Termination of coverage

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§ 4090c. Termination of coverage

Continuation of insurance under the group policy shall terminate upon the occurrence of any of the following:

(1) The date 18 months after the date that insurance under the policy would have terminated due to a qualifying event, as defined in subsection 4090a(b) of this title.

(2) The person fails to make timely payment of the required contribution.

(3) The person is covered by Medicare.

(4) The person is covered by any other group insured or uninsured arrangement that provides dental coverage or hospital and medical coverage for individuals in a group, under which the person was not covered immediately prior to the occurrence of a qualifying event, as defined in subsection 4090a(b) of this title, and no preexisting condition exclusion applies; provided, however, that the person shall remain eligible for continuation coverages which are not available under the insured or uninsured arrangement.

(5) The date on which the group policy is terminated or, in the case of an employee, the date the decedent's or terminated employee's employer terminates participation under the group policy. If such coverage is replaced by similar coverage under another group policy:

(A) the person shall have the right to become covered under that replacement policy, for the balance of the period that he or she would have remained covered under the prior group policy;

(B) the minimum level of benefits to be provided by the replacement policy shall be the applicable level of benefits of the prior group policy reduced by any benefits payable under that prior group policy; and

(C) the prior group policy shall continue to provide benefits to the extent of its accrued liabilities and extensions of benefits as if the replacement has not occurred. (Added 1983, No. 165 (Adj. Sess.), § 1; amended 1985, No. 184 (Adj. Sess.), § 3; 2001, No. 121 (Adj. Sess.), § 5, eff. June 5, 2002; 2009, No. 61, § 16, eff. June 2, 2009.)


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