33-22-141. Crediting previous coverage. (1) (a) A period of creditable coverage may not be counted, with respect to enrollment of an individual under a group health plan, if there was a 63-day break in coverage.
(b) The 63-day period provided for in subsection (1)(a) must be counted from the date that the certificate of creditable coverage was issued to the individual.
(2) The time that an individual is in a waiting period for coverage under a group health plan or for group health insurance coverage or is in an affiliation period, as defined in 33-31-102, may not be considered in determining the continuous period under subsection (1).
(3) Except as provided in subsection (4), for the purposes of applying 33-22-514, a group health plan or a health insurance issuer offering group health insurance coverage shall count a period of creditable coverage without regard to the specific benefits coverage during the period.
(4) (a) A group health plan or a health insurance issuer offering group health insurance may elect to apply the provisions of 33-22-514 based on coverage of benefits within each of several classes or categories of benefits specified in regulations implementing Public Law 104-191, rather than as provided under subsection (3). If electing to apply the provisions of 33-22-514 pursuant to this subsection (4), a group health plan or a health insurance issuer shall:
(i) make the election on a uniform basis for all participants and beneficiaries; and
(ii) count a period of creditable coverage with respect to any class or category of benefits if any level of benefits is covered within the class or category.
(b) In the case of an election under this subsection (4), a group health plan shall:
(i) prominently state in a disclosure statement concerning the group health plan to each enrollee at the time of enrollment that the group health plan has made an election; and
(ii) include a description of the effect of the election in the statement.
(c) In the case of an election under this subsection (4), a health insurance issuer shall:
(i) prominently state in a disclosure statement concerning the health insurance coverage to each employer at the time of the offer or sale of the health insurance coverage that the health insurance issuer has made an election; and
(ii) include a description of the effect of the election in the statement.
(5) Periods of creditable coverage with respect to an individual must be established through presentation of certifications described in 33-22-142 or in such other manner as may be specified in regulations implementing Public Law 104-191.
History: En. Sec. 34, Ch. 416, L. 1997; amd. Sec. 4, Ch. 384, L. 2003.
Structure Montana Code Annotated
Title 33. Insurance and Insurance Companies
Chapter 22. Disability Insurance
33-22-101. Exceptions to scope
33-22-102. Third-party ownership
33-22-104. through 33-22-106 reserved
33-22-107. Premium increase restriction -- exception -- notice of rate increase and policy changes
33-22-110. Preexisting conditions
33-22-113. Disability insurance coverage of persons eligible for public medical assistance
33-22-116. Prohibition on coverage of abortion services in qualified health plans
33-22-118. through 33-22-120 reserved
33-22-121. Notice required for cancellation or refusal to renew
33-22-122. Contents of notice -- proof -- limitation on recovery -- exemptions
33-22-123. Return of unearned premium
33-22-125. Independent chiropractic physical examination or review of records
33-22-126. and 33-22-127 reserved
33-22-128. Coverage for children with hearing loss -- definitions
33-22-130. Coverage for adopted children from time of placement -- preexisting conditions
33-22-131. Coverage for treatment of inborn errors of metabolism
33-22-132. Coverage for mammography examinations
33-22-133. Coverage for minimum hospital stay following childbirth
33-22-134. Postmastectomy care
33-22-135. Coverage for reconstructive breast surgery after mastectomy -- benefits and conditions
33-22-137. Cost-sharing requirements -- applicability
33-22-138. Coverage for telehealth services -- rulemaking
33-22-139. Coverage of therapies for Down syndrome
33-22-141. Crediting previous coverage
33-22-142. Certification of creditable coverage
33-22-144. through 33-22-149 reserved
33-22-152. Continuation of dependent coverage
33-22-154. and 33-22-155 reserved
33-22-156. Health insurance rates -- filing required -- use
33-22-157. Standards for review -- notice of deficiency
33-22-158. Trade secret disclosure exemption
33-22-160. through 33-22-165 reserved
33-22-167. through 33-22-169 reserved
33-22-171. Maximum allowable cost list -- limitations on drugs
33-22-173. Maximum allowable cost -- appeals process
33-22-174. Opt-out of reference pricing -- notification
33-22-175. Allowable and prohibited fees on pharmacies
33-22-176. Limitation on copayments
33-22-177. Rights of pharmacies
33-22-178. and 33-22-179 reserved
33-22-180. Contract coverage -- nondiscrimination -- penalty