§ 15-1A-05

(a) This section applies to all grandfathered plans except grandfathered plans that are individual plans and to every health benefit plan that is not a grandfathered plan.

(b) A carrier may not:

(1) exclude or limit benefits because a health condition was present before the effective date of coverage; or

(2) deny coverage because a health condition was present before or on the date of denial.

(c) The prohibition in subsection (b) of this section applies whether or not:

(1) any medical advice, diagnosis, care, or treatment was recommended or received for the condition; or

(2) the health condition was identified as a result of:

(i) a pre–enrollment questionnaire or physical examination given to an individual; or

(ii) a review of records relating to the pre–enrollment period.