33-22-109. Riders. (1) Except for group health insurance coverage provided by a group health plan or a health insurance issuer, a policy of disability insurance may contain a provision that excludes coverage for specific conditions through the use of elimination riders for conditions for which medical advice, diagnosis, care, or treatment was recommended by or received from a provider of health care services within 3 years preceding the effective date of coverage of an insured person. The provisions of 33-22-110 do not apply to elimination riders. An insured person may apply to the insurer for removal or modification of a rider, and the insurer shall respond to the application within 60 days of receipt.

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Terms Used In Montana Code 33-22-109

  • Contract: A legal written agreement that becomes binding when signed.
  • Elimination rider: means a provision attached to a policy that excludes coverage for a specific condition that would otherwise be covered under the policy. See Montana Code 33-22-140
  • Group health insurance coverage: means health insurance coverage offered in connection with a group health plan or health insurance coverage offered to an eligible group as described in 33-22-501. See Montana Code 33-22-140
  • Group health plan: means an employee welfare benefit plan, as defined in 29 U. See Montana Code 33-22-140
  • Health insurance issuer: means an insurer, a health service corporation, or a health maintenance organization. See Montana Code 33-22-140
  • Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201

(2)An insurer may not, except upon agreement by the insured, retroactively impose an elimination rider on an existing policy, certificate, or contract.