| (a) A health carrier offering coverage through a health
group cooperative must use a standard presentation form for employer
members of the health group cooperative that includes the information
listed in subsection (b) of this section. A standard presentation
form may include additional information.
(b) A standard presentation form must include, at a
minimum:
(1) an explanation that the coverage is being offered
through a health group cooperative;
(2) the name of the health group cooperative;
(3) an explanation of small employers' eligibility
to join the health group cooperative and purchase coverage without
regard for membership in any other organization or the health status
or claims experience of the employer and employees;
(4) an explanation of any fees or charges associated
with membership in the health group cooperative;
(5) a statement that coverage is available to a small
employer on a guaranteed-issue basis from any health carrier offering
coverage in the small employer market with no requirement of joining
a health group cooperative;
(6) for multiple plans that are offered through the
health group cooperative, an explanation that the employer may select
any of the plans without limitation due to health status or claims
experience;
(7) a description of the plans offered through the
health group cooperative by the health carrier; and
(8) if coverage is offered under Insurance Code Chapter
1507 (concerning Consumer Choice of Benefits Plans), a written disclosure
in compliance with Chapter 21, Subchapter AA (relating to Consumer
Choice Health Benefit Plans).
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