33-22-142. Certification of creditable coverage. (1) (a) A group health plan and a health insurance issuer offering group or individual health insurance coverage shall issue the certification described in subsection (3) within 10 days after a request by an individual who ceases to be covered under the group or individual health plan.
(b) A request for the certification may be made no later than 24 months after the date of termination of coverage.
(2) The certification may be provided, to the extent practicable, at a time consistent with notices required under any applicable COBRA continuation provision.
(3) Certification is the written:
(a) certification of the period of creditable coverage of the individual under a group or individual health plan and the coverage under any applicable COBRA continuation provision;
(b) certification of the waiting period, if any, and affiliation period, as defined in 33-31-102, if applicable, imposed with respect to the individual for any coverage under a group health plan;
(c) certification of the date of issuance of the certificate specified on the form; and
(d) notification to the individual of:
(i) the individual's conversion rights;
(ii) the availability of COBRA continuation coverage; and
(iii) other notification as determined necessary and in the form prescribed by rule by the commissioner.
(4) To the extent that medical care under a group health plan consists of group health insurance coverage, a group health plan satisfies the certification requirement of this section if the health insurance issuer offering the coverage provides the certification in accordance with this section.
(5) In the case of an election described in 33-22-141 by a group health plan or health insurance issuer, if the group health plan or health insurance issuer enrolls an individual for coverage under the group health plan and the individual provides a certification of coverage of the individual, the entity that issued the certification shall upon request of the group health plan or health insurance issuer promptly disclose information on coverage of classes and categories of health benefits available under the certified coverage. The entity may charge the requesting group health plan or health insurance issuer the reasonable cost of disclosing the information.
(6) At the time that an individual ceases to be covered by a group or individual health plan, the group health plan or health insurance issuer shall notify the individual that the individual may request the certification described in subsection (3) within the timeframes described in subsection (1).
History: En. Sec. 36, Ch. 416, L. 1997; amd. Sec. 5, Ch. 384, L. 2003; amd. Sec. 25, Ch. 271, L. 2009; amd. Sec. 20, Ch. 63, L. 2015; amd. Sec. 1, Ch. 225, L. 2015.
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