Indiana Code
Chapter 15. Small Employer Group Health Insurance
27-8-15-28. Waiver of Exclusion and Limitation Period

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

Indiana Code

Title 27. Insurance

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

27-8-15-2. Repealed

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"

27-8-15-7. "Commissioner"

27-8-15-8. "Department"

27-8-15-8.5. "Eligible Employee"

27-8-15-9. "Health Insurance Plan"

27-8-15-10. "Insurer"

27-8-15-10.5. "Late Enrollee"

27-8-15-11. "Midpoint Rate"

27-8-15-12. "New Business Premium Rate"

27-8-15-13. "Rating Period"

27-8-15-14. "Small Employer"

27-8-15-15. "Small Employer Insurer"

27-8-15-16. Premium Rates

27-8-15-17. Rating Factors

27-8-15-18. Offer to Transfer

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

27-8-15-25. Availability of Information and Documentation to Commissioner; Disclosure by Commissioner

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. Conversion Policy

27-8-15-31.1. Continuing Coverage

27-8-15-32. Employees Becoming Eligible After Employer's Commencement of Health Insurance Plan Entitled to Coverage

27-8-15-33. Mandatory Coverage by Employer Insurer to All Employer's Eligible Employees and Employees' Dependents; Employees Declining Coverage; Minimum Participation and Contribution Requirements

27-8-15-34. Repealed

27-8-15-34.1. All Products Required to Be Offered; All Employers Required to Be Accepted