Legislation
SECTION 3232-A
Certification of creditable coverage
Insurance (ISC) CHAPTER 28, ARTICLE 32
§ 3232-a. Certification of creditable coverage. (a) Every insurer who
delivers or issues for delivery individual health insurance policies or
group or blanket accident and health insurance policies shall provide to
covered individuals written certification, in a form as the
superintendent may approve, of:
(1) the period of creditable coverage, as defined in section three
thousand two hundred thirty-two of this article, of the individual under
such policy and any continuation coverage of the individual pursuant to
state or federal law; and
(2) any waiting period or affiliation period (if applicable) imposed
with respect to the individual for any coverage under the policy.
(b) The insurer shall provide such written certification:
(1) at the time an individual ceases to be covered under the policy,
including any period of time such individual was covered pursuant to any
right of continuation under such policy; and
(2) on the request on behalf of an individual made not later than
twenty-four months after the date of cessation of the coverage described
in paragraph one of this subsection.
(c) In the event of an election by an insurer or a group health plan
to count the period of creditable coverage based on coverage of benefits
within classes or categories of benefits as provided in state or federal
law, if that insurer or group health plan enrolls an individual for
coverage under its policy or plan and such individual provides written
certification of coverage of the individual pursuant to subsection (a)
of this section, then upon request of such insurer or group health plan,
the insurer that issued the certification of coverage so provided by the
individual shall promptly disclose to such requesting insurer or group
health plan information on coverage of classes and categories of health
benefits available under its policy. An insurer disclosing such
information may charge the requesting plan or insurer for the reasonable
cost of such disclosure.
(d) An insurer who delivers or issues for delivery group or blanket
accident and health insurance policies is deemed to have satisfied the
requirements of subsection (a) of this section if the policyholder by
written agreement with the insurer actually provides the written
certification in accordance with this section.
delivers or issues for delivery individual health insurance policies or
group or blanket accident and health insurance policies shall provide to
covered individuals written certification, in a form as the
superintendent may approve, of:
(1) the period of creditable coverage, as defined in section three
thousand two hundred thirty-two of this article, of the individual under
such policy and any continuation coverage of the individual pursuant to
state or federal law; and
(2) any waiting period or affiliation period (if applicable) imposed
with respect to the individual for any coverage under the policy.
(b) The insurer shall provide such written certification:
(1) at the time an individual ceases to be covered under the policy,
including any period of time such individual was covered pursuant to any
right of continuation under such policy; and
(2) on the request on behalf of an individual made not later than
twenty-four months after the date of cessation of the coverage described
in paragraph one of this subsection.
(c) In the event of an election by an insurer or a group health plan
to count the period of creditable coverage based on coverage of benefits
within classes or categories of benefits as provided in state or federal
law, if that insurer or group health plan enrolls an individual for
coverage under its policy or plan and such individual provides written
certification of coverage of the individual pursuant to subsection (a)
of this section, then upon request of such insurer or group health plan,
the insurer that issued the certification of coverage so provided by the
individual shall promptly disclose to such requesting insurer or group
health plan information on coverage of classes and categories of health
benefits available under its policy. An insurer disclosing such
information may charge the requesting plan or insurer for the reasonable
cost of such disclosure.
(d) An insurer who delivers or issues for delivery group or blanket
accident and health insurance policies is deemed to have satisfied the
requirements of subsection (a) of this section if the policyholder by
written agreement with the insurer actually provides the written
certification in accordance with this section.