State Codes and Statutes

Statutes > Nebraska > Chapter44 > 44-4221

44-4221. Purchase pool coverage; eligibility.(1) To be eligible to purchase pool coverage, an individualshall:(a) Be a resident of the state for a period of at least six months andshall be an individual:(i) Who is not eligiblefor coverage under a group health plan comparable to pool coverage, medicareby reason of age, or medical assistance pursuant to the Medical AssistanceAct or section 43-522, or any successor program, and who does not have anyother health insurance coverage comparable to pool coverage;(ii) Who, if such individualwas offered the option of continuation coverage under COBRA or under a similarprogram, both elected such continuation coverage and exhausted such continuationcoverage; and(iii)(A) Whohas received, within six months prior to application to the pool,a rejection in writing, for reasons of health, from an insurer for health insurance coverage comparable to pool coverage;(B) Who currently has, or has been offered within six months prior toapplication to the pool, health insurance coverage comparable to pool coverage by an insurer whichincludes a restrictive rider which limits health insurancecoverage for a preexisting medical condition; or(C) Who has been refused healthinsurance coverage comparable to pool coverage, or has beenoffered health insurance coverageat a rate exceeding the premium rate for pool coverage, within six monthsprior to application to the pool;(b) Be a resident of the state for any length of time and be an individual:(i) For whom, as of the date the individual seeks pool coverage underthis section, the aggregate of the periods of creditable coverage is eighteenor more months and whose most recent prior creditable coverage was under agroup health plan, governmental plan, or church plan;(ii) Who is not eligible for coverage under a group health plan, medicare,or medical assistance pursuant to the Medical Assistance Act or section 43-522,or any successor program, and who does not have any other health insurancecoverage;(iii) With respect to whom the most recent prior creditable coveragewas not terminated for factors relating to nonpayment of premiums or fraud;and(iv) Who, if such individualwas offered the option of continuation coverage under COBRA or under a similarprogram, both elected such continuation coverage and exhausted such continuationcoverage; or(c) Be a resident of the state for any length of time and be a qualifiedtrade adjustment assistance eligible individual.(2) The board may adopt and promulgate a list of medical or health conditionsfor which an individual would be eligible for pool coverage without applyingfor health insurance coverage pursuant to subdivision (1)(a) of this section.Individuals who can demonstrate the existence or history of any medical orhealth conditions on the list adopted and promulgated by the board shall beeligible to apply directly to the pool for pool coverage. SourceLaws 1985, LB 391, § 21; Laws 1992, LB 1006, § 35; Laws 1997, LB 862, § 26; Laws 1998, LB 1035, § 7; Laws 1998, LB 1063, § 2; Laws 2000, LB 1253, § 24; Laws 2004, LB 1047, § 12; Laws 2006, LB 1248, § 61; Laws 2009, LB358, § 4. Cross ReferencesMedical Assistance Act, see section 68-901.

State Codes and Statutes

Statutes > Nebraska > Chapter44 > 44-4221

44-4221. Purchase pool coverage; eligibility.(1) To be eligible to purchase pool coverage, an individualshall:(a) Be a resident of the state for a period of at least six months andshall be an individual:(i) Who is not eligiblefor coverage under a group health plan comparable to pool coverage, medicareby reason of age, or medical assistance pursuant to the Medical AssistanceAct or section 43-522, or any successor program, and who does not have anyother health insurance coverage comparable to pool coverage;(ii) Who, if such individualwas offered the option of continuation coverage under COBRA or under a similarprogram, both elected such continuation coverage and exhausted such continuationcoverage; and(iii)(A) Whohas received, within six months prior to application to the pool,a rejection in writing, for reasons of health, from an insurer for health insurance coverage comparable to pool coverage;(B) Who currently has, or has been offered within six months prior toapplication to the pool, health insurance coverage comparable to pool coverage by an insurer whichincludes a restrictive rider which limits health insurancecoverage for a preexisting medical condition; or(C) Who has been refused healthinsurance coverage comparable to pool coverage, or has beenoffered health insurance coverageat a rate exceeding the premium rate for pool coverage, within six monthsprior to application to the pool;(b) Be a resident of the state for any length of time and be an individual:(i) For whom, as of the date the individual seeks pool coverage underthis section, the aggregate of the periods of creditable coverage is eighteenor more months and whose most recent prior creditable coverage was under agroup health plan, governmental plan, or church plan;(ii) Who is not eligible for coverage under a group health plan, medicare,or medical assistance pursuant to the Medical Assistance Act or section 43-522,or any successor program, and who does not have any other health insurancecoverage;(iii) With respect to whom the most recent prior creditable coveragewas not terminated for factors relating to nonpayment of premiums or fraud;and(iv) Who, if such individualwas offered the option of continuation coverage under COBRA or under a similarprogram, both elected such continuation coverage and exhausted such continuationcoverage; or(c) Be a resident of the state for any length of time and be a qualifiedtrade adjustment assistance eligible individual.(2) The board may adopt and promulgate a list of medical or health conditionsfor which an individual would be eligible for pool coverage without applyingfor health insurance coverage pursuant to subdivision (1)(a) of this section.Individuals who can demonstrate the existence or history of any medical orhealth conditions on the list adopted and promulgated by the board shall beeligible to apply directly to the pool for pool coverage. SourceLaws 1985, LB 391, § 21; Laws 1992, LB 1006, § 35; Laws 1997, LB 862, § 26; Laws 1998, LB 1035, § 7; Laws 1998, LB 1063, § 2; Laws 2000, LB 1253, § 24; Laws 2004, LB 1047, § 12; Laws 2006, LB 1248, § 61; Laws 2009, LB358, § 4. Cross ReferencesMedical Assistance Act, see section 68-901.

State Codes and Statutes

State Codes and Statutes

Statutes > Nebraska > Chapter44 > 44-4221

44-4221. Purchase pool coverage; eligibility.(1) To be eligible to purchase pool coverage, an individualshall:(a) Be a resident of the state for a period of at least six months andshall be an individual:(i) Who is not eligiblefor coverage under a group health plan comparable to pool coverage, medicareby reason of age, or medical assistance pursuant to the Medical AssistanceAct or section 43-522, or any successor program, and who does not have anyother health insurance coverage comparable to pool coverage;(ii) Who, if such individualwas offered the option of continuation coverage under COBRA or under a similarprogram, both elected such continuation coverage and exhausted such continuationcoverage; and(iii)(A) Whohas received, within six months prior to application to the pool,a rejection in writing, for reasons of health, from an insurer for health insurance coverage comparable to pool coverage;(B) Who currently has, or has been offered within six months prior toapplication to the pool, health insurance coverage comparable to pool coverage by an insurer whichincludes a restrictive rider which limits health insurancecoverage for a preexisting medical condition; or(C) Who has been refused healthinsurance coverage comparable to pool coverage, or has beenoffered health insurance coverageat a rate exceeding the premium rate for pool coverage, within six monthsprior to application to the pool;(b) Be a resident of the state for any length of time and be an individual:(i) For whom, as of the date the individual seeks pool coverage underthis section, the aggregate of the periods of creditable coverage is eighteenor more months and whose most recent prior creditable coverage was under agroup health plan, governmental plan, or church plan;(ii) Who is not eligible for coverage under a group health plan, medicare,or medical assistance pursuant to the Medical Assistance Act or section 43-522,or any successor program, and who does not have any other health insurancecoverage;(iii) With respect to whom the most recent prior creditable coveragewas not terminated for factors relating to nonpayment of premiums or fraud;and(iv) Who, if such individualwas offered the option of continuation coverage under COBRA or under a similarprogram, both elected such continuation coverage and exhausted such continuationcoverage; or(c) Be a resident of the state for any length of time and be a qualifiedtrade adjustment assistance eligible individual.(2) The board may adopt and promulgate a list of medical or health conditionsfor which an individual would be eligible for pool coverage without applyingfor health insurance coverage pursuant to subdivision (1)(a) of this section.Individuals who can demonstrate the existence or history of any medical orhealth conditions on the list adopted and promulgated by the board shall beeligible to apply directly to the pool for pool coverage. SourceLaws 1985, LB 391, § 21; Laws 1992, LB 1006, § 35; Laws 1997, LB 862, § 26; Laws 1998, LB 1035, § 7; Laws 1998, LB 1063, § 2; Laws 2000, LB 1253, § 24; Laws 2004, LB 1047, § 12; Laws 2006, LB 1248, § 61; Laws 2009, LB358, § 4. Cross ReferencesMedical Assistance Act, see section 68-901.