CHAPTER 19. REPLACEMENT COVERAGE IN EVENT OF RECEIVERSHIP

IC 27-13-19
    Chapter 19. Replacement Coverage in Event of Receivership

IC 27-13-19-1
"Discontinuance" defined
    Sec. 1. As used in this chapter, "discontinuance" means thetermination of the contract between a group contract holder and ahealth maintenance organization due to the receivership of the healthmaintenance organization. The term does not refer to the terminationof an individual contract.
As added by P.L.26-1994, SEC.25.

IC 27-13-19-2
Replacement coverage; challenge of enrollee
    Sec. 2. (a) A carrier that provides replacement coverage withrespect to group health care services after the discontinuance of theprior health maintenance organization contract or policy providinghealth care services must, immediately upon beginning to provide thereplacement coverage, cover all enrollees who were covered underthe previous health maintenance organization contract or policy onthe date of discontinuance.
    (b) A carrier that provides replacement coverage under thissection may challenge whether an individual designated as anenrollee under the previous health maintenance organization contractqualified as an enrollee under the previous health maintenanceorganization contract.
As added by P.L.26-1994, SEC.25.

IC 27-13-19-3
Provisions reducing or excluding benefits
    Sec. 3. (a) Except as provided in subsection (b), a provision in asucceeding carrier's contract of replacement coverage that wouldoperate to reduce or exclude benefits on the basis that the conditiongiving rise to the benefits preexisted the effective date of thesucceeding carrier's contract may not be applied with respect to thoseenrollees who were covered under the prior carrier's contract orpolicy on the date of discontinuance.
    (b) A provision in a succeeding carrier's contract of replacementcoverage may operate to reduce or exclude benefits on the basis ofa preexisting condition to the extent that the prior carrier's contractor policy would have required that benefits for the condition bereduced or excluded.
As added by P.L.26-1994, SEC.25.