Indiana § 27-8-15-31 Conversion policy

Indiana Statutes

§ 27-8-15-31 — Conversion policy

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

(a)If an eligible employee who has been continuously covered under a health insurance plan for at least ninety

(90)days:

(1)loses coverage under the plan as the result of:

(A)termination of employment;

(B)reduction of hours;

(C)marriage dissolution; or

(D)attainment of any age specified in the plan;

(2)is not eligible for continuation coverage under the federal Consolidated Omnibus Budget Reconciliation Act of 1985; and

(3)requests a conversion policy from the small employer insurer that insured the health insurance plan; the individual is entitled to receive a conversion policy from the small employer insurer.

(b)A request under subsection (a) must be made within thirty (30) days after the individual loses coverage under the health insurance plan.

(c)The premium for a conversio

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(a) If an eligible employee who has been
continuously covered under a health insurance plan for at least ninety
(90) days:
(1) loses coverage under the plan as the result of:
(A) termination of employment;
(B) reduction of hours;
(C) marriage dissolution; or
(D) attainment of any age specified in the plan;
(2) is not eligible for continuation coverage under the federal
Consolidated Omnibus Budget Reconciliation Act of 1985; and
(3) requests a conversion policy from the small employer insurer
that insured the health insurance plan;
the individual is entitled to receive a conversion policy from the small
employer insurer.
(b) A request under subsection (a) must be made within thirty (30)
days after the individual loses coverage under the health insurance
plan.
(c) The premium for a conversion policy issued under this section
shall not exceed one hundred fifty percent (150%) of the rate that
would have been charged under the small employer health insurance
plan with respect to the individual if the individual had been covered
as an eligible employee under the plan during the same period. If the
health insurance plan under which the individual was covered is
canceled or is not renewed, the rates shall be based on the rate that
would have been charged with respect to the individual if the plan had
continued in force, as determined by the small employer insurer in
accordance with standard actuarial principles.
(d) A conversion policy issued under this section must be approved
by the insurance commissioner as described in IC 27-8-5-1. The
commissioner may not approve a conversion policy unless the policy
and its benefits are:
(1) comparable to those required under IC 27-13-1-4(a)(2)
through IC 27-13-1-4(a)(5);
(2) reasonable in relation to the premium charged; and
(3) in compliance with IC 27-8-6-1.
If the benefit limits of the conversion policy are not more than the
benefit limits of the small employer's health insurance plan, the small
employer insurer shall credit the individual with any waiting period,
deductible, or coinsurance credited to the individual under the small
employer's health insurance plan.
(e) This section expires on the effective date of a mechanism
enacted by the general assembly to offset the potential fiscal impact on
small employers and small employer insurers that results from the
establishment of a continuation policy under section 31.1 of this
chapter.