31.10.37.04

.04 Delivery Requirements for Certificates.

A. A carrier shall deliver a certificate under a group health insurance contract, a group nonprofit health service plan contract, a group health maintenance organization contract, or a group dental plan organization contract to the:

(1) Certificate holder within 60 days of the effective date of the certificate holder's coverage; or

(2) Group contract holder within 60 days of the effective date of the certificate holder's effective date of coverage, for delivery to each certificate holder.

B. A carrier may satisfy the requirement of §A of this regulation by making the certificate available to the certificate holder on the Internet, if:

(1) Written notice of the availability of the certificate on the Internet is provided to the:

(a) Certificate holder in writing within 60 days of the date of the certificate holder's effective date of coverage; or

(b) Group contract holder or insurance producer of record within 60 days of the effective date of the certificate holder's effective date of coverage, for the group contract holder or insurance producer of record to provide delivery to the certificate holder; and

(2) The written notice described in §B(1) of this regulation includes an option for the certificate holder to request the certificate be delivered to the certificate holder by mail.

C. The certificate requested under §B of this regulation shall be made available in paper form within 60 days of the receipt by the carrier of the request for the paper certificate from the certificate holder.

D. If a carrier cannot comply with the requirements of §A of this regulation because the group contract holder delays providing the necessary information to the carrier to issue the certificate, the carrier's time limit to provide the certificate is extended to the shorter of:

(1) 30 days from the date the employer group provides the information to the carrier; or

(2) 120 days from the effective date of the employer group contract.