Arizona Laws 20-2307. Eligibility; annual open enrollment period
A. Except as otherwise provided in this section or section 20-2308 or 20-2309, an accountable health plan may not exclude from coverage any employee or a spouse or a dependent child of the employee if the person meets the eligibility requirements established by the employer.
Terms Used In Arizona Laws 20-2307
- Accountable health plan: means an entity that offers, issues or otherwise provides a health benefits plan and that is approved by the director as an accountable health plan pursuant to section 20-2303. See Arizona Laws 20-2301
- Dependent: A person dependent for support upon another.
- employee: includes the employees of the employer and the individual proprietor or self-employed person if the employer is an individual proprietor or self-employed person. See Arizona Laws 20-2301
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Health benefits plan: means a hospital and medical service corporation policy or certificate, a health care services organization contract, a group disability policy, a certificate of insurance of a group disability policy that is not issued in this state, a multiple employer welfare arrangement or any other arrangement under which health services or health benefits are provided to two or more individuals. See Arizona Laws 20-2301
- Late enrollee: means an employee or dependent who requests enrollment in a health benefits plan after the initial enrollment period that is provided under the terms of the health benefits plan if the initial enrollment period is at least thirty-one days. See Arizona Laws 20-2301
- Person: includes a corporation, company, partnership, firm, association or society, as well as a natural person. See Arizona Laws 1-215
B. Subsection A of this section does not apply to a period in which an employee is excluded from coverage under the health benefits plan pursuant to an employer requirement that imposes a minimum period of service before the employee and the employee’s dependents are eligible for coverage.
C. An accountable health plan may deny enrollment to employees or family members of an employer if the employees or family members are located outside the service area of the accountable health plan and if the denial is applied uniformly without regard to health status-related factors or insurability.
D. An accountable health plan that provides an annual open enrollment period of at least thirty-one days may deny enrollment to a late enrollee until the next annual open enrollment period or may require acceptable evidence of insurability.