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1999 SESSION

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HB 2283 Guaranteed availability of individual health insurance coverage.

Introduced by: Harvey B. Morgan | all patrons    ...    notes | add to my profiles

SUMMARY AS ENACTED WITH GOVERNOR'S RECOMMENDATION: (all summaries)

Accident and sickness insurance; guaranteed availability of individual health insurance coverage. Requires health insurance issuers to include questions on forms for individual health insurance that will enable the health insurance issuer to determine whether an applicant qualifies as an “eligible individual.” “Eligible individuals” must be issued individual health insurance coverage without a preexisting conditions limitation if the coverage is issued within 63 days of termination of coverage under a prior group health insurance contract.

The bill also limits the use of preexisting condition exclusions in health care coverage policies and plans issued by Virginia-regulated health insurers, health maintenance organizations, and corporations furnishing subscription contracts for health care coverage. A “preexisting condition exclusion” is generally defined as a limitation or exclusion of benefits relating to a medical condition present before coverage under a policy or plan was applied for or obtained, regardless of whether the condition was diagnosed or treated before that time. The bill’s provisions stipulate that limitations for preexisting conditions exclusions for health insurance coverage offered by a health insurance issuer in the individual market must be the same as that offered by a health insurance issuer in connection with a group plan in the small or large group market. The bill also reduces the preexisting conditions exclusion period from 12 to six months, and from 18 to 12 months for a late enrollee. Finally, the bill redefines an “eligible individual” to reduce the aggregate of the periods of creditable coverage from 18 or more months to 12 or more months. It also includes individual health insurance coverage in the list of health insurance coverages that will be considered the most recent prior creditable coverage.


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