A carrier for a small group health plan may refuse to renew the plan if the employer fails to?

In the context of small group health plans, a carrier's ability to refuse renewal is primarily tied to the employer's responsibilities, which include the timely payment of premiums. When an employer fails to pay the premium, it directly impacts the carrier's financial obligations and potential liabilities. Premium payments are essential for maintaining coverage, and without them, the insurance contract cannot be sustained.

While the other options may relate to certain operational or performance standards, they do not provide the carrier with the clearcut ability to refuse renewal like non-payment of premiums does. An employer exceeding a specified number of claims or generating minimum revenues does not inherently justify renewing or terminating coverage; those are more about the insurer’s management of risk and financial health rather than fundamental terms of the coverage agreement. Similarly, maintaining a minimum AM Best rating might affect perceptions of an insurer's reliability, but it does not serve as a direct contractual basis for refusing to renew a health plan. Thus, failure to pay the premium is the definitive reason for a carrier to refuse renewal of a small group health plan.