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1999 SESSION

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SB 1081 Health care coverage; preexisting conditions.

Introduced by: John S. Edwards | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Health care coverage; preexisting conditions. 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 twelve to six months, and from eighteen to twelve months for a late enrollee. Finally, the bill redefines an “eligible individual” to reduce the aggregate of the periods of creditable coverage from eighteen or more months to twelve 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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