Extension of benefits

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§ 4091e. Extension of benefits

(a) Every group health insurance policy or subscriber contract issued on or after July 1, 1989, or under which the level of benefits is altered, modified, or amended on or after July 1, 1989, shall provide a reasonable extension of benefits in the event of total disability of the employee or member on the date of termination of the group policy or contract in accordance with the provisions of this section.

(b) A policy or contract providing benefits for loss of time from work or specific indemnity during hospital confinement shall provide that termination of the policy or contract during a loss of time or confinement shall have no effect on benefits payable for the loss of time or confinement.

(c) A policy or contract providing hospital or medical expense coverage benefits shall provide an extension of benefits of at least 12 months under "major medical" and "comprehensive medical" type coverages, and at least 90 days under other types of hospital or medical expense coverages.

(d) The provisions of a policy or contract relating to extension of benefits or accrued liability shall be described in the policy or contract as well as in group insurance certificates. The benefits payable during a period of extension or accrued liability may be subject to the policy's or contract's regular benefit limits.

(e) The provisions of this section do not require an extension of dental benefits. (Added 1989, No. 113, § 21.)


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