North Carolina Administrative Code (Last Updated: November 13, 2014) |
TITLE 11. INSURANCE |
CHAPTER 18. MUTIPLE EMPLOYER WELFARE ARRANGEMENTS |
11 NCAC 18 .0112. CLAIMS PAYMENTS
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In order to assure that all valid claims for payments for benefits provided are paid within a reasonable time, the following standards apply:
(1) Each MEWA shall pay within 30 days of receipt by the MEWA or its administrator, if applicable, all valid claims for benefits.
(2) If the MEWA requires additional information, the MEWA shall request such additional information in writing within the 30‑day period; and upon receipt of the additional information, the claim shall be paid within 30 days of receipt of the additional information.
(3) If the claim is denied, the MEWA shall provide the reason or reasons for the denial in writing to the claimant and the claimant's health care provider.
History Note: Authority G.S. 58‑2‑40(1); 58‑49‑40; 58‑49‑50;
Eff. July 1, 1992.