§ 27-20-58. Prohibition on rescission of coverage.
(a)(1) Coverage under a health benefit plan subject to the jurisdiction of the commissioner
under this chapter with respect to an individual, including a group to which the individual
belongs or family coverage in which the individual is included, shall not be subject
to rescission after the individual is covered under the plan, unless:
(i) The individual or a person seeking coverage on behalf of the individual, performs
an act, practice, or omission that constitutes fraud; or
(ii) The individual makes an intentional mi
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§ 27-20-58. Prohibition on rescission of coverage.
(a)(1) Coverage under a health benefit plan subject to the jurisdiction of the commissioner
under this chapter with respect to an individual, including a group to which the individual
belongs or family coverage in which the individual is included, shall not be subject
to rescission after the individual is covered under the plan, unless:
(i) The individual or a person seeking coverage on behalf of the individual, performs
an act, practice, or omission that constitutes fraud; or
(ii) The individual makes an intentional misrepresentation of material fact, as prohibited
by the terms of the plan or coverage.
(2) For purposes of subsection (a)(1)(i), a person seeking coverage on behalf of an individual
does not include an insurance producer or employee or authorized representative of
the health carrier.
(b) At least thirty (30) days' advance written notice shall be provided to each plan enrollee
or, for individual health insurance coverage, primary subscriber, who would be affected
by the proposed rescission of coverage before coverage under the plan may be rescinded
in accordance with subsection (a) regardless of, in the case of group health insurance
coverage, whether the rescission applies to the entire group or only to an individual
within the group.
(c) This section applies to grandfathered health plans.