Legislation

Search OpenLegislation Statutes

This entry was published on 2014-09-22
The selection dates indicate all change milestones for the entire volume, not just the location being viewed. Specifying a milestone date will retrieve the most recent version of the location before that date.
SECTION 4318-A
Certification of creditable coverage by corporations organized under this article
Insurance (ISC) CHAPTER 28, ARTICLE 43
§ 4318-a. Certification of creditable coverage by corporations
organized under this article. (a) Every corporation subject to the
provisions of this article that issues individual health insurance
contracts or group or blanket accident and health insurance contracts
shall provide covered individuals with written certification, in a form
as the superintendent may approve, of:

(1) the period of creditable coverage, as defined in section four
thousand three hundred eighteen of this article, of the individual under
such contract and under any continuation coverage pursuant to state or
federal law; and

(2) any waiting period or affiliation period (if applicable) imposed
with respect to the individual for coverage under any such contract.

(b) The corporation shall provide such certification:

(1) at the time an individual ceases to be covered under the contract,
including any period of time the individual was covered pursuant to any
right of continuation under the contract; 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 contract or plan and the individual provides a
certification of coverage of the individual under subsection (a) of this
section, then upon request of such insurer or group health plan, any
corporation subject to the provisions of this article that issued the
certification of coverage 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
the corporation's contract. The corporation may charge the requesting
plan or insurer for the reasonable cost of disclosing such information.

(d) A corporation that issues group or blanket accident and health
insurance contracts is deemed to have satisfied the requirements of
subsection (a) of this section if the contract holder by written
agreement with the corporation actually provides the written
certification in accordance with this section.