State Codes and Statutes

Statutes > North-carolina > Chapter_58 > GS_58-51-110

§ 58‑51‑110. Renewal, discontinuance, or replacement of group health insurance.

(a)        This sectionapplies to group accident, group health, or group accident and health policiesor certificates that are delivered, issued for delivery, renewed, or used in thisState which provide hospital, surgical, or major medical expense insurance, orany combination of these coverages, on an expense incurred or service basis. Itspecifically includes a certificate issued under a policy that was issued to atrust located out of this State, but which includes participating employerslocated in this State. Renewal of these policies or certificates is presumed tooccur on the anniversary date that the coverage was first effective on theemployees of the employer.

(b)        Whenever a contractdescribed in subsection (a) of this section is replaced by another groupcontract within 15 days of termination of coverage of the previous groupcontract, the liability of the succeeding insurer for insuring persons coveredunder the previous group contract is:

(1)        Each person who iseligible for coverage in accordance with the succeeding insurer's plan ofbenefits, regardless of any other provisions of the new group contract relatingto active employment or hospital confinement or pregnancy, shall be covered bythe succeeding insurer's plan of benefits; and

(2)        Each person notcovered under the succeeding insurer's plan of benefits in accordance withsubdivision (b)(1) of this section must nevertheless be covered by thesucceeding insurer if that person was validly covered, including benefitextension, under the prior plan on the date of discontinuance and if the personis a member of the class of persons eligible for coverage under the succeedinginsurer's plan. (1989,c. 775, s. 3; 1991, c. 720, s. 88; 1991 (Reg. Sess., 1992), c. 837, s. 4; 2001‑334,s. 6.)

State Codes and Statutes

Statutes > North-carolina > Chapter_58 > GS_58-51-110

§ 58‑51‑110. Renewal, discontinuance, or replacement of group health insurance.

(a)        This sectionapplies to group accident, group health, or group accident and health policiesor certificates that are delivered, issued for delivery, renewed, or used in thisState which provide hospital, surgical, or major medical expense insurance, orany combination of these coverages, on an expense incurred or service basis. Itspecifically includes a certificate issued under a policy that was issued to atrust located out of this State, but which includes participating employerslocated in this State. Renewal of these policies or certificates is presumed tooccur on the anniversary date that the coverage was first effective on theemployees of the employer.

(b)        Whenever a contractdescribed in subsection (a) of this section is replaced by another groupcontract within 15 days of termination of coverage of the previous groupcontract, the liability of the succeeding insurer for insuring persons coveredunder the previous group contract is:

(1)        Each person who iseligible for coverage in accordance with the succeeding insurer's plan ofbenefits, regardless of any other provisions of the new group contract relatingto active employment or hospital confinement or pregnancy, shall be covered bythe succeeding insurer's plan of benefits; and

(2)        Each person notcovered under the succeeding insurer's plan of benefits in accordance withsubdivision (b)(1) of this section must nevertheless be covered by thesucceeding insurer if that person was validly covered, including benefitextension, under the prior plan on the date of discontinuance and if the personis a member of the class of persons eligible for coverage under the succeedinginsurer's plan. (1989,c. 775, s. 3; 1991, c. 720, s. 88; 1991 (Reg. Sess., 1992), c. 837, s. 4; 2001‑334,s. 6.)


State Codes and Statutes

State Codes and Statutes

Statutes > North-carolina > Chapter_58 > GS_58-51-110

§ 58‑51‑110. Renewal, discontinuance, or replacement of group health insurance.

(a)        This sectionapplies to group accident, group health, or group accident and health policiesor certificates that are delivered, issued for delivery, renewed, or used in thisState which provide hospital, surgical, or major medical expense insurance, orany combination of these coverages, on an expense incurred or service basis. Itspecifically includes a certificate issued under a policy that was issued to atrust located out of this State, but which includes participating employerslocated in this State. Renewal of these policies or certificates is presumed tooccur on the anniversary date that the coverage was first effective on theemployees of the employer.

(b)        Whenever a contractdescribed in subsection (a) of this section is replaced by another groupcontract within 15 days of termination of coverage of the previous groupcontract, the liability of the succeeding insurer for insuring persons coveredunder the previous group contract is:

(1)        Each person who iseligible for coverage in accordance with the succeeding insurer's plan ofbenefits, regardless of any other provisions of the new group contract relatingto active employment or hospital confinement or pregnancy, shall be covered bythe succeeding insurer's plan of benefits; and

(2)        Each person notcovered under the succeeding insurer's plan of benefits in accordance withsubdivision (b)(1) of this section must nevertheless be covered by thesucceeding insurer if that person was validly covered, including benefitextension, under the prior plan on the date of discontinuance and if the personis a member of the class of persons eligible for coverage under the succeedinginsurer's plan. (1989,c. 775, s. 3; 1991, c. 720, s. 88; 1991 (Reg. Sess., 1992), c. 837, s. 4; 2001‑334,s. 6.)