# KY Insurance Advisory Opinion 1998-04: Participation Requirements For Groups

> Kentucky · Agency guidance · In force

URL: https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-04

## Section

- **Citation:** KY Insurance Advisory Opinion 1998-04
- **Heading:** Participation Requirements For Groups
- **Jurisdiction:** Kentucky
- **Kind:** Agency guidance
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Kentucky Department of Insurance Bulletins and Advisory Opinions / Participation Requirements For Groups

## Text

The following advisory opinion is to advise the reader of the current position of the Kentucky Department
of Insurance ("Department ") on the specified issue. The Advisory Opinion is lot legally binding on either
the Department or the reader.
Kentucky Department of Insurance
Advisory Opinion 98-04
In re: Participation Requirements for Groups
RELEVANT FACTS AND STATUTES: The Department has received inquiries regarding if insurers can have
participation requirements that require that a certain number of employees be non-family members.
DEPARTMENT'S POSITION: Section 1(33) of HB 315 defines small employers as "...an employer who
employed an average of at least two (2) but not more than fifty (50) employees...." Section 1(34) of HB
315 defines large group as an..."employer with fifty-one (51 ) or more employees...." Section 2 of the HB
315 permits insurers in the small group or large group market to set certain participation requirements.
None of the requirements specified permits the insurer to modify the definition of "employer" however.
Therefore, if the employer has bona fide employees who are also family members, the insurer shall
require the same participation requirements for employers with family members as those employers
who do not employ family members. Family relationship cannot be a factor in determining participation
requirements.
Any questions may be directed to D. J. Wasson, Principal Assistant to Commissioner (502) 564-6026.
____________________________________
George Nichols III
Commissioner
Date:12/21/98

## Nearby sections

- [KY Insurance Advisory Opinion 1998-01 The Issuance And Renewal Of Health Benefit Plans Under 98 RS HB 315/En](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-01.md)
- [KY Insurance Advisory Opinion 1998-02 Hospice Care Coverage Under Health Benefit Plans](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-02.md)
- [KY Insurance Advisory Opinion 1998-03 Health Care Discount Programs](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-03.md)
- [KY Insurance Advisory Opinion 1998-04 Participation Requirements For Groups](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-04.md)
- [KY Insurance Advisory Opinion 1998-05 Damages For Motor Vehicle Loss Of Use And Settlement Of Claims For Motor Vehicles](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-05.md)
- [KY Insurance Advisory Opinion 1999-01 Conversion Plans As Health Benefits Plans](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-01.md)
- [KY Insurance Advisory Opinion 1999-02 Use Of Fee Schedules For Payment Of Medical Expenses In Basic And Added Reparation Benefits Coverage](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-02.md)
- [KY Insurance Advisory Opinion 1999-03 Experience-Information Reports Of Insurers](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-03.md)
- [KY Insurance Advisory Opinion 1999-05 Group Claim Experience](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-05.md)
- [KY Insurance Advisory Opinion 1999-06 Claims Practice](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-06.md)
- [KY Insurance Advisory Opinion 1999-07 Dual Rates For Medicare Supplement Policies](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-07.md)
- [KY Insurance Advisory Opinion 1999-08 Any Willing Provider Law](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-08.md)
- [KY Insurance Advisory Opinion 1999-12 Bulletin 98-2 Personal Lines Property Insurance For Earthquake Damages](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-12.md)
- [KY Insurance Advisory Opinion 1999-13 Waiver Of Our Right To Recover From Others Endorsements (Ncci Form Wc 00 01 13)](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-13.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-04. Check the current official text before relying on it. Not legal advice.