§ 27-18.5-10. Prohibition on preexisting condition exclusions.
(a) A health insurance policy, subscriber contract, or health plan offered, issued, issued
for delivery, or issued to cover a resident of this state by a health insurance company
licensed pursuant to this title and/or chapter shall not limit or exclude coverage
for any individual by imposing a preexisting condition exclusion on that individual.
(b) As used in this section, "preexisting condition exclusion� means any limitation or
exclusion of benefits, including a denial of coverage, applicable to an individual
as a result of information rela
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§ 27-18.5-10. Prohibition on preexisting condition exclusions.
(a) A health insurance policy, subscriber contract, or health plan offered, issued, issued
for delivery, or issued to cover a resident of this state by a health insurance company
licensed pursuant to this title and/or chapter shall not limit or exclude coverage
for any individual by imposing a preexisting condition exclusion on that individual.
(b) As used in this section, "preexisting condition exclusion� means any limitation or
exclusion of benefits, including a denial of coverage, applicable to an individual
as a result of information relating to an individual's health status before the individual's
effective date of coverage, or if the coverage is denied, the date of denial, under
the health benefit plan, such as a condition (whether physical or mental) identified
as a result of a pre-enrollment questionnaire or physical examination given to the
individual, or review of medical records relating to the pre-enrollment period.
(c) This section shall not apply to grandfathered health plans providing individual health
insurance coverage.
(d) This section shall not apply to insurance coverage providing benefits for: (1) Hospital
confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care;
(5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity;
(8) Sickness or bodily injury or death by accident or both; and (9) Other limited
benefit policies.
Notes
Legislative Intent.
P.L. 2012, ch. 256, § 1, and P.L. 2012, ch. 262, § 1, provide: "Purpose and Intent. It is the purpose of this act to amend Rhode Island
statutes so as to be consistent with health insurance consumer protections enacted
in federal law. This act is intended to establish health insurance rules, standards,
and policies pursuant to, and in furtherance of, the health insurance standards established
in the federal Patient Protection and Affordable Care Act of 2010, as amended by the
federal Health Care and Education Reconciliation Act of 2010.�