PART 6.1. HEALTH DISABILITY INSURANCE CONVERSION [12670. - 12692.5.]
Part 6.1 added by Stats. 1981, Ch. 1096, Sec. 2.
§§ 12670–12692.5 · 26 sections
- § 12670 It is the intent of the Legislature to ensure that persons covered by a group policy, who become ineligible for that coverage have access to benefits pursuant…
- § 12671 As used in this part, the following terms have the following meanings: (a) “Group policy” means a group health insurance policy providing medical, hospital,…
- § 12672 (a) Any group policy issued, amended, or renewed in this state on or after January 1, 1983, which provides insurance for employees or members on an…
- § 12673 Conversion coverage shall be required to be made available to an employee or member unless such coverage under the group policy terminates for one or more of…
- § 12674 A converted policy shall be issued effective on the day following the termination of coverage under the group policy if written application and the first…
- § 12675 The premium for the conversion coverage shall be determined in accordance with the insurer’s rates applicable to the age and class of risk of each person to be…
- § 12676 The conversion coverage shall cover the employee or member and his or her dependents who were covered by the group policy on the date of termination of…
- § 12677 The insurer shall not be required to issue a converted policy covering any person if such person is entitled to be covered by Medicare.
- § 12678 The insurer shall not be required to issue a converted policy covering any person if any of the following exists: (a) The person is covered for similar…
- § 12679 A converted policy may provide that the insurer may at any time request information from any person covered thereunder as to whether he or she is covered for…
- § 12680 If conversion coverage is issued and benefits are also provided to a person under Section 12678, the insurer may limit the conversion benefits provided or…
- § 12681 An insurer shall not be required to issue a converted policy providing benefits in excess of those provided under the group policy from which conversion is…
- § 12682 The converted policy shall not exclude, as a preexisting condition, any condition covered by the group policy. The converted policy may provide for a reduction…
- § 12682.1 This section does not apply to a policy that primarily or solely supplements Medicare. The commissioner may adopt rules consistent with federal law to govern…
- § 12682.2 (a) (1) At least 60 days prior to the policy renewal date, an insurer that does not otherwise issue individual health insurance policies shall issue the notice…
- § 12683 Subject to the provisions and conditions of this part, if the group policy from which conversion is made covers the employee or member for basic hospital or…
- § 12684 Subject to the provisions and conditions of this part, if the group policy from which conversion is made provides the employee or member with major medical or…
- § 12685 The insurer may, at its option, offer alternative plans for group health conversion in addition to those required by this part.
- § 12686 (a) In the event coverage would be continued under a group policy on an employee or member following his or her retirement prior to the time he or she is or…
- § 12687 Notwithstanding any other provision in this part, whenever an employee or member chooses among two or more conversion policies, such choice shall be made…
- § 12688 Notwithstanding any provision in this part to the contrary, a hospital service corporation or any insurer which customarily offers individual conversion…
- § 12689 A notification of the conversion coverage shall be included in each certificate of coverage or other legally required document explaining coverage; provided,…
- § 12690 Nothing in this part shall prohibit insurers from establishing one or more pools from which the converted policies provided for on this part may be issued.
- § 12691 A converted policy which is delivered in a jurisdiction other than this state may be in a form which could be delivered in such jurisdiction as a converted…
- § 12692 On and after January 1, 1985, every insurer and nonprofit hospital service plan issuing group disability insurance which covers hospital, medical, or surgical…
- § 12692.5 Notwithstanding any other provision of this part, Sections 12672, 12673, 12674, 12675, 12676, 12677, 12678, 12679, 12680, 12681,