Source: http://www.state.me.us/pfr/insurance/review_checklists/Rate_filing_Group_hospital_confinement_indemnity.htm
Timestamp: 2014-10-20 13:26:08
Document Index: 775986289

Matched Legal Cases: ['§2816', '§2707', '§2847', '§5016', '§2836', '§2833', '§2847', '§2846', '§5013', '§2844', '§4320', '§4233']

Group Hospital Confinement Indemnity - H14G : Form & Rate Filing Review Checklists : Bureau of Insurance
> Company Services > Review Checklists > H14G - Group Hospital Confinement Indemnity
H14G - Group Hospital Confinement Indemnity
Required provisions 24-A M.R.S.A. §2816
Application statements, notice of claim, proof of loss, assignment of benefits Third Party Notice, Cancellation and Reinstatement
24-A M.R.S.A. §2707-A
§2847-C 24-A M.R.S.A.
§5016
Third party notice of cancellation and reinstatement for cognitive impairment or functional incapacity Designation of Classification of Coverage
Must comply with all applicable provisions of Rule 755 including, but not limited to, Sections 4, 5, 6(A), 6(E), 7(A), 7(B), 7(F), and 8.
Limits on priority liens 24-A M.R.S.A. §2836
Policy must contain the terms under which the policy can or cannot be renewed Child coverage 24-A M.R.S.A. §2833-A
If radiological procedures are covered Penalty for failure to notify of hospitalization 24-A M.R.S.A. §2847-A
AIDS 24-A M.R.S.A. §2846
may not provide more restrictive benefits for expenses resulting from Acquired Immune Deficiency Syndrome (AIDS) or related illness. Notice Regarding Policies or Certificates Which are Not Medicare Supplement Policies 24-A M.R.S.A. §5013, Rule 275, Sec. 17(D)
There must be a notice predominantly displayed on the first page of the policy that states: "THIS [POLICY OR CERTIFICATE] IS NOT A MEDICARE SUPPLEMENT [POLICY OR CONTRACT]. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare available from the company." Coordination of benefits 24-A M.R.S.A. §2844
Must provide an extension of benefits of at least 6 months for a person who is totally disabled on the date the group or subgroup policy is discontinued. For a policy providing specific indemnity during hospital confinement, "extension of benefits" means that discontinuance of the policy during a disability has no effect on benefits payable for that confinement. Representations on Applications
There shall be a provision that all statements contained in any such application for insurance shall be deemed representations and not warranties. Child coverage
§4320-B Extension of coverage for dependent children. Certain policies subject to ACA must extend coverage to age 26.
24-A M.R.S.A. §4233-B
A health maintenance organization shall provide notice to policyholders regarding the availability of dependent coverage under this section upon each renewal of coverage or at lease once annually, whichever occurs more frequently. Notice provided under this subsection must include information about enrolment periods and notice of the insurer’s definition of and benefit limitations for preexisting conditions.