HARRY HUGHES, Governor

2853

(1)  THE DATE ON WHICH THE QUALIFIED SECONDARY
BENEFICIARY BECOMES ELIGIBLE FOR HOSPITAL, MEDICAL, OR SURGICAL
BENEFITS UNDER A AN INSURED OR SELF-INSURED GROUP HEALTH BENEFIT
PROGRAM OR PLAN, OTHER THAN THE GROUP CONTRACT, WHICH IS:

(I)  WRITTEN ON AN EXPENSE INCURRED BASIS; OR

(II)  WITH A HEALTH MAINTENANCE ORGANIZATION.

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

(3)  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 HAD BEEN NO APPLICABLE
CHANGE IN STATUS;

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

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

(I)  WRITTEN ON AN EXPENSE INCURRED BASIS; OR

(II)  WITH A HEALTH MAINTENANCE ORGANIZATION.

(6)  IN THE CASE OF AN INDIVIDUAL WHO IS A QUALIFIED
SECONDARY BENEFICIARY BY REASON OF HAVING BEEN THE INSURED'S
SPOUSE, THE DATE ON WHICH THE INDIVIDUAL REMARRIES.

(D)  ANY COVERAGE  UNDER THIS SECTION SHALL BE IDENTICAL TO
THE COVERAGE OFFERED    UNDER THE GROUP CONTRACT TO SIMILARLY
SITUATED BENEFICIARIES  WHERE THERE HAS BEEN NO APPLICABLE CHANGE
IN STATUS.

(E)  FROM THE DATE OF THE APPLICABLE CHANGE IN STATUS UNTIL
THE DATE ON WHICH THE TERMINATION STATEMENT IS RECEIVED BY THE
EMPLOYER, THE EMPLOYEE INSURED SHALL PAY TO THE EMPLOYER, THROUGH
PAYROLL DEDUCTION OR OTHERWISE AS MAY BE DETERMINED BY THE
EMPLOYER, THE SUM OF THE EMPLOYER'S CONTRIBUTION FOR A QUALIFIED
SECONDARY BENEFICIARY AS DEFINED IN SUBSECTION (A)(6)(I) OF THIS
SECTION AND THE AMOUNT OF CONTRIBUTION WHICH WOULD HAVE BEEN PAID
BY THE EMPLOYEE INSURED IF THERE HAD BEEN NO APPLICABLE CHANGE IN
STATUS.

(F)  EVERY CERTIFICATE ISSUED TO AN INSURED UNDER A GROUP
CONTRACT SHALL INCLUDE A STATEMENT, IN A MANNER AND FORM APPROVED
BY THE COMMISSIONER, WHICH ADVISES THE INSURED OF THE FOLLOWING: