§ 4090f. Exemptions; termination
(a) The insurer shall not be required to issue a converted policy if:
(1) termination under the group policy occurred because the person:
(A) was not entitled to continuation of group coverage under section 4090a of this title; or
(B) failed to elect continuation as provided in section 4090b of this title;
(2) the person is or could be covered by Medicare;
(3) the person is covered for similar benefits by another individual policy; or
(4) the person is or could be covered for similar benefits under any arrangement of coverage for individuals in a group, whether insured or uninsured or similar benefits are provided for or available to such person, by reason of any state or federal law and together with the converted policy’s benefits, would result in overinsurance according to the insurer’s standards for overinsurance.
(b) The converted policy may provide that as of any premium due date the insurer may refuse to renew or to cancel the policy if the person:
(1) would be overinsured or the person fails to provide the insurer with information upon which it can make a determination as to overinsurance;
(2) would be eligible for coverage under Medicare or under any other state or federal law providing for benefits similar to those provided by the converted policy; or
(3) is in default of any required contribution.
(c) Notice of the conversion privilege shall be included in each certificate of coverage. (Added 1983, No. 165 (Adj. Sess.), § 1.)
Structure Vermont Statutes
Title 8 - Banking and Insurance
Chapter 107 - Health Insurance
§ 4062. Filing and approval of policy forms and premiums
§ 4062b. Medicare supplemental health insurance
§ 4062c. Compliance with federal law
§ 4062e. Compliance with Medicaid recovery provisions
§ 4062f. Discretionary clauses prohibited
§ 4063. Form and contents of policy
§ 4063a. Coverage for civil unions
§ 4063b. Coverage for employees of an employer domiciled outside Vermont
§ 4064. Provisions applying to policies delivered in another state
§ 4065. Required standard policy provisions
§ 4066. Optional standard policy provisions
§ 4067. Omission of inapplicable or inconsistent standard provisions
§ 4068. Order of standard policy provisions
§ 4070. Requirements of other jurisdictions
§ 4071. Regulations on filing policies
§ 4072. Nonconforming policies
§ 4073. Applications for insurance
§ 4077. Termination; comprehensive major medical policies; grace period
§ 4079. Group insurance policies; definitions
§ 4079a. Association health plans
§ 4080. Required policy provisions
§ 4080d. Coordination of insurance coverage with Medicaid
§ 4080e. Medicare supplemental health insurance policies; community rating; disability
§ 4081. Blanket health insurance
§ 4082. Blanket insurance; policy contents
§ 4083. Discrimination prohibited
§ 4084a. Short-term, limited-duration health insurance
§ 4085a. Rebates prohibited for group insurance policies
§ 4086. Exemption from attachment and trustee process
§ 4087. Penalties for violations
§ 4088a. Chiropractic services
§ 4088b. Clinical trials for cancer patients
§ 4088c. Chemotherapy treatment
§ 4088d. Coverage for covered services provided by naturopathic physicians
§ 4088e. Notice of preferred drug list changes
§ 4088g. Coverage for covered services provided by athletic trainers
§ 4088h. Health insurance and the Blueprint for Health
§ 4088i. Coverage for diagnosis and treatment of early childhood developmental disorders
§ 4088j. Choice of providers for vision care and medical eye care services
§ 4088k. Physical therapy co-payments for certain plans
§ 4088l. Coverage for hearing aids [Effective January 1, 2024]
§ 4089. Services for victims of sexual assault
§ 4089a. Mental health care services review
§ 4089b. Health insurance coverage, mental health, and substance use disorder
§ 4089d. Coverage; dependent children
§ 4089e. Treatment of inherited metabolic diseases
§ 4089f. Independent external review of health care service decisions
§ 4089g. Craniofacial disorders
§ 4089h. Cancellation or nonrenewal of health insurance coverage
§ 4089i. Prescription drug coverage
§ 4089j. Retail pharmacies; filling of prescriptions
§ 4090a. Continuation of group
§ 4090b. Continuation; notice; terms
§ 4090c. Termination of coverage
§ 4090e. Conversion; notice; terms
§ 4090f. Exemptions; termination
§ 4091b. Policies and contracts covered
§ 4091c. Termination for nonpayment of premium or subscription charges
§ 4091d. Notice of termination
§ 4091e. Extension of benefits
§ 4092. Newborn infants; coverage
§ 4096. Home health care; insurance
§ 4099c. Reproductive health equity in health insurance coverage
§ 4099d. Midwifery coverage; home births
§ 4100a. Mammograms; coverage required
§ 4100c. Adopted child coverage
§ 4100d. Child vaccine benefits
§ 4100e. Required coverage for off-label use
§ 4100f. Prostate screenings; coverage required
§ 4100g. Colorectal cancer screening, coverage required
§ 4100h. Orally administered anticancer medication; coverage required
§ 4100i. Anesthesia coverage for certain dental procedures
§ 4100j. Coverage for tobacco cessation programs
§ 4100l. Coverage of health care services delivered by audio-only telephone