§ 44-4221 — Purchase pool coverage; eligibility

(1) To be eligible to purchase pool coverage, an individual
shall:
(a) Be a resident of the state for a period of at least six months and
shall be an individual:
(i) Who is not eligible
for coverage under a group health plan comparable to pool coverage, medicare
by reason of age, or medical assistance pursuant to the Medical Assistance
Act or section 43-522 , or any successor program, and who does not have any
other health insurance coverage comparable to pool coverage;
(ii) Who, if such individual
was offered the option of continuation coverage under COBRA or under a similar
program, both elected such continuation coverage and exhausted such continuation
coverage; and
(iii)(A) Who
has received, within six months prior to application to the pool,
a rejection in writing, for reasons of health, from an insurer for health insurance coverage comparable to pool coverage;
(B) Who currently has, or has been offered within six months prior to
application to the pool, health insurance coverage comparable to pool coverage by an insurer which
includes a restrictive rider which limits health insurance
coverage for a preexisting medical condition; or
(C) Who has been refused health
insurance coverage comparable to pool coverage, or has been
offered health insurance coverage
at a rate exceeding the premium rate for pool coverage, within six months
prior to application to the pool;
(b) Be a resident of the state for any length of time and be an individual:
(i) For whom, as of the date the individual seeks pool coverage under
this section, the aggregate of the periods of creditable coverage is eighteen
or more months and whose most recent prior creditable coverage was under a
group health plan, governmental plan, or church plan;
(ii) Who is not eligible for coverage under a group health plan, medicare,
or medical assistance pursuant to the Medical Assistance Act or section 43-522 ,
or any successor program, and who does not have any other health insurance
coverage;
(iii) With respect to whom the most recent prior creditable coverage
was not terminated for factors relating to nonpayment of premiums or fraud;
and
(iv) Who, if such individual
was offered the option of continuation coverage under COBRA or under a similar
program, both elected such continuation coverage and exhausted such continuation
coverage; or
(c) Be a resident of the state for any length of time and be a qualified
trade adjustment assistance eligible individual.
(2) The board may adopt and promulgate a list of medical or health conditions
for which an individual would be eligible for pool coverage without applying
for health insurance coverage pursuant to subdivision (1)(a) of this section.
Individuals who can demonstrate the existence or history of any medical or
health conditions on the list adopted and promulgated by the board shall be
eligible to apply directly to the pool for pool coverage.

Legislative History

Source: Laws 1985, LB 391, § 21; Laws 1992, LB 1006, § 35; Laws 1997, LB 862, § 26; Laws 1998, LB 1035, § 7; Laws 1998, LB 1063, § 2; Laws 2000, LB 1253, § 24; Laws 2004, LB 1047, § 12; Laws 2006, LB 1248, § 61; Laws 2009, LB358, § 4. Cross References: Medical Assistance Act, see section 68-901.