Nebraska Statutes 44-5260.01. Certification of creditable coverage
(1) Small employer carriers shall provide written certification of creditable coverage to individuals in accordance with subsection (2) of this section.
Terms Used In Nebraska Statutes 44-5260.01
- Affiliation period: means a period of time that must expire before health insurance coverage provided by a carrier becomes effective and during which the carrier is not required to provide benefits. See Nebraska Statutes 44-5227.01
- Group health plan: shall mean an employee welfare benefit plan as defined by Nebraska Statutes 44-5241.02
- Health benefit plan: shall mean any hospital or medical policy or certificate, major medical expense insurance, or health maintenance organization subscriber contract. See Nebraska Statutes 44-5242
- Medical care: shall mean amounts paid for:
(1)(a) The diagnosis, care, mitigation, treatment, or prevention of disease or (b) the purpose of affecting any structure or function of the body. See Nebraska Statutes 44-5244.01
- Small employer: shall mean any person, political subdivision, firm, corporation, limited liability company, partnership, or association that is actively engaged in business that, on at least fifty percent of its working days during the preceding calendar quarter, employed at least two and no more than fifty eligible employees, the majority of whom were employed within this state. See Nebraska Statutes 44-5253
- Small employer carrier: shall mean a carrier that offers health benefit plans covering eligible employees of one or more small employers in this state. See Nebraska Statutes 44-5254
- Waiting period: means the period that must pass with respect to an individual before the individual is eligible to be covered for benefits under the terms of the health benefit plan. See Nebraska Statutes 44-5255.01
(2) The certification of creditable coverage shall be provided:
(a) At the time an individual ceases to be covered under the health benefit plan or otherwise becomes covered under a COBRA continuation provision;
(b) In the case of an individual who becomes covered under a COBRA continuation provision, at the time the individual ceases to be covered under that provision; and
(c) At the time a request is made on behalf of an individual if the request is made not later than twenty-four months after the date of cessation of coverage described in subdivision (2)(a) or (b) of this section, whichever is later.
(3) Small employer carriers may provide the certification of creditable coverage required under subdivision (2)(a) of this section at a time consistent with notices required under any applicable COBRA continuation provision.
(4) The certificate of creditable coverage required to be provided pursuant to subsection (1) of this section shall contain:
(a) Written certification of the period of creditable coverage of the individual under the health benefit plan and the coverage, if any, under the applicable COBRA continuation provision; and
(b) The waiting period, if any, and, if applicable, affiliation period imposed with respect to the individual for any coverage under the health benefit plan.
(5) To the extent medical care under a group health plan consists of group health insurance coverage, the plan is deemed to have satisfied the certification requirement under subsection (1) of this section if the small employer carrier offering the coverage provides for certification in accordance with subsection (2) of this section.
(6)(a) If an individual enrolls in a group health plan that uses the alternative method of counting creditable coverage pursuant to subdivision (4)(c)(iv) of section 44-5260 and the individual provides a certificate of coverage that was provided to the individual pursuant to subsection (3) of this section, on request of the group health plan, the entity that issued the certification to the individual promptly shall disclose to the group health plan information on the classes and categories of health benefits available under the entity’s health benefit plan.
(b) The entity providing the information pursuant to subdivision (6)(a) of this section may charge the requesting group health plan the reasonable cost of disclosing the information.