Maine Revised Statutes Title 24-A Sec. 4232 – Replacement coverage
Current as of: 2023 | Check for updates
|
Other versions
1. Group hospital, medical or surgical expenses, or service benefits. Any insurer or nonprofit health insurance plan that issues replacement coverage with respect to group hospital, medical or surgical expenses or service benefits within a period of 60 days from the date of discontinuance of a prior health maintenance organization contract or policy providing the hospital, medical or surgical expenses or service benefits shall immediately cover all enrollees who were validly covered under the previous health maintenance organization contract or policy at the date of discontinuance and who would otherwise be eligible for coverage under the succeeding insurer’s or nonprofit health insurance plan’s contract, regardless of any provisions in that contract relating to active employment, hospital confinement or pregnancy.
[PL 1989, c. 842, §18 (NEW).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 4232
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- health insurance: means insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto, including provision for the mental and emotional welfare of human beings by defraying the costs of legal services only to the extent provided for in chapter 38. See Maine Revised Statutes Title 24-A Sec. 704
- Health maintenance organization: means a public or private organization that is organized under the laws of the Federal Government, this State, another state or the District of Columbia or a component of such an organization, and that:
2. Preexisting conditions. No provision in a succeeding insurer’s or nonprofit hospital or medical service corporation‘s contract of replacement coverage may reduce or exclude benefits to enrollees covered under the prior health maintenance organization’s contract on the date of discontinuance, on the basis that the condition giving rise to benefits preexisted the effective date of the succeeding contract, except to the extent that benefits for the condition would have been reduced or excluded under the prior contract.
[PL 1989, c. 842, §18 (NEW).]
SECTION HISTORY
PL 1989, c. 842, §18 (NEW).