§ 23-86-114 — Group accident and health insurance - Continuation of coverage beyond termination of employment, change in marital status, etc

Arkansas § 23-86-114

• Jurisdiction: Arkansas
• Title: 23

Text

(a) Every group accident and health insurance policy, contract, or certificate providing hospital, surgical, or major medical coverage, other than accident only or specified disease policies, shall contain a provision that any certificate holder, member, or spouse whose coverage under the policy would otherwise terminate due to termination of employment or membership or a change in marital status may continue coverage under the policy for themselves and their eligible dependents as provided in this section. (b) The continued coverage need not include benefits for dental care, vision services, or prescription drug expenses. (c) (1) Continuation of coverage shall be available only to individuals who have been insured continuously under the group policy during the three-month period prior to the termination of employment membership or change in marital status. (2) Continuation of coverage shall not be available to an individual who is eligible for: (A) Federal Medicare coverage; or (B) (i) Full coverage under any other group accident and health policy or contract. (ii) This coverage must provide benefits for all preexisting conditions to be considered full coverage. (iii) Accordingly, under this subdivision (c)(2), an individual may continue his or her previous group coverage until all preexisting conditions are covered or would be covered under another group policy or contract or until termination pursuant to subsection (f) of this section or pursuant to the applicable provisions of federal law. (d) An individual who wishes to continue coverage must request continuation in writing not later than ten (10) days after the termination of employment or membership or the change in marital status. (e) An individual who requests continuation of coverage must pay the premium required by the policyholder on a monthly basis and in advance. Payments shall be made in accordance with the group policy. (f) Continuation of coverage shall end upon the earliest of the following dates: (1) One hundred twenty (120) days after continuation of coverage began; (2) The end of the period for which the individual made a timely contribution; (3) The contribution due date following the date the individual becomes eligible for Medicare; or (4) (A) The date on which the policy is terminated or the group withdraws from the plan. (B) However, if the group policy is replaced, continuation shall continue under the new coverage. (g) At the termination of the continued coverage, an individual shall be offered the conversion policy under the group policy. (h) Individuals choosing to utilize the conversion privilege under the group policy may do so and thereby waive their right to continuation of coverage. (i) This section shall not be applicable to healthcare plans in which the employer is self-insured.

Legislative History

Acts 1985, No. 814, §§ 1-10; 1985, No. 853, §§ 1-10; A.S.A. 1947, §§ 66-3721 -- 66-3730; Acts 1987, No. 456, § 18; 2001, No. 1063, § 14.