TITLE 27
Insurance
CHAPTER 27-19
Nonprofit Hospital Service Corporations
SECTION 27-19-62
§ 27-19-62 Prohibition on rescission of
coverage.
(a)(1) Coverage under a health plan subject to the jurisdiction of the
commissioner under this chapter with respect to an individual, including a
group to which the individual belongs or family coverage in which the
individual is included, shall not be rescinded after the individual is covered
under the plan, unless:
(A) The individual or a person seeking coverage on behalf of
the individual, performs an act, practice or omission that constitutes fraud; or
(B) The individual makes an intentional misrepresentation of
material fact, as prohibited by the terms of the plan or coverage.
(2) For purposes of paragraph (1)(A), a person seeking
coverage on behalf of an individual does not include an insurance producer or
employee or authorized representative of the health carrier.
(b) At least thirty (30) days advance written notice shall be
provided to each health benefit plan enrollee or, for individual health
insurance coverage, primary subscriber, who would be affected by the proposed
rescission of coverage before coverage under the plan may be rescinded in
accordance with subsection (a) regardless of, in the case of group health
insurance coverage, whether the rescission applies to the entire group or only
to an individual within the group.
(c) For purposes of this section, "to rescind" means to
cancel or to discontinue coverage with retroactive effect for reasons unrelated
to timely payment of required premiums or contribution to costs of coverage.
(d) This section applies to grandfathered health plans.
History of Section.
(P.L. 2012, ch. 256, § 6; P.L. 2012, ch. 262, § 6.)
