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Session Laws, 1986
Volume 768, Page 2549   View pdf image
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HARRY HUGHES, Governor

2549

(II) WITH A HEALTH MAINTENANCE ORGANIZATION;

(4)  THE DATE ON WHICH THE QUALIFIED SECONDARY
BENEFICIARY BECOMES ENTITLED TO BENEFITS UNDER TITLE XVIII OF THE
SOCIAL SECURITY ACT;

(5)  THE DATE ON WHICH THE QUALIFIED SECONDARY
BENEFICIARY ACCEPTS HOSPITAL, MEDICAL, OR SURGICAL COVERAGE
EITHER UNDER ANY NONGROUP INSURANCE CONTRACT OR POLICY:

(I)  WRITTEN ON AN EXPENSE INCURRED BASIS; OR

(II)  WITH A HEALTH MAINTENANCE ORGANIZATION;

(6)  THE DATE ON WHICH THE QUALIFIED SECONDARY
BENEFICIARY ELECTS NO LONGER TO HAVE COVERAGE UNDER THE GROUP
CONTRACT;

(7)  THE DATE ON WHICH THE EMPLOYER CEASES TO PROVIDE
BENEFITS TO ITS EMPLOYEES UNDER A GROUP CONTRACT; OR

(8)  IN THE CASE OF ANY INDIVIDUAL WHO IS A QUALIFIED
SECONDARY BENEFICIARY BY REASON OF HAVING BEEN A DEPENDENT CHILD,
THE DATE ON WHICH THE INDIVIDUAL WOULD NO LONGER HAVE BEEN
COVERED UNDER THE GROUP CONTRACT IF THERE HAS BEEN NO APPLICABLE
CHANGE IN STATUS.

(E)  ANY CONTINUATION COVERAGE UNDER THIS SECTION:

(1)  SHALL BE PROVIDED WITHOUT EVIDENCE OF
INSURABILITY OR ADDITIONAL WAITING PERIODS;

(2)  SHALL PROVIDE FOR THE PAYMENT TO THE EMPLOYER BY
A QUALIFIED SECONDARY BENEFICIARY OF AN AMOUNT WHICH DOES NOT
EXCEED:

(I)  THE SUM OF THE EMPLOYER CONTRIBUTION AND
ANY CONTRIBUTION WHICH WOULD HAVE BEEN REQUIRED TO BE PAID BY THE
INSURED IF THERE HAD BEEN NO APPLICABLE CHANGE IN STATUS; AND

(II)  A REASONABLE ADMINISTRATIVE FEE WHICH
SHALL BE SUBJECT TO REVIEW AND APPROVAL BY THE COMMISSIONER;

(3)  SHALL PERMIT THE PAYMENT OF ANY SUCH AMOUNT IN
MONTHLY INSTALLMENTS IF SO ELECTED BY THE QUALIFIED SECONDARY
BENEFICIARY; AND

(4)  SHALL BE IDENTICAL TO THE COVERAGE OFFERED UNDER
THE GROUP CONTRACT TO SIMILARLY SITUATED INDIVIDUALS WHERE THERE
HAS BEEN NO APPLICABLE CHANGE IN STATUS.

(F)  (1) THE ELECTION PERIOD FOR THE COVERAGE PROVIDED UNDER
THIS SECTION SHALL BEGIN WITH THE DATE ON WHICH THERE HAS BEEN
AN APPLICABLE CHANGE IN STATUS AND END NO SOONER THAN 45 DAYS
AFTER SUCH DATE.

 

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Session Laws, 1986
Volume 768, Page 2549   View pdf image
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