(a.1) Any group member or qualifying eligible individual who is an assistance-eligible individual as provided by Section 3001 of Title III of the federal American Recovery and Reinvestment Act (P.L. 111-5), as amended, during the period permitted under such act whose coverage has been terminated and who has been continuously covered under the group contract or group plan, and under any contract or plan providing similar benefits that it replaces, for at least six months immediately prior to such termination, shall be entitled to have his or her coverage and the coverage of his or her eligible dependents continued under the contract or plan in accordance with paragraph (2) of subsection (c) of this Code section. Such coverage shall continue for the fractional policy month remaining, if any, at termination plus up to the maximum number of additional policy months specified in paragraph (2) of subsection (c) of this Code section upon payment of the premium to the insurer by cash, certified check, or money order, at the same rate for active group members set forth in the contract or plan, on a monthly basis in advance as such premium becomes due during this coverage period. An assistance-eligible individual who is in a transition period as defined in Section 3001 of Title III of the federal American Recovery and Reinvestment Act (P.L. 111-5), as amended, shall be treated for purposes of any continuation of coverage provision as having timely paid such premium if such individual was covered under the continuation of coverage to which such premium relates for the period immediately preceding such transition period, if such individual remains eligible for such continuation of coverage, and if such individual pays the amount of such premium not later than 30 days after the date of provision of notice regarding eligibility for extended continuation of coverage. For the period that the assistance-eligible individual is eligible for the premium reduction assistance as provided in Section 3001 of Title III of the federal American Recovery and Reinvestment Act (P.L. 111-5), as amended, such premium payment shall be calculated as 35 percent of the rate for active group members including any portion of the premium paid by a former employer or other person if such employer or other person no longer contributes premium payments for this coverage.
(a.2) The rights and benefits under this Code section attributable to Section 3001 of Title III of the federal American Recovery and Reinvestment Act (P.L. 111-5), as amended, shall expire when that Act expires. Any extension of such benefits shall require an Act of the Georgia General Assembly. Under no circumstances shall the extended benefits for assistance-eligible individuals become the responsibility of this state or any insurer after the expiration of the premium subsidy made available to individuals pursuant to Section 3001 of Title III of the federal American Recovery and Reinvestment Act (P.L. 111-5), as amended.
History. Code 1981, § 33-24-21.1 , enacted by Ga. L. 1986, p. 688, § 1; Ga. L. 1990, p. 8, § 33; Ga. L. 1997, p. 1462, § 3; Ga. L. 1998, p. 1064, § 4; Ga. L. 2002, p. 441, § 10; Ga. L. 2009, p. 737, § 1/SB 94; Ga. L. 2010, p. 87, § 1/HB 1268; Ga. L. 2011, p. 752, § 33/HB 142; Ga. L. 2013, p. 873, § 2/HB 389; Ga. L. 2014, p. 866, § 33/SB 340; Ga. L. 2017, p. 164, § 16/HB 127; Ga. L. 2019, p. 386, § 33/SB 133.
The 2019 amendment, effective July 1, 2019, substituted “assistance-eligible” for “assistance eligible” throughout this Code section; substituted “Assistance-eligible” for “Assistance eligible” at the beginning of paragraph (a)(1); deleted “nonprofit hospital or nonprofit medical service corporation,” following “health maintenance organization,” in subparagraph (a)(2)(C); in subsection (a.2), substituted “Act” for “act” near the end of the first sentence and substituted “this state” for “the State of Georgia” in the middle of the second sentence; substituted “this Code section” for “this chapter” in subparagraphs (c)(2)(B) and (c)(2)(C); deleted “currently” preceding “offered under the group plans” in the middle of the first sentence of paragraph (c)(3); substituted “Termination” for “termination” at the beginning of subparagraphs (d)(1)(A) and (d)(1)(B), substituted “Any” for “any” at the beginning of subparagraph (d)(1)(C), substituted “Failure” for “failure” at the beginning of subparagraph (d)(2)(A), substituted “The” for “the” at the beginning of subparagraph (d)(2)(B), and substituted “Any” for “any” at the beginning of subparagraph (d)(2)(C); and substituted “Code section” for “chapter” near the beginning of subsection (m).
Cross references.
Renewal or continuation of coverage at option of insured, § 33-29-21 .
Individual health insurance coverage availability, T. 33, C. 29A.
Continuation of similar coverage, § 33-30-15 .
Code Commission notes.
Pursuant to Code Section 28-9-5, in 1997, “Code” was inserted preceding “section” in subparagraph (a)(6)(A) (now (a)(7)(A)), and in paragraph (g)(1), an ending quote and a semicolon were substituted for a period and an ending quote.
Pursuant to Code Section 28-9-5, in 2009, in paragraph (c)(2), “May 5, 2009,” was substituted for “the effective date of this paragraph”, and in subsection (l), “June 4, 2009” was substituted for “30 days after the effective date of this subsection”.
Pursuant to Code Section 28-9-5, in 2010, an extra comma was deleted following “months” in the second sentence of paragraph (c)(1).
Editor’s notes.
Ga. L. 1997, p. 1462, § 1, not codified by the General Assembly, provides that the Act, which amended this Code section, is intended to comply with the requirements of the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as well as to provide an acceptable alternative mechanism for the availability of individual health insurance coverage as contemplated by that federal Act; and further provides that the Act shall be narrowly construed to achieve such purpose without otherwise limiting the state’s legislative or regulatory powers with respect to insurance.
Ga. L. 2002, p. 441, § 1, not codified by the General Assembly, provides that: “This Act shall be known and may be cited as the ‘Consumers’ Health Insurance Protection Act.’ ”
Ga. L. 2002, p. 441, § 11, not codified by the General Assembly, provides that: “This Act shall apply only to health benefit plan contracts issued, delivered, issued for delivery, or renewed in this state on or after October 1, 2002; provided, however, that Section 8 of this Act shall apply to all claims relating to health care services provided on or after July 1, 2002. Any carrier, plan, network, panel, or agent thereof conducting a post-payment audit or imposing a retroactive denial on any claim initially submitted prior to July 1, 2002, shall, no later than June 30, 2003, provide written notice to the claimant of the intent to conduct such an audit or impose such a retroactive denial of any such claim or part thereof, including the specific reason for the audit or denial and shall complete the audit or retroactive denial and provide notice to the claimant of any payment or refund due prior to January 1, 2004.” The reference to Section 8 of the Act apparently should be to Section 9 of the Act, which enacted Article 3 of Chapter 20A of this title.
Ga. L. 2013, p. 873, § 1/HB 389, not codified by the General Assembly, provides that: “This Act shall be known and may be cited as the ‘Georgia Health Insurance Enhancement Act of 2013.’ ”
U.S. Code.
The Patient Protection and Affordable Care Act, referred to in this Code section, are codified throughout the United States Code and primarily in T. 42.
Law reviews.
For review of 1998 legislation relating to insurance, see 15 Georgia St. U.L. Review 153 (1998).
For note on the 2002 amendment of this Code section, see 19 Georgia St. U.L. Review 220 (2002).
Structure Georgia Code
Chapter 24 - Insurance Generally
Article 1 - General Provisions
§ 33-24-2. Applicability of Chapter
§ 33-24-3. Insurable Interest; Personal Insurance
§ 33-24-4. Insurable Interest; Property Insurance
§ 33-24-6.1. Prerequisites for Replacement Life Insurance Exceeding Insurance Being Surrendered
§ 33-24-8. Admissibility in Evidence of Applications in Actions Between Insurer and Insured
§ 33-24-9. Approval or Disapproval of Forms
§ 33-24-10. Grounds for Disapproval of Forms
§ 33-24-10.1. Standard or Uniform Claim Form
§ 33-24-13. Execution of Policies; Use of Facsimile Signatures
§ 33-24-14.1. Electronic Delivery of Plan Documentation
§ 33-24-15. When Policies or Contracts Become Effective
§ 33-24-16. Construction of Policies
§ 33-24-16.1. Clarification of Term “Actual Charge” or “Actual Fee”
§ 33-24-17. Assignment of Policies
§ 33-24-18. Contents of Insurance Policies and Annuity Contracts Generally
§ 33-24-19. Incorporation of Constituent Documents in Policies
§ 33-24-22. Provision in Health Insurance Policies for Coverage of Newly Born or Adopted Children
§ 33-24-28. Termination of Coverage of Dependent Child Upon Attainment of Specified Age
§ 33-24-28.1. Coverage of Treatment of Mental Health or Substance Use Disorders
§ 33-24-28.2. Coverage of Outpatient Surgery
§ 33-24-30. Excluding or Denying Coverage on Basis of Violation of Civil Air Regulations
§ 33-24-30.1. Excluding or Denying Coverage on Basis of Lawful Firearms Possession
§ 33-24-32. Underwriters’ and Combination Policies
§ 33-24-33. Binders and Other Contracts for Temporary Insurance
§ 33-24-35. Withdrawal or Retirement From Group Insurance Plan
§ 33-24-38. Renewal or Extension of Policies by Certificate or Endorsement
§ 33-24-41. Discharge of Insurer by Payment Generally
§ 33-24-41.2. Written Notice by Insurer to Claimant of Payment of Claim in Third-Party Settlement
§ 33-24-42. Payment of Claims in Event of Simultaneous Deaths
§ 33-24-44. Cancellation of Policies Generally
§ 33-24-44.1. Procedure for Cancellation by Insured and Notice
§ 33-24-46. Cancellation or Nonrenewal of Certain Property Insurance Policies
§ 33-24-49. Deposit of Funds Covered by Bonds
§ 33-24-50. Action as Sureties Upon Guaranteed Arrest Bond Certificates; Acceptance of Certificates
§ 33-24-52. Direct Response Insurance Business
§ 33-24-54. Payments to Nonparticipating or Nonpreferred Providers of Health Care Services
§ 33-24-56. Prohibition Against Requiring Referral From Primary Care Physician to Dermatologist
§ 33-24-56.2. Surveillance Tests for Ovarian Cancer
§ 33-24-56.3. Colorectal Cancer Screening and Testing
§ 33-24-56.4. Short Title; Definitions; Payment for Telehealth Services
§ 33-24-58. Newborn Baby and Mother Protection Act; Short Title
§ 33-24-58.1. Newborn Baby and Mother Protection Act; Legislative Findings and Declaration
§ 33-24-59.1. Coverage for Treatment of Dependent Children With Cancer
§ 33-24-59.3. Payments Sent Directly to Health Care Provider by Insurer
§ 33-24-59.6. Prescribed Female Contraceptive Drugs or Devices; Insurance Coverage
§ 33-24-59.9. Registered Nurse First Assistants
§ 33-24-59.10. Coverage for Autism
§ 33-24-59.12. Patient Access to Eye Care
§ 33-24-59.14. Definitions; Prompt Pay Requirements; Penalties
§ 33-24-59.15. Definitions; Dental Insurance
§ 33-24-59.16. Equal Access to Child’s Health Insurance Information; Exceptions
§ 33-24-59.18. Coverage for Treatment of a Terminal Condition
§ 33-24-59.20. Access to Stage Four Advanced, Metastatic Cancer Treatments in Health Benefit Plans
§ 33-24-59.22. Prescription Drug Program Defined; Cost Sharing; Denial of Coverage; Dispensing Fees
§ 33-24-59.23. Carrier Issuing Health Benefit Plans to Pay Insurance Agent’s Commissions; Regulation
§ 33-24-59.26. Limitation on Definition of “Preexisting Condition”
§ 33-24-59.27. Right to Shop for Insurance Coverage; Disclosure of Pricing Information; Notice
§ 33-24-59.28. Insurer Obligations for Early Prescription Refills During Emergencies