§ 27-8-15-28 — Waiver of exclusion and limitation period

Indiana § 27-8-15-28

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 8: LIFE, ACCIDENT, AND HEALTH
• Ch. 15: Small Employer Group Health Insurance

Text

(a) As used in this section, "health insurance
plan" means coverage provided under any of the following:
(1) A hospital or medical expense incurred policy or certificate.
(2) A hospital or medical service plan contract.
(3) A health maintenance organization subscriber contract.
(4) Medicare or Medicaid.
(5) An employer based health insurance arrangement.
(6) An individual health insurance policy.
(7) A policy issued by the Indiana comprehensive health
insurance association under IC 27-8-10.
(8) An employee welfare benefit plan (as defined in 29 U.S.C.
1002) that is self-funded.
(9) A conversion policy issued under section 31 or 31.1 of this
chapter.
(b) Except as provided in section 29 of this chapter, a small
employer insurer shall waive the exclusion period described in section
27 of this chapter applicable to a preexisting condition or the limitation
period with respect to a particular service in a health insurance plan for
the time an eligible employee or a dependent of an eligible employee
was previously covered by a health insurance plan if the following
conditions are met:
(1) The eligible employee or a dependent of the eligible employee
was previously covered by a health insurance plan that provided
benefits with respect to the particular service.
(2) Coverage under the health insurance plan was continuous to
a date not more than sixty-three (63) days before the effective
date of enrollment by:
(A) the eligible employee; or
(B) a dependent of the eligible employee.
(c) In determining whether an eligible employee or a dependent of
the eligible employee meets the requirements of subsection (b)(2), a
waiting period imposed by a small employer insurer or small employer
before new coverage may become effective must be excluded from the
calculation.
(d) This section does not preclude the application of any waiting
period applicable to all new enrollees under a plan.

Legislative History

As added by P.L.93-1995, SEC.16. Amended by P.L.190-1996, SEC.6; P.L.91-1998, SEC.19.