58-67-130. Replacement coverage.
(a) Any carrier providing replacement coverage with respect to group hospital, medical, or surgical expense or service benefits, within a period of 60 days from the date of discontinuance of a prior HMO contract or policy providing such hospital, medical or surgical expense or service benefits, shall immediately cover all enrollees who were validly covered under the previous HMO contract or policy at the date of discontinuance and who would otherwise be eligible for coverage under the succeeding carrier's contract, regardless of any provisions of the contract relating to active employment or hospital confinement or pregnancy.
(b) Except to the extent benefits for the condition would have been reduced or excluded under the prior carrier's contract or policy, no provision in a succeeding carrier's contract of replacement coverage that would operate to reduce or exclude benefits on the basis that the condition giving rise to benefits preceded the effective date of the succeeding carrier's contract shall be applied with respect to those enrollees validly covered under the prior carrier's contract or policy on the date of discontinuance. (1989, c. 776. s. 13.)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 67 - Health Maintenance Organization Act.
§ 58-67-10 - Establishment of health maintenance organizations.
§ 58-67-11 - Additional HMO application information.
§ 58-67-12 - Commissioner use of consultants and other professionals.
§ 58-67-20 - Issuance and continuation of license.
§ 58-67-30 - Management and exclusive agreements; custodial agreements.
§ 58-67-35 - Powers of health maintenance organizations.
§ 58-67-45 - Fiduciary responsibilities.
§ 58-67-50 - Evidence of coverage and premiums for health care services.
§ 58-67-55 - Statements filed with Commissioner.
§ 58-67-65 - Prohibited practices.
§ 58-67-66 - Collaboration with local health departments.
§ 58-67-70 - Coverage for chemical dependency treatment.
§ 58-67-74 - Coverage for certain treatment of diabetes.
§ 58-67-75 - No discrimination against mentally ill or chemically dependent individuals.
§ 58-67-76 - Coverage for mammograms and cervical cancer screening.
§ 58-67-77 - Coverage for prostate-specific antigen (PSA) tests.
§ 58-67-78 - Coverage of certain prescribed drugs for cancer treatment.
§ 58-67-79 - Coverage for reconstructive breast surgery following mastectomy.
§ 58-67-80 - Meaning of terms "accident", "accidental injury", and "accidental means".
§ 58-67-85 - Master group contracts, filing requirement; required and prohibited provisions.
§ 58-67-88 - Continuity of care.
§ 58-67-90 - Licensing and regulation of agents.
§ 58-67-95 - Powers of insurers, hospitals, prepaid health plans, and medical service corporations.
§ 58-67-105 - Hazardous financial condition.
§ 58-67-110 - Protection against insolvency.
§ 58-67-115 - Hold harmless agreements or special deposit.
§ 58-67-120 - Continuation of benefits.
§ 58-67-125 - Enrollment period.
§ 58-67-130 - Replacement coverage.
§ 58-67-135 - Incurred but not reported claims.
§ 58-67-140 - Suspension or revocation of license.
§ 58-67-145 - Rehabilitation, liquidation, or conservation of health maintenance organization.
§ 58-67-155 - Administrative procedures.
§ 58-67-165 - Penalties and enforcement.
§ 58-67-170 - Statutory construction and relationship to other laws.
§ 58-67-171 - Other laws applicable to HMOs.
§ 58-67-175 - Filings and reports as public documents.