Ga. Comp. R. & Regs. R. 120-2-101-.06 - Child-Only Program Reporting due in 2014
Insurers that are active in the individual health insurance market in Georgia in 2013 and comply with requirements to make child-only health products available shall report as required in O.C.G.A. §33-29B-7 by March 1, 2014.
The report submitted on March 1, 2014 for the child-only 2013 coverage program shall include this information and follow this reporting format:
2013 Georgia Child-Only Individual Health Insurance Program Report
Name of Insurer: ________________________ NAIC# ___________
|
Total Number of Applicants that applied during Open Enrollment Period |
Number of Applicants that enrolled during Open Enrollment Period |
Number of Applicants that were declined during Open Enrollment Period |
Reason(s) for Denial of Applicants |
|
(Include limited identifying details for each applicant case so denied, respecting potential privacy concerns) |
Contact Person preparing this Report: _______________________Ph: _______________
Email: ___________________________
Certification by Responsible Officer of the Insurer:
I hereby affirm that the information included in this report of 2013 activities of the company is correct and complete.
Signed: _________________________________
Printed Name: ___________________________ Title: : ________________________
Date: __________________________________
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
Insurers that are active in the individual health insurance market in Georgia in 2013 and comply with requirements to make child-only health products available shall report as required in O.C.G.A. §33-29B-7 by March 1, 2014.
The report submitted on March 1, 2014 for the child-only 2013 coverage program shall include this information and follow this reporting format:
2013 Georgia Child-Only Individual Health Insurance Program Report
Name of Insurer: ________________________ NAIC# ___________
| Total Number of Applicants that applied during Open Enrollment Period | Number of Applicants that enrolled during Open Enrollment Period | Number of Applicants that were declined during Open Enrollment Period | Reason(s) for Denial of Applicants |
| (Include limited identifying details for each applicant case so denied, respecting potential privacy concerns) |
Contact
Email: ___________________________
Certification by Responsible Officer of the Insurer:
I hereby affirm that the information included in this report of 2013 activities of the company is correct and complete.
Signed: _________________________________
Printed Name: ___________________________ Title: : ________________________
Date: __________________________________