Sec. 28. (a) As used in this section, "health insurance plan" means coverage provided under any of the following:
(1) A hospital or medical expense incurred policy or certificate.
(2) A hospital or medical service plan contract.
(3) A health maintenance organization subscriber contract.
(4) Medicare or Medicaid.
(5) An employer based health insurance arrangement.
(6) An individual health insurance policy.
(7) A policy issued by the Indiana comprehensive health insurance association under IC 27-8-10.
(8) An employee welfare benefit plan (as defined in 29 U.S.C. 1002) that is self-funded.
(9) A conversion policy issued under section 31 or 31.1 of this chapter.
(b) Except as provided in section 29 of this chapter, a small employer insurer shall waive the exclusion period described in section 27 of this chapter applicable to a preexisting condition or the limitation period with respect to a particular service in a health insurance plan for the time an eligible employee or a dependent of an eligible employee was previously covered by a health insurance plan if the following conditions are met:
(1) The eligible employee or a dependent of the eligible employee was previously covered by a health insurance plan that provided benefits with respect to the particular service.
(2) Coverage under the health insurance plan was continuous to a date not more than sixty-three (63) days before the effective date of enrollment by:
(A) the eligible employee; or
(B) a dependent of the eligible employee.
(c) In determining whether an eligible employee or a dependent of the eligible employee meets the requirements of subsection (b)(2), a waiting period imposed by a small employer insurer or small employer before new coverage may become effective must be excluded from the calculation.
(d) This section does not preclude the application of any waiting period applicable to all new enrollees under a plan.
As added by P.L.93-1995, SEC.16. Amended by P.L.190-1996, SEC.6; P.L.91-1998, SEC.19.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 15. Small Employer Group Health Insurance
27-8-15-0.1. Application of Certain Amendments to Chapter
27-8-15-1. Application of Chapter
27-8-15-3. "Actuarial Certification"
27-8-15-4. "Base Premium Rate"
27-8-15-5. "Benefit Design Characteristics"
27-8-15-6. "Case Characteristics"
27-8-15-8.5. "Eligible Employee"
27-8-15-9. "Health Insurance Plan"
27-8-15-12. "New Business Premium Rate"
27-8-15-15. "Small Employer Insurer"
27-8-15-19. Cancellation or Refusal of Renewal of Plans
27-8-15-20. Renewal Cessation; Notice
27-8-15-21. Renewal Cessation; Prohibitions
27-8-15-22. Disclosure of Premium Rate Changes
27-8-15-23. Maintenance of Rating and Renewal Practice Information and Documentation
27-8-15-24. Maintenance of Actuarial Certification; Submission to Department
27-8-15-26. Suspension of Premium Rate Provisions
27-8-15-27. Application in Conformity With Act; Compliance
27-8-15-28. Waiver of Exclusion and Limitation Period
27-8-15-29. Application in Conformity With Act; Exclusion of Coverage
27-8-15-30. Plan Modifications Prohibited
27-8-15-31.1. Continuing Coverage
27-8-15-34.1. All Products Required to Be Offered; All Employers Required to Be Accepted