Current through Register Vol. 35, No. 18, September 24, 2024
A.
Duration and non-renewability. The term of a short-term plan shall
not exceed three months and shall not be extendable or renewable. Continuation
and conversion rights of short-term plan dependents extend only to the original
termination date of the policy.
B.
When issuance prohibited. A short-term plan shall not be issued to
an individual, if that person was enrolled in any short-term plan that provided
the same or similar coverage during the preceding 12 months.
C.
Guaranteed issue. A
short-term plan shall be guaranteed issue to eligible applicant's without
regard to health status or any preexisting condition(s).
D.
Cancellation and rescission.
A short-term plan shall not be cancelled or rescinded except as provided
herein:
(1) A short-term plan shall not be
rescinded except in the case of intentional misrepresentation, concealment or
fraud by the insured or covered person.
(2) A short-term plan shall not be canceled
except:
(a) as the result of change to or
implementation of federal or state laws that no longer permit the continued
offering of the coverage; or
(b)
due to the covered person's:
(i) nonpayment
of premium;
(ii) violation of
published policies of the carrier approved by the superintendent;
(iii) fraudulent acts or material
misrepresentation; or
(iv) material
breach of the terms of the plan.
(c) Nothing in this section shall be
construed to provide a covered person with any benefits they would not
otherwise be entitled to under a short-term plan.
(3) Notice required.
(a) When a short-term plan is cancelled for
nonpayment of premium, the insurer shall notify the covered person in writing
ten days prior to the cancellation date that the plan will be canceled, unless
payment is made prior to the cancellation date.
(b) When cancellation or rescission is for
any other authorized reason, the insurer shall notify the covered person in
writing 20 days prior to the cancellation or rescission date, or the expiration
date of the short-term plan, whichever occurs first. An insurer may provide
less than 20 days notice only if the remaining duration of the plan is less
than 20 days. In such case, notice shall be provided no later than 10 days
prior to the cancellation or rescission date or the expiration date of the
plan, whichever occurs first. The notice shall specifically state the reason(s)
for the cancellation or rescission.
(c) A written notice required by this
subsection shall be printed in 12 point or larger font, and phrased in simple
language.
E.
Prohibition against pre-existing condition exclusion. A carrier
shall not exclude coverage of a benefit covered under a short-term plan due to
any preexisting condition(s) or other conditions disclosed on the application
of coverage.
F.
Waiting
periods. A carrier shall not impose a waiting period for a benefit
covered under a short-term plan.
