Montana Code Annotated
Part 1. General Provisions
33-22-141. Crediting previous coverage

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

Montana Code Annotated

Title 33. Insurance and Insurance Companies

Chapter 22. Disability Insurance

Part 1. General Provisions

33-22-101. Exceptions to scope

33-22-102. Third-party ownership

33-22-103. Repealed

33-22-104. through 33-22-106 reserved

33-22-107. Premium increase restriction -- exception -- notice of rate increase and policy changes

33-22-108. reserved

33-22-109. Riders

33-22-110. Preexisting conditions

33-22-111. Policies and certificates to provide for freedom of choice of practitioners -- professional practice not enlarged

33-22-112. Disability insurance coverage of services of state institutions -- provision void -- rate of payment

33-22-113. Disability insurance coverage of persons eligible for public medical assistance

33-22-114. Coverage required for services provided by physician assistants, advanced practice registered nurses, and registered nurse first assistants

33-22-115. Provider agreement limited to covered services -- dental network constraints -- penalty -- definitions

33-22-116. Prohibition on coverage of abortion services in qualified health plans

33-22-117. Construction

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

33-22-124. reserved

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

33-22-129. Coverage for outpatient self-management training and education for treatment of diabetes -- limited benefit for medically necessary equipment and supplies

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

33-22-136. Insurance for spouse and dependents of deceased peace officer, game warden, or firefighter

33-22-137. Cost-sharing requirements -- applicability

33-22-138. Coverage for telehealth services -- rulemaking

33-22-139. Coverage of therapies for Down syndrome

33-22-140. Definitions

33-22-141. Crediting previous coverage

33-22-142. Certification of creditable coverage

33-22-143. Rules

33-22-144. through 33-22-149 reserved

33-22-150. Reciprocal limitations on claim filing and claim audits -- time limit for reimbursements or offsets -- exceptions

33-22-151. Offset agreement

33-22-152. Continuation of dependent coverage

33-22-153. Coverage of routine patient costs for participants in cancer clinical trials -- definitions -- limitations

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

33-22-159. Rulemaking

33-22-160. through 33-22-165 reserved

33-22-166. Repealed

33-22-167. through 33-22-169 reserved

33-22-170. Definitions

33-22-171. Maximum allowable cost list -- limitations on drugs

33-22-172. Maximum allowable cost or reference price list -- price formulation, updating, and disclosure -- exceptions

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