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2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 1 - General Provisions › Section 26-18-130 - Requirements of Other Jurisdictions.

26-18-130. Requirements of other jurisdictions.
Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state or country under which the insurer is organized.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 1 - General Provisions › Section 26-18-131 - Policies Issued for Delivery in Another State.

26-18-131. Policies issued for delivery in another state.
If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public official of the other state informs the commissioner that the policy is not subject to approval or disapproval by the official, the commissioner, by ruling, may require that the policy meet the standards set forth in W.S. 26-18-103 through 26-18-130.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 1 - General Provisions › Section 26-18-132 - Policies Less Favorable Than Provisions of Chapter Prohibited.

26-18-132. Policies less favorable than provisions of chapter prohibited.
Any policy provision which is not subject to this chapter shall not make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions of the policy which are subject to this chapter.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 1 - General Provisions › Section 26-18-133 - Age Limit.

26-18-133. Age limit.
If a policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy is not effective, and if that date falls within a period for which the insurer accepts a premium or if the insurer accepts a premium after that date, the coverage provided by the policy continues in force until the end of the period for which premium is accepted. If the insured's age is misstated and if according to the insured's correct age the coverage provided by the policy would not be effective, or would cease prior to the acceptance of the premium, the insurer's liability is limited to the refund, upon request, of all premiums paid for the period not covered by the policy.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 1 - General Provisions › Section 26-18-134 - Prohibited Policy Plans and Provisions.

26-18-134. Prohibited policy plans and provisions.
(a) No insurer shall deliver or issue for delivery in this state any disability insurance policy:
(i) Providing benefits or values for surviving or continuing policyholders contingent upon the lapse or termination for any reason of other policyholders policies;
(ii) Containing any clause, provision or agreement providing a premium, deposit or other payment for, or promising the distribution of, any bonus, special fund or guaranteed payment other than the insurance benefits specified in the policy, except that this restriction does not apply to the payment of dividends to the holders of participating policies.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 1 - General Provisions › Section 26-18-135 - Filing of Rates; Adherence to Rates Filed.

26-18-135. Filing of rates; adherence to rates filed.
Each insurer issuing disability insurance policies for delivery in this state, before use thereof, shall file with the commissioner its premium rates and classification of risks pertaining to the policies. The insurer shall adhere to its rates and classifications as filed with the commissioner. The insurer may change the filings as it deems proper.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 1 - General Provisions › Section 26-18-136 - Franchise Disability Insurance.

26-18-136. Franchise disability insurance.
(a) Disability insurance on a franchise plan is that form of disability insurance issued to:
(i) Four (4) or more employees of any corporation, copartnership or individual employer or any governmental corporation, agency or department thereof; or
(ii) Ten (10) or more members, employees or employees of members of any labor union or of any trade, professional or other association which:
(A) Has a constitution or bylaws; and
(B) Repealed by Laws 2003, Ch. 160, 2.
(C) Issues to the persons specified in this paragraph, with or without their dependents, the same form of an individual policy varying only as to amounts and kinds of coverage applied for by those persons under an arrangement in which the premiums on the policies may be paid to the insurer periodically by:
(I) The employer, with or without payroll deductions;
(II) The association or union for its members; or
(III) Some designated person acting on behalf of the employer, association or union.
(b) "Employees", as used in this section, includes the officers, managers, employees and retired employees of the employer and the individual proprietor or partners if the employer is an individual proprietor or partnership.
(c) Prior to marketing or offering any disability insurance for a franchise plan formed for the sole purpose of obtaining insurance, the producer shall file a written report with the department setting forth the name of the entity or entities, the insurer and its address and the offering producer and his address. The department shall keep the name of the association confidential.
(d) The provisions of the Small Employer Health Insurance Availability Act, W.S. 26-19-301 et seq., shall apply to all insurance issued under this section.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 2 - Multi-State Cooperation › Section 26-18-201 - Definitions.

26-18-201. Definitions.
(a) As used in this article:
(i) "Comprehensive individual medical and surgical insurance policy" shall have the same meaning as "health benefit plan" as that term is defined in W.S. 26-19-302(a)(xii), including, at a minimum, comprehensive major medical coverage for medical and surgical benefits;
(ii) "Health insurance," "health benefit plan" and "health benefit policy" mean a health benefit plan as defined by W.S. 26-19-302(a)(xii);
(iii) "High deductible health plan" means accident and sickness insurance plans sold or maintained under the applicable provisions of section 223 of the Internal Revenue Code;
(iv) "Primary state" means the state designated by the issuer as the state whose covered laws shall govern the health insurance issuer in the sale of health insurance coverage;
(v) "Secondary state" means any state that is not the primary state.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 2 - Multi-State Cooperation › Section 26-18-202 - Sale of Medical and Surgical Insurance Policies Approved in Identified Other States.

26-18-202. Sale of medical and surgical insurance policies approved in identified other states.
In accordance with the provisions of this article, the commissioner shall identify at least five (5) states with insurance laws sufficiently consistent with Wyoming laws. The commissioner may approve for sale in Wyoming selected comprehensive individual medical and surgical insurance policies that have been approved for issuance in those other states where the insurer is authorized to engage in the business of insurance so long as the insurer is also authorized to engage in the business of insurance in this state and provided that the policy meets the requirements set forth in this article. High deductible health plans that meet national standards for comprehensive medical and surgical coverage may be among the policies automatically approved in Wyoming if approved in the states identified as acceptable by the commissioner.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 2 - Multi-State Cooperation › Section 26-18-203 - Approval of Policies.

26-18-203. Approval of policies.
A policy approved and issued pursuant to this article shall be treated as if it were issued by an insurer domiciled in Wyoming regardless of the insurer's actual domiciliary.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 2 - Multi-State Cooperation › Section 26-18-204 - Financial Requirements; Continuing Compliance.

26-18-204. Financial requirements; continuing compliance.
(a) Any insurer selling an insurance policy pursuant to this article, and any plan approved under this article, shall satisfy actuarial standards and insurer solvency requirements set forth by the National Association of Insurance Commissioners (NAIC) and adopted by regulation promulgated by the commissioner or as otherwise prescribed by regulation promulgated by the commissioner so long as the regulation is not inconsistent with NAIC standards.
(b) Any policy sold in Wyoming under the coverage and administrative laws and regulations of another state that are not covered by a guarantee association or similar association of that state shall be protected under the Wyoming Life and Health Insurance Guaranty Association Act under Chapter 42 of this title.
(c) The commissioner shall have the authority to determine whether an insurer satisfies the standards required by this section and shall not approve a policy or plan that he finds not in compliance with this section. The commissioner shall have the authority to determine whether the policies sold pursuant to this article continue to satisfy the requirements set forth in this section in the same manner as he does with an individual accident and sickness insurance policy approved pursuant to this code. The commissioner shall have the authority to suspend or revoke new sales of out-of-state policies if the laws and regulations of those states are determined to egregiously harm Wyoming residents. Upon suspension or revocation, the issuers of the out-of-state policies shall be required to notify in writing all affected Wyoming policyholders of the suspension or revocation determination by the commissioner.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 2 - Multi-State Cooperation › Section 26-18-206 - Rules and Regulations.

26-18-206. Rules and regulations.
(a) The commissioner shall draft rules and regulations necessary to implement this article but shall be under no obligation to draft rules and regulations until after March 15, 2011. The commissioner may adopt the rules provided they are consistent with the requirements of W.S. 26-18-206.
(b) Any dispute resolution mechanism or provision for notice and hearing in this title shall apply to insurers issuing and delivering plans pursuant to this article.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 3 - Sale of Out-of-State Health Insurance Policies › Section 26-18-301 - Definitions.

26-18-301. Definitions.
(a) As used in this article:
(i) "Health insurance," "health benefit plan" and "health benefit policy" mean a health benefit plan as defined by W.S. 26-1-102(a)(xxxii);
(ii) "High deductible health plan" means health insurance plans sold or maintained under the applicable provisions of section 223 of the Internal Revenue Code;
(iii) "Small employer" means small employer as defined by W.S. 26-19-302(a)(xxii);
(iv) "Small employer health insurance policy" is any policy defined by W.S. 26-19-303(a).
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 3 - Sale of Out-of-State Health Insurance Policies › Section 26-18-302 - Sale of Health Insurance Policies Approved in Other States.

26-18-302. Sale of health insurance policies approved in other states.
(a) The insurance commissioner shall approve for sale in Wyoming any individual or small employer health insurance policy or high deductible health plan that is currently approved for issuance in another state where the insurer or the insurer's affiliate or subsidiary is authorized to transact insurance, subject to the following:
(i) Approval shall include approval of any relevant policy forms, provided the forms have been approved by the appropriate regulatory body in the other state;
(ii) The insurer or the insurer's affiliate or subsidiary filing and issuing the policy in Wyoming is also authorized to transact insurance in this state pursuant to title 26, chapter 3 of the Wyoming statutes;
(iii) The policy meets the requirements of this article;
(iv) The insurer shall agree that the Wyoming insurance commissioner may enforce the provisions of the insurance policy and resolve disputes between the insurer and the policyholder in the same manner as the regulatory authorities in the other state, provided that if a contested case arises it shall be subject to the provisions of the Wyoming Administrative Procedure Act and any appeals shall be resolved in Wyoming courts;
(v) The insurer shall inform the commissioner whether the policy will be priced as it is in the other state or at a Wyoming specific price;
(vi) For small employer health insurance policies, all policies shall be subject to the provisions of W.S. 26-19-306(a) and (c)(vi);
(vii) The commissioner shall review any provider network requirements in the policy and may require modification of those requirements if the insurer lacks sufficient within network providers in Wyoming;
(viii) Any authorized insurer may offer an individual or small employer an insurance policy with benefits equivalent to those in any policy approved for sale in Wyoming under this article provided that the offered policy meets the requirements of this article.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 3 - Sale of Out-of-State Health Insurance Policies › Section 26-18-303 - Financial Requirements; Continuing Compliance.

26-18-303. Financial requirements; continuing compliance.
(a) Any insurer selling a health insurance policy pursuant to this article and any policy approved pursuant to this article shall satisfy actuarial standards of the National Association of Insurance Commissioners, the requirements of this article and any regulations of the department implementing this article.
(b) The commissioner shall determine whether an insurer satisfies the requirements of this article and shall expeditiously approve policies and plans that comply with this article. The commissioner shall have the authority to determine whether a health insurance policy or plan sold pursuant to this article continues to satisfy the requirements of this article in the same manner as for other policies under this code. The commissioner shall have the authority to require an insurer to participate in the Wyoming health insurance pool and to make other payments required of insurers under this code.
(c) Any policy sold pursuant to this article shall be protected under the Wyoming Life and Health Guaranty Association Act under Chapter 42 of this title.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 3 - Sale of Out-of-State Health Insurance Policies › Section 26-18-304 - Disclaimers Required.

26-18-304. Disclaimers required.
(a) Each written application for a policy sold pursuant to this article shall contain the following language in boldface type at the beginning of the document:
Warning!
The benefits of this policy may primarily be governed by the laws of a state other than Wyoming. All of the laws applicable to policies filed in this state may not apply to this policy. Any purchase of individual health insurance should be considered carefully since future medical conditions may make it impossible to qualify for another individual health insurance policy.
(b) Each policy sold pursuant to this article shall contain the following language in boldface type at the beginning of the document:
Warning!
The benefits of this policy may be governed primarily by the laws of a state other than Wyoming. The benefits covered may be different from other policies you can purchase in this state. Consult your insurance agent or insurer to determine which health benefits are covered under this policy.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 18 - Disability Insurance Policies › Article 3 - Sale of Out-of-State Health Insurance Policies › Section 26-18-305 - Rules and Regulations.

26-18-305. Rules and regulations.
(a) The commissioner shall adopt rules and regulations necessary to implement this article.
(b) Any dispute resolution mechanism or provision for notice and hearing in this code shall apply to insurers issuing and delivering policies pursuant to this article.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-101 - Scope and Applicability of Article; Short Title.

26-19-101. Scope and applicability of article; short title.
(a) This article applies only to group disability and blanket disability insurance contracts.
(b) This article may be cited as the "Group and Blanket Disability Insurance Law".
(c) This article does not apply to any contract made or issued prior to January 1, 1968, nor to any extensions, renewals, reinstatements or modifications of or amendments to any contract whenever made.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-105 - Readjustment of Premiums; Dividends.

26-19-105. Readjustment of premiums; dividends.
Any group disability insurance contract may provide for the readjustment of the rate of premium based upon the experience under the contract. If a policy dividend is declared or a reduction in rate is made or continued for the first or any subsequent year of insurance under any group disability insurance policy issued to any policyholder, the excess, if any, of the aggregate dividends or rate reductions under the policy and all other group insurance policies of the policyholder over the aggregate expenditure for insurance under those policies made from funds contributed by the policyholder, or by an employer of insured persons, or by a union or association to which the insured persons belong, including expenditures made in connection with administration of the policies, shall be applied by the policyholder for the sole benefit of insured employees or members.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-106 - Blanket Disability Insurance; Defined.

26-19-106. Blanket disability insurance; defined.
(a) Blanket disability insurance is that form of disability insurance covering groups of persons under a policy or contract issued to:
(i) Any common carrier or to any operator, owner or lessee of a means of transportation, who is deemed the policyholder, covering a group of persons who may become passengers as defined by reference to their travel status on the common carrier or the means of transportation;
(ii) An employer, who is deemed the policyholder, covering any group of employees, dependents or guests, defined by reference to specified hazards incident to an activity or activities or operations of the policyholder;
(iii) A college, school or other institution of learning, a school district or school jurisdictional unit, or to the head, principal or governing board of any educational unit, who is deemed the policyholder, covering students, teachers or employees;
(iv) Any religious, charitable, recreational, educational or civic organization, or branch thereof, which is deemed the policyholder, covering any group of members or participants defined by reference to specified hazards incident to an activity or operations sponsored or supervised by the policyholder;
(v) A sports team, camp or sponsor thereof, which is deemed the policyholder, covering members, campers, employees, officials or supervisors;
(vi) Any volunteer fire department, first aid, civil defense or other similar volunteer organization, which is deemed the policyholder, covering any group of members or participants defined by reference to specified hazards incident to an activity or operations sponsored or supervised by the policyholder;
(vii) A newspaper or other publisher, which is deemed the policyholder, covering its carriers;
(viii) An association, including a labor union, which has a constitution and bylaws and which is deemed the policyholder, covering any group of members or participants defined by reference to specified hazards incident to an activity or operations sponsored or supervised by the policyholder. Prior to marketing or offering any blanket disability insurance to an association, including a labor union, formed for the sole purpose of obtaining insurance, the producer shall file a written report with the department setting forth the name of the association, the insurer and its address and the offering producer and his address. The department shall keep the name of the association confidential. The provisions of the Small Employer Health Insurance Availability Act, W.S. 26-19-301 et seq., shall apply to all insurance issued to an association under this section. As used in this paragraph, "association" shall not include a multiple employer welfare arrangement;
(ix) Cover any other risk or class of risks which, in the commissioner's discretion, may be properly eligible for blanket disability insurance. The commissioner's discretion may be exercised on an individual risk basis or class of risks, or both.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-108 - Group Disability and Blanket Insurance Standard Provisions; Application and Certificate Need Not Be Furnished.

26-19-108. Group disability and blanket insurance standard provisions; application and certificate need not be furnished.
An individual application need not be required from a person covered under a blanket disability policy or contract, nor is it necessary for the insurer to furnish each person a certificate.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-109 - To Whom Benefits Are Payable.

26-19-109. To whom benefits are payable.
(a) Any benefits under any group or blanket disability policy or contract are payable to the person insured, or to his designated beneficiary or beneficiaries, or to his estate, except that if the person insured is a minor or otherwise not competent to give a valid release, the benefits may be made payable to his parent, guardian or other person actually supporting him. The policy may provide that any indemnities provided by the policy because of hospital, nursing, medical or surgical services, at the insurer's option and unless the insured requests otherwise in writing not later than the time of filing proofs of loss, may be paid directly to the hospital or person rendering the services. The policy may not require that the service be rendered by a particular hospital or person. Any payment made under the policy discharges the insurer's obligation with respect to the amount of insurance so paid.
(b) Any group disability policy which contains provisions for the insurer to pay benefits for expenses incurred for hospital, nursing, medical or surgical services for members of the family or dependents of a person insured may provide for the continuation of the benefit provisions entirely or partially after the death of the person insured.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-110 - Additional Disability Insurance Groups; Requirements.

26-19-110. Additional disability insurance groups; requirements.
(a) Group disability insurance offered to a resident under a group disability insurance policy issued to a group other than one described in W.S. 26-19-102 is subject to the following requirements:
(i) A group disability insurance policy shall not be delivered in this state unless the commissioner finds that:
(A) The issuance of the group policy is not contrary to the best interest of the public;
(B) The issuance of the group policy would result in economies of acquisition or administration;
(C) The benefits are reasonable in relation to the premiums charged;
(D) The insurer possesses and maintains capital and surplus requirements provided by W.S. 26-3-108 and reserve requirements provided by W.S. 26-6-107.
(ii) Group disability insurance coverage shall not be offered in this state by an insurer under a policy issued in another state unless the commissioner determines the requirements of paragraph (i) of this subsection are met and the insurer files with the commissioner:
(A) A copy of the group master contract;
(B) A copy of the statute of the state where the group policy is issued that authorizes the issuance of the group policy;
(C) Evidence of approval of the group policy in the state where the group policy is issued; and
(D) Copies of all supportive material used by the insurer to secure approval of the group in the state where the group policy is issued.
(iii) If the commissioner fails to make the determination provided by paragraph (ii) of this subsection within forty-five (45) days of filing by the insurer of the documents required by paragraph (ii) of this subsection, the requirements of paragraph (i) of this subsection are deemed to be met.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-111 - Notice of Compensation.

26-19-111. Notice of compensation.
(a) The insurer shall distribute to prospective insureds a written notice that compensation shall or may be paid for a program of group insurance which would qualify under W.S. 26-19-102(a)(ii) or 26-19-110, if compensation of any kind shall or may be paid to:
(i) A policyholder or sponsoring or endorsing entity in the case of group policy; or
(ii) A sponsoring or endorsing entity in the case of individual, blanket or franchise policies marketed by means of direct response solicitation.
(b) Notice required by this section shall be distributed:
(i) Whether compensation is direct or indirect; and
(ii) Whether compensation is:
(A) Paid to or retained by the policyholder or sponsoring or endorsing entity; or
(B) Paid to or retained by a third party at the direction of the policyholder, sponsoring or endorsing entity or an entity affiliated by way of ownership, contract or employment.
(c) The notice required by this section shall be placed on or accompany any application or enrollment form provided to prospective insureds.
(d) As used in this section:
(i) "Direct response solicitation" means a solicitation through a sponsoring or endorsing entity by the mails, telephone or other mass communications media; and
(ii) "Sponsoring or endorsing entity" means an organization which has arranged for the offering of a program of insurance in a manner which communicates that eligibility for participation in the program is dependent upon affiliation with the organization or that it encourages participation in the program.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-112 - Dependent Group Disability Insurance.

26-19-112. Dependent group disability insurance.
Except for a policy issued under W.S. 26-19-102(a)(vi), a group disability insurance policy may be extended to insure the employees' or members' or any class of employees' or members' family members or dependents. If the employee or member does not pay any part of the premium for the family members or dependents coverage, the policy shall insure all eligible employees, members or any class of employees or members.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-114 - Failure to Pay Premiums; Notification.

26-19-114. Failure to pay premiums; notification.
When an employer or trustee of a fund established or adopted by an employer, which employer or trustee is deemed the policyholder of the group disability insurance policy insuring the employer's employees for the benefit of persons other than the employer and where the employer or trustee routinely pays any part of the premium for the policy, if the employer or trustee fails to pay the routinely paid portion of the premium when required under the policy for any reason, the employer or trustee shall notify the employee or beneficiary, electronically or in writing, within thirty (30) days of the failure to pay.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 1 - In General › Section 26-19-115 - Multiple Employer Welfare Arrangements; Required License; Applicability of the Small Employer Health Insurance Availability Act; Hearings; Rules.

26-19-115. Multiple employer welfare arrangements; required license; applicability of the Small Employer Health Insurance Availability Act; hearings; rules.
(a) A multiple employer welfare arrangement, as defined in W.S. 26-1-102(a)(xliii), intending to operate in Wyoming shall provide to the department all necessary documents to facilitate a determination of jurisdiction under W.S. 26-1-108. The department may specify required documents under this subsection by rule.
(b) Before operating in this state, a multiple employer welfare arrangement subject to the jurisdiction of the department shall obtain an annual license. The department shall collect a fee for each license or renewal, as provided in W.S. 26-4-101(a)(xx).
(c) Except as otherwise provided in this subsection, the provisions of the Small Employer Health Insurance Availability Act, W.S. 26-19-301 through 26-19-310, shall apply to multiple employer welfare arrangements subject to the jurisdiction of the department, including arrangements providing benefits to one (1) or more employees of a small employer, as defined in W.S. 26-19-302(a)(xxii). The provisions of W.S. 26-19-303(a) shall not apply.
(d) The provisions of chapter 20 of this title shall apply to those multiple employer welfare arrangements subject to the jurisdiction of the department.
(e) The commissioner may suspend, revoke or refuse to issue or renew a license required by subsection (b) of this section, consistent with the Wyoming Administrative Procedure Act, W.S. 16-3-101 through 16-3-115 and 26-2-125 through 26-2-129.
(f) The commissioner may adopt rules to implement this section, including specifying the conditions under which actions may be taken under subsection (e) of this section, which shall be consistent with other insurance statutes governing suspensions, revocations or refusals to issue or renew licenses.
2023 Wyoming Statutes › Title 26 - Insurance Code › Chapter 19 - Group and Blanket Disability Insurance › Article 2 - Group Coverage Replacement Act › Section 26-19-201 - Purpose and Scope of Article.

26-19-201. Purpose and scope of article.
(a) The purpose of this article is to:
(i) Provide for continuance of coverage for all participants when a succeeding carrier's contract replaces a prior plan's benefits; and
(ii) Prohibit the imposition of preexisting condition limitations under certain circumstances.
(b) This article is applicable to all insurance policies and subscriber contracts issued or provided by an insurance company or a nonprofit service corporation on a group or group-type basis covering persons as employees of employers or as members of unions, associations, multiple employer trusts or organizations, or any arrangement subject to the jurisdiction of the insurance department.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.