Code of Massachusetts Regulations
940 CMR - OFFICE OF THE ATTORNEY GENERAL
Title 940 CMR 9.00 - Group Health Care Insurers, Termination Of Coverage
Section 9.06 - Exemption for Offer of Continuation of Coverage

(1) Temporary Continuation and Conversion Coverage. A Group Health Care Insurer is exempt from the provisions of 940 CMR 9.04 if, within 60 days of the effective date of the termination of a Group Health Insurance Plan for nonpayment of premiums, it sends written notice of termination to all Subscribers, in the manner set forth in 940 CMR 9.05, in which it offers each Subscriber the opportunity to elect "Temporary Continuation of Coverage" for the period between the effective date of termination of the Group Health Insurance Plan and the date of the notice. The Group Health Care Insurer also must offer, to those Subscribers who elect Temporary Continuation of Coverage and who pay the required premiums for the entire available period of the temporary coverage, "Conversion Plan" coverage that becomes effective upon termination of the Temporary Continuation of Coverage.

(2) Terms and Conditions. To qualify for this exemption, the benefits offered and the premiums charged for the Temporary Continuation of Coverage must be the same as the benefits offered and premiums charged under the Group Health Insurance Plan at the time of its termination. Conversion Plan benefits and premiums may vary from those offered and charged under the Group Health Insurance Plan, as long as they meet the requirements of all applicable statutes and regulations, including those promulgated or enforced by the Division of Insurance. Any offer of Temporary Continuation of Coverage or Conversion Plan coverage under 940 CMR 9.06 may not be subject to any further conditions including, but not limited to, waiting periods or health screening. A Group Health Care Insurer must allow Subscribers at least 60 days from the date of an offer of Temporary Continuation of Coverage and Conversion Plan coverage to elect such coverage and to remit the premiums then due. Thereafter, a Group Health Care Insurer may not require a Subscriber who has elected coverage under a Conversion Plan to remit premiums more than one month in advance of the period to which the premiums apply.