Title 33, Chapter 30, Section 1
( 33-30-1)
(a) "Group accident and sickness insurance" is that form of accident
and sickness insurance covering the groups of persons listed in
paragraphs (1) through (6) of this subsection, with or without one
or more members of their families or one or more of their dependents
or covering one or more members of the families or one or more
dependents of persons in such groups, and issued upon the following
basis: (1) Under a policy issued to an employer or trustees of a fund
established by an employer, who shall be deemed the policyholder,
insuring at least two employees of such employer for the benefit
of persons other than the employer. As used in this paragraph, the
term "employees" includes the officers, managers, and employees of
the employer; the individual proprietor or partners, if the
employer is an individual proprietor or partnership; the officers,
managers, and employees of subsidiary or affiliated corporations;
and the individual proprietors, partners, and employees of
individuals and firms, if the business of the employer and such
individual or firm is under common control through stock
ownership, contract, or otherwise. The term may include retired
employees. A policy issued to insure employees of a public body
may provide that the term "employees" shall include elected or
appointed officials; (2) Under a policy issued to an association, including a labor
union, which shall have a constitution and bylaws and which has
been organized and is maintained in good faith for purposes other
than that of obtaining insurance, insuring at least 25 members,
employees, or employees of members of the association for the
benefit of persons other than the association or its officers or
trustees. As used in this paragraph, the term "employees" may
include retired employees; (3) Under a policy issued to the trustees of a fund established by
two or more employers in the same industry, by one or more labor
unions, by one or more employers and one or more labor unions, or
by an association, as defined in paragraph (2) of this Code
section, which trustees shall be deemed the policyholder, to
insure not less than 25 employees of the employers or members of
the union or of such association or of members of such association
for the benefit of persons other than the employers or other
unions or such associations. As used in this paragraph, the term
"employees" includes the officers, managers, and employees of the
employer and the individual proprietor or partners, if the
employer is an individual proprietor or partnership. The term may
include retired employees. The policy may provide that the term
"employees" shall include the trustees or their employees, or
both, if their duties are principally connected with such
trusteeship; (4) Under a policy issued to any person or organization to which a
policy of group life insurance may be delivered in this state, to
insure any class or classes of individuals that could be insured
under such group life policy; (5) Under a policy issued to cover any other substantially similar
group which in the discretion of the Commissioner may be subject
to the issuance of a group accident and sickness policy or
contract; or (6)(A) Under a policy issued to a legal entity providing a
multiple employer welfare arrangement, which means any employee
benefit plan which is established or maintained for the purpose
of offering or providing accident and sickness benefits to the
employees of two or more employers, including self-employed
individuals, and their dependents. The term does not apply to
any plan or arrangement which is established or maintained by a
tax-exempt rural electric cooperative or a collective bargaining
agreement. (B) The amounts of insurance under the policy must be based upon
some plan precluding individual selection either by the
employees, employers, or trustee. (b) As used in this chapter, the term "true association" means an
organization that: (1) Has been in existence for at least five years; (2) Has been formed and maintained in good faith for purposes
other than obtaining insurance; (3) Does not condition membership in the association on any health
status related factor relating to an individual (including an
employee of an employer or a dependent of an employee); (4) Makes health insurance coverage offered through the
association available to all members regardless of any health
status related factor relating to such members (or individual
eligible for coverage through a member); (5) Does not make health insurance coverage offered through the
association available other than in connection with a member of
the association; and (6) Meets such additional requirements as may be imposed under
Georgia law or regulation. |