Current through 2024, ch. 69
Section 59A-23G-7 - Exclusion prohibition not applicable to excepted benefit plans or policiesA. Notwithstanding any other provisions of law, an excepted benefits policy or plan shall not exclude coverage for losses incurred for a preexisting condition more than twelve months from the effective date of coverage. The policy or plan shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment recommended by or received from a physician within twelve months before the effective date of coverage.B. As used in this section, "excepted benefits" means benefits furnished pursuant to the following: (1) coverage-only accident or disability income insurance;(2) coverage issued as a supplement to liability insurance;(4) workers' compensation or similar insurance;(5) automobile medical payment insurance;(6) credit-only insurance;(7) coverage for on-site medical clinics;(8) other similar insurance coverage specified in office of superintendent of insurance rules, under which benefits for medical care are secondary or incidental to other benefits;(9) the following benefits if offered separately: (a) limited-scope dental or vision benefits;(b) benefits for long-term care, nursing home care, home health care, community-based care or any combination of those benefits; and(c) other similar limited benefits specified in office of superintendent of insurance rules;(10) the following benefits, offered as independent, non-coordinated benefits: (a) coverage-only for a specified disease or illness; or(b) hospital indemnity or other fixed indemnity insurance; and(11) the following benefits if offered as a separate insurance policy: (a) medicare supplemental health insurance as defined pursuant to Section 1882(g)(1) of the federal Social Security Act; and(b) coverage supplemental to the coverage provided pursuant to Chapter 55 of Title 10 USCA and similar supplemental coverage provided to coverage pursuant to a group health plan.Added by 2019, c. 235,s. 7, eff. 6/14/2019.