376.438. Group policies, modifying or amending benefits shall provide extension of benefits in event of total disability at date of termination or discontinuance.
Group policies, modifying or amending benefits shall provideextension of benefits in event of total disability at date oftermination or discontinuance.
376.438. 1. Every group policy or other contract subject to sections376.431 to 376.442, or under which the level of benefits is hereafteraltered, modified or amended, must provide a reasonable provision forextension of benefits in the event of total disability at the date of anytermination or discontinuance of the group policy or contract, regardlessof the reason for the termination or discontinuance, as required by thefollowing subdivisions of this subsection:
(1) In the case of a group life plan which contains a disabilitybenefit extension of any type, such as premium waiver extension, extendeddeath benefit in event of total disability, or payment of income for aspecified period during total disability, the discontinuance of the grouppolicy shall not operate to terminate such extension;
(2) In the case of a group plan providing benefits for loss of timefrom work or specific indemnity during hospital confinement, discontinuanceof the policy during a disability shall have no effect on benefits payablefor that disability or confinement;
(3) In the case of health maintenance organization, hospital ormedical expense coverages other than dental and maternity expense, areasonable extension of benefits or accrued liability provision isrequired. Such a provision will be considered reasonable if it provides anextension of at least twelve months under health maintenance organization,major medical and comprehensive medical type coverages, and under othertypes of hospital or medical expense coverages provides either an extensionof at least ninety days or an accrued liability for expenses incurredduring a period of disability or during a period of at least ninety daysstarting with a specific event which occurred while coverage was in force.
2. Any applicable extension of benefits or accrued liability shall bedescribed in any policy or contract involved as well as in insurancecertificates of coverage issued to employees or members. The benefitspayable during any period of extension or accrued liability may be subjectto the policy's or contract's regular benefit limits.
(L. 1985 H.B. 623, A.L. 1999 H.B. 903)(1997) Statute is not preempted by ERISA. United of Omaha v. Business Men's Assurance Co., 104 F.3d 1034 (8th Cir.).