative procedures.| The commissioner may issue regulations in accordance with W.S. 26-2-110 for the implementation and administration of the Small Employer Health Insurance Availability Act.
WY Stat § 26-19-311 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 3 - Small Employer Health Insurance Availability|Section 26-19-311 - Small Employer Carrier Reinsurance Account Created.

26-19-311. Small employer carrier reinsurance account created.| There is created an account in which all money received or collected to support the small employer carrier reinsurance program created pursuant to this act shall be credited and continuously appropriated for the purposes of this act. All claims, insurer reimbursements, cost of administration and other necessary expenses incurred pursuant to this act shall be paid from the account. All money in the account not immediately necessary for the purposes of this act, which amount is certified by the board to the state treasurer, shall be invested and any interest earned shall be credited to the account.
WY Stat § 26-19-312 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 19 - Group and Blanket Disability Insurance|Article 3 - Small Employer Health Insurance Availability|Section 26-19-312 - Small Employer Carrier Reinsurance Program Assessments; Premium Tax Credit.

26-19-312. Small employer carrier reinsurance program assessments; premium tax credit.| (a) After each calendar year, the board shall determine the amount of assessment needed to support the small carrier reinsurance program considering all payments made, costs incurred, premiums received and other income received.  (b) All authorized insurers liable for premium tax shall be assessed as necessary to meet the requirements determined under subsection (a) of this section. The assessment shall be in proportion to the gross premium tax owed and shall be expressed as a percentage of the gross premium tax owed. The gross premium tax is the premium tax owed before any deduction for any assessments. The assessment pursuant to this subsection for any individual insurer shall not exceed forty percent (40%) of the gross premium tax owed.  (c) On or before June 1 of each year, the board shall determine each insurer's assessment for the calendar year. Any deficit incurred by the program shall be recouped by assessment apportioned as provided by this section. Notification of assessments shall be mailed by the board not later than June 1 of each year.  (d) The total amount of assessment paid by any insurer pursuant to this section plus an amount equal to five percent (5%) of that total assessment shall be allowed as a credit against any premium or retaliatory tax owed by the member under this code for the year for which the assessment is payable. If assessments including the additional credit authorized exceed the premium or retaliatory tax owed considering all assessments pursuant to this act and other acts, the credits may be carried forward to other tax years until used.  (e) If assessments exceed actual losses and administrative expenses of the program, the excess shall be paid to the state treasurer, credited to the account created by W.S. 26-19-311 and used by the administrator to offset future losses or to reduce program premiums. As used in this subsection, "future losses" includes reserves for incurred but unreported claims.  (f) The board may require initial calendar year 2006 and interim assessments as reasonably necessary for the organizational, administrative and interim operating expenses of the program and to pay claims in excess of premiums collected. Any initial or interim assessments shall be credited as offsets against any regular assessment due following the close of the calendar year.  (g) Assessments collected pursuant to the small employer carrier reinsurance program shall be paid to the state treasurer and credited to the account created by W.S. 26-19-311.
WY Stat § 26-20-101 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 20 - Mandated Coverage|Article 1 - Newborn and Adopted Children Coverage|Section 26-20-101 - Newly Born and Adopted Child Coverage Required.

26-20-101. Newly born and adopted child coverage required.| (a) All individual and group health insurance policies providing coverage on an expense incurred basis, and individual and group service or indemnity type contracts issued by any insurer including any nonprofit corporation which provide coverage for a family member of the insured or subscriber, shall also provide, as to the family members' coverage, that the health insurance benefits applicable for children are automatically payable with respect to:  (i) A newly born child of the insured or subscriber from the moment of birth; and  (ii) An adopted child from the earlier of the date the petition for adoption is filed or entry of the child in the adoptive home, except that when the child is in the custody of the state, coverage shall begin at the date of entry of a final decree of adoption. Coverage for an adopted child shall continue unless the petition is denied.
WY Stat § 26-20-102 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 20 - Mandated Coverage|Article 1 - Newborn and Adopted Children Coverage|Section 26-20-102 - Specific Coverage.

26-20-102. Specific coverage.| The coverage for newly born children shall consist of coverage of injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. The coverage for adopted children shall consist of coverage of injury or sickness including the necessary care and treatment of medical conditions existing prior to the date of placement.
WY Stat § 26-20-103 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 20 - Mandated Coverage|Article 1 - Newborn and Adopted Children Coverage|Section 26-20-103 - Premiums.

26-20-103. Premiums.| If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth of a child or the placement for adoption of a child and payment of the required premium or fees shall be furnished to the insurer or nonprofit service or indemnity corporation within thirty-one (31) days after the date of birth or after the date coverage of a child placed for adoption begins in order to have the coverage continue beyond the thirty-one (31) day period.
WY Stat § 26-20-104 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 20 - Mandated Coverage|Article 1 - Newborn and Adopted Children Coverage|Section 26-20-104 - Applicability of Article.

26-20-104. Applicability of article.| The requirements of this article regarding newly born children apply to all insurance policies and subscriber contracts delivered or issued for delivery in this state more than one hundred twenty (120) days after May 30, 1975. The requirements of this article regarding adopted children apply to all insurance policies and subscriber contracts delivered or issued for delivery in this state after June 8, 1989.
WY Stat § 26-20-201 (2021)
2021 Wyoming Statutes|Title 26 - Insurance Code|Chapter 20 - Mandated Coverage|Article 2 - Diabetes Coverage|Section 26-20-201 - Diabetes Coverage Required.

26-20-201. Diabetes coverage required.| (a) All individual and group health insurance policies providing coverage on an expense incurred basis, individual and group service or indemnity type contracts issued by any insurer including any nonprofit corporation and individual and group service contracts issued by a health maintenance organization, which provide coverage shall also provide coverage for the equipment, supplies and outpatient self-management training and education, including medical nutrition therapy for the treatment of insulin-dependent diabetes, insulin-using diabetes, gestational diabetes and noninsulin using diabetes if prescribed by a health care professional legally authorized to prescribe such items under law. Covered diabetes outpatient self-management training and education shall be provided by a certified, registered or licensed health care professional with expertise in diabetes. For purposes of this section, required covered outpatient self-management training and education shall be limited to:  (i) A one-time evaluation and training program when medically necessary, within one (1) year of diagnosis;  (ii) Additional medically necessary self-management training shall be provided upon a significant change in symptoms, condition or treatment. This additional training shall be limited to three (3) hours per year.  (b) The benefits provided under this section shall be subject to the same annual deductibles or coinsurance established for all other covered benefits within a given policy. Private third-party payors may not reduce or eliminate coverage due to the requirements of this section. Enforcement of this section shall be performed by the commissioner or his designee.  (c) This section shall apply to a private health benefit plan as defined under W.S. 26-1-102(a)(xxxiii) delivered or issued on or after July 1, 2001.