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This entry was published on 2021-12-24
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Pre-existing condition provisions in group and blanket disability policies
Insurance (ISC) CHAPTER 28, ARTICLE 32
* § 3234. Pre-existing condition provisions in group and blanket
disability policies. (a) Every group or blanket policy issued or issued
for delivery in this state which provides benefits by reason of the
disability of the insured and which includes a pre-existing condition
provision shall contain in substance the following provision or
provisions which in the opinion of the superintendent are more favorable
to the members of the group:

(1) In determining whether a pre-existing condition provision applies
to an eligible person, the group or blanket disability policy shall
credit the time the person was previously covered under a previous group
or blanket disability insurance plan or policy or employer-provided
disability benefit arrangement, if the previous coverage was continuous
to a date not more than sixty days prior to the effective date of the
new coverage. The credit shall apply to the extent that the previous
coverage or level of benefits was substantially similar to the new
coverage or level of benefits; and

(2) No pre-existing condition provision shall exclude coverage for a
period in excess of twelve months following the effective date of
coverage for the covered person.

(b) Nothing herein shall be construed to prohibit or restrict an
insurer from utilizing other forms of underwriting for the members of
the group in lieu of, or in addition to, the pre-existing condition
provision described in subsection (a) of this section.

* NB There are 2 § 3234's