<?xml version='1.0' encoding='utf-8'?>
<section article="gin" article_name="Insurance" number="15-413" title_number="15" title_name="Health Insurance" subtitle_number="4" subtitle_name="Eligibility for Coverage; Continuation and Conversion of Policies">
  <level label="a">
    <level label="1">
      <text>Except as provided in paragraph (2) of this subsection, this section applies to each group health insurance policy that:</text>
      <level label="i">
        <level label="1">
          <text>is issued or delivered in the State;</text>
        </level>
        <level label="2">
          <text>is issued to a policyholder that is incorporated or has a main office in the State; or</text>
        </level>
        <level label="3">
          <text>covers individuals who reside or work in the State; and</text>
        </level>
      </level>
      <level label="ii">
        <text>provides benefits in the event of the disability of an individual covered under the policy.</text>
      </level>
    </level>
    <level label="2">
      <text>This section does not apply to:</text>
      <level label="i">
        <text>a policy issued under Title 13 of this article if the insurance under the policy is terminated because of the prepayment or refinancing, wholly or partly, with the same creditor of a prior debt; or</text>
      </level>
      <level label="ii">
        <text>except as the Commissioner provides by regulation, a group policy issued to an employer to cover its employees.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <text>Each group policy subject to this section shall provide that a covered individual whose coverage under the group policy is terminated for any reason other than failure of the covered individual to pay a required premium or contribution is entitled, without evidence of insurability, to an individual policy of disability income insurance.</text>
  </level>
  <level label="c">
    <text>By regulation the Commissioner may exempt from the requirements of this section certain types of group policies that the Commissioner considers appropriate.</text>
  </level>
  <level label="d">
    <level label="1">
      <text>An individual policy issued under this section shall take effect immediately after the termination of coverage under the group policy if the covered individual:</text>
      <level label="i">
        <text>makes a timely written request for an individual policy; and</text>
      </level>
      <level label="ii">
        <text>pays the first premium for the individual policy.</text>
      </level>
    </level>
    <level label="2">
      <text>By regulation the Commissioner shall establish rules to determine when a written request and payment of the required premium are timely.</text>
    </level>
  </level>
  <level label="e">
    <text>An individual policy issued under this section shall be guaranteed renewable for the term or to the limiting age for which benefits would have been provided if coverage under the group policy had not terminated.</text>
  </level>
  <level label="f">
    <text>The level of benefits under an individual policy issued under this section shall equal approximately the disability benefits that would have been provided if coverage under the group policy had not terminated.</text>
  </level>
  <level label="g">
    <level label="1">
      <text>The premium for an individual policy issued under this section shall be determined in accordance with the insurer’s table of premium rates that is applicable to the attained age and class of risk of the covered individual for the type and amount of insurance provided.</text>
    </level>
    <level label="2">
      <text>The insurer shall reserve the right to change the premium on any policy anniversary subject to approval by the Commissioner.</text>
    </level>
  </level>
  <level label="h">
    <text>The Commissioner may establish requirements that govern notification by the insurer or group policyholder to the individual whose coverage under the group policy is being terminated of the right of conversion to an individual policy.</text>
  </level>
  <level label="i">
    <text>The insurer may limit the right of conversion to individuals who have been covered under the group policy for at least 1 year.</text>
  </level>
  <level label="j">
    <text>Each group health insurance policy that was issued before January 1, 1984, shall be amended to comply with the requirements of this section on the first policy renewal anniversary date on or after January 1, 1984.</text>
  </level>
</section>
