(a) Any carrier providing replacement coverage with respect to group dental benefits within a period of sixty days from the date of discontinuance of a prior dental insurer contract or policy providing such dental benefits shall immediately cover all enrollees who were validly covered under the previous dental insurer contract or policy at the date of discontinuance and who would otherwise be eligible for coverage under the succeeding carrier’s contract, regardless of any provisions of the contract relating to active employment.
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Terms Used In Hawaii Revised Statutes 432G-9

  • Carrier: means a dental insurer, a health maintenance organization, an insurer, a nonprofit hospital and medical service corporation, a mutual benefit society, or other entity responsible for the payment of benefits or provision of services under a group contract. See Hawaii Revised Statutes 432G-1
  • Contract: A legal written agreement that becomes binding when signed.
  • Dental insurer: means any person who undertakes to provide or to arrange for or administer one or more dental insurance plans and who has met the requirements of chapter 423. See Hawaii Revised Statutes 432G-1
  • Discontinuance: means the termination of the contract between a group contract holder and a dental insurer due to the insolvency of the dental insurer, and does not refer to the termination of any agreement between any individual subscriber and a dental insurer. See Hawaii Revised Statutes 432G-1
  • Replacement coverage: means the benefits provided by a succeeding carrier. See Hawaii Revised Statutes 432G-1
(b) Except to the extent benefits for the condition would have been reduced or excluded under the prior carrier’s contract or policy, no provision in a succeeding carrier’s contract of replacement coverage which would operate to reduce or exclude benefits on the basis that the condition giving rise to a claim for benefits preexisted the effective date of the succeeding carrier’s contract shall be applied with respect to those enrollees validly covered under the prior carrier’s contract or policy on the date of discontinuance.

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