§432D-29 Prohibition on rescissions of coverage. (a) Notwithstanding sections 431:10-226.5 and 431:10A-106 to the contrary, a health maintenance organization shall not rescind coverage under a health benefit plan with respect to an individual, including a group to which the individual belongs or family coverage in which the individual is included, after the individual is covered under the plan, unless:
(1) The individual or a person seeking coverage on behalf of the individual performs an act, practice, or omission that constitutes fraud;
(2) The individual makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage; or
(3) The individual fails to timely pay required premiums or contributions toward the cost of coverage; provided that the rescission is in compliance with federal regulations.
As used in this subsection, "a person seeking coverage on behalf of the individual" shall not include an insurance producer or employee or authorized representative of the health carrier.
(b) A health maintenance organization shall provide at least thirty days advance written notice to each plan enrollee or, for individual health insurance coverage, to each primary subscriber, who would be affected by the proposed rescission of coverage before coverage under the plan may be rescinded in accordance with subsection (a) regardless of whether, in the case of group health insurance coverage, the rescission applies to the entire group or only to an individual within the group.
(c) This section applies regardless of any applicable contestability period. [L 2014, c 186, §3]
Structure Hawaii Revised Statutes
432D. Health Maintenance Organization Act
432D-1.5 Bona fide trade associations.
432D-2 Establishment of health maintenance organizations.
432D-3 Powers of health maintenance organizations.
432D-4 Fiduciary responsibilities.
432D-5 Annual and quarterly reports.
432D-6 Information to enrollees or subscribers.
432D-8 Protection against insolvency.
432D-9 Uncovered expenditures insolvency deposit.
432D-9.5 Reserve credit for reinsurance.
432D-12 Powers of insurers and hospital and medical service corporations.
432D-14 Suspension, revocation, or denial of certificate of authority.
432D-15 Rehabilitation, liquidation, or conservation of health maintenance organizations.
432D-16 Summary orders and supervision.
432D-18 Penalties and enforcement.
432D-19 Statutory construction and relationship to other laws.
432D-20 Filings and reports as public documents.
432D-21 Confidentiality of medical information.
432D-22 Acquisition of control of or merger of a health maintenance organization.
432D-23 Required provisions and benefits.
432D-23.5 Coverage for telehealth.
432D-23.6 Federally funded programs; exemption.
432D-24 Coordination of benefits.
432D-25 Disclosure of health care coverage and benefits.
432D-26 Genetic information nondiscrimination in health insurance coverage.
432D-27 Policies relating to domestic abuse cases.
432D-28 Federal law compliance.
432D-29 Prohibition on rescissions of coverage.
432D-30 Medication synchronization; proration; dispensing fees.
432D-31 Extension of dependent coverage.
432D-32 Prohibition of preexisting condition exclusions.
432D-33 Prohibited discrimination in premiums or contributions.