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Session Laws, 1993
Volume 772, Page 1795   View pdf image
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WILLIAM DONALD SCHAEFER, Governor                         Ch. 297

(1)     The date on which the qualified secondary beneficiary becomes eligible
for hospital, medical, or surgical benefits under 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 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 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 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:

(1)     The availability of benefits under this section; and

(2)     A summary of the eligibility for and duration of such benefits.

(g)     (1) No employer who terminates coverage following notice by the insured or
qualified secondary beneficiary and no insurer who terminates coverage following notice
by the employer shall be liable to the insured or qualified secondary beneficiary for
benefits which would have otherwise been payable under this section if termination is:

(i) Made in good faith;

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Session Laws, 1993
Volume 772, Page 1795   View pdf image
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