627.646 Conversion on termination of eligibility.
627.646 Conversion on termination of eligibility.
(1) Every health insurance policy providing hospital or medical expense coverage hereafter delivered or issued for delivery in this state or under which benefits are altered, modified, or amended shall contain a provision that, if the insurance on a person covered under the policy ceases because of the termination of such person’s eligibility for coverage prior to his or her becoming eligible for Medicare or Medicaid benefits, then such person shall be entitled to have issued to him or her by the insurer, without evidence of insurability, a policy of health insurance, either individual or family, whichever is appropriate, provided application for the policy is made and the first premium is paid to the insurer within 31 days after such termination, and provided further that:
(a) The coverage under the policy shall be in an amount equal to or, at the option of the insured, less than the amount of health insurance which ceases because of such termination.
(b) The premium on the policy shall be at the insurer’s then customary rate applicable to such policies, to the class of risk to which such person then belongs, and to his or her age attained on the effective date of the policy.
(c) The policy of health insurance will not result in overinsurance on the basis of the company underwriting standards at the time of issue.
(d) The policy of health insurance may be reduced by the amount of any benefits paid for the same injury or same sickness under the prior policy.
(e) The policy of health insurance may exclude any condition excluded by the prior policy.
(2) An insurer shall offer maternity benefits and dental benefits if those benefits were provided in the policy.
(3) The provisions of this section shall be effectuated in such a way as to result in continuous coverage during the 31-day period for such insured.
(4) This section does not apply to disability income, Medicare supplement, accident only, hospital indemnity, specified disease, limited benefit, nonconventional, or excess policies.
History. s. 1, ch. 78-385; s. 2, ch. 81-318; ss. 495, 497, 809(2nd), ch. 82-243; ss. 60, 79, ch. 82-386; s. 3, ch. 90-249; s. 114, ch. 92-318; s. 345, ch. 97-102.