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Session Laws, 1999
Volume 796, Page 1659   View pdf image
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SUBSECTION SHALL PROVIDE BENEFITS FOR THE GLASSES OR CONTACT LENSES IF
THE GLAS
SES OR CONTACT LENSES ARE RECEIVED BY THE INDIVIDUAL THAT
PROVIDES COVERAGE FOR GLASSES OR CONTACT LENSES SHALL CONTINUE TO
PROVIDE COVERED BENEFITS, IN ACCORDANCE WITH THE POLICY IN EFFECT AT THE
TIME THE INDIVIDUAL'S COVERAGE TERMINATES, FOR THE GLASSES OR CONTACT
LENSES IF THE INDIVIDUAL RECEIVES THE GLASSES OR CONTACT LENSES WITHIN 30
DAYS AFTER THE DATE OF THE ORDER

(I) (1) THIS SUBSECTION APPLIES TO INSURERS THAT PROVIDE GROUP,
BLANKET, OR INDIVIDUAL ACCIDENTAL DEATH OR DISMEMBERMENT BENEFITS.

(2) AN INSURER SUBJECT TO THIS SUBSECTION SHALL PROVIDE
BENEFITS COVERED BENEFITS, IN ACCORDANCE WITH THE POLICY IN EFFECT AT
THE TIME THE INDIVIDUAL'S COVERAGE TERMINATES, FOR A COVERED LOSS THAT
OCCURS AFTER THE DATE COVERAGE TERMINATES IF:

(I) AN ACCIDENT OCCURS WHILE THE INDIVIDUAL IS COVERED;

AND

(II) THE LOSS OCCURS WITHIN 90 DAYS AFTER THE ACCIDENT.

(J) (1) THIS SUBSECTION APPLIES TO INSURERS, NONPROFIT HEALTH
SERVICE PLANS, HEALTH MAINTENANCE ORGANIZATIONS, AND DENTAL PLAN
ORGANIZATIONS THAT PROVIDE GROUP, BLANKET, OR INDIVIDUAL DENTAL
BENEFITS.

(2) EXCEPT AS PROVIDED IN PARAGRAPH (3) OF THIS SUBSECTION, AN
ENTITY SUBJECT TO THIS SUBSECTION SHALL PROVIDE BENEFITS COVERED
BENEFITS, IN ACCORDANCE WITH THE POLICY IN EFFECT AT THE TIME THE
INDIVIDUAL'S COVERAGE TERMINATES, FOR A COURSE OF TREATMENT FOR AT
LEAST 90 DAYS AFTER THE DATE COVERAGE TERMINATES IF THE TREATMENT:

(I) BEGINS BEFORE THE DATE COVERAGE TERMINATES; AND

(II) REQUIRES TWO OR MORE VISITS ON SEPARATE DAYS TO A
DENTIST'S OFFICE.

(3) AN ENTITY SUBJECT TO THIS SUBSECTION THAT PROVIDES
COVERAGE FOR ORTHODONTICS SHALL PROVIDE BENEFITS COVERED BENEFITS, IN
ACCORDANCE WITH THE POLICY IN EFFECT AT THE TIME THE INDIVIDUAL'S
COVERAGE TERMINATES. FOR ORTHODONTICS:

(I) FOR 60 DAYS AFTER THE DATE COVERAGE TERMINATES IF THE
ORTHODONTIST HAS AGREED TO OR IS RECEIVING MONTHLY PAYMENTS; OR

(II) UNTIL THE LATER OF 60 DAYS AFTER THE DATE COVERAGE
TERMINATES OR THE END OF THE QUARTER IN PROGRESS, IF THE ORTHODONTIST
HAS AGREED TO ACCEPT OR IS RECEIVING PAYMENTS ON A QUARTERLY BASIS.

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to
all policies, contracts, and health benefit plans issued, delivered, or renewed in the

 

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Session Laws, 1999
Volume 796, Page 1659   View pdf image
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