reglab/housing_qa huggingface dataset:
MT Code § 33-22-510 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-510. Insured's family -- conversion entitlement

  33-22-510. Insured's family -- conversion entitlement. Subject to the conditions set forth in this section, the conversion privilege is also available:   (1) to the surviving spouse, if any, at the death of the employee or member, with respect to the spouse and children whose coverage under the group policy terminates by reason of the death, otherwise to each surviving child whose coverage under the group policy terminates by reason of the death, or if the group policy provides for continuation of dependent's coverage following the employee's or member's death, at the end of the continuation;   (2) to the spouse of the employee or member upon termination of coverage of the spouse, by reason of ceasing to be a qualified family member under the group policy, while the employee or member remains under the group policy, including children whose coverage under the group policy terminates at the same time; or   (3) to a child solely with respect to the child upon termination of child's coverage by reason of ceasing to be a qualified family member under the group policy if a conversion privilege is not otherwise provided in this section with respect to the termination.   History: En. Sec. 8, Ch. 579, L. 1981; amd. Sec. 1229, Ch. 56, L. 2009.
MT Code § 33-22-511 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-511. Applicability

  33-22-511. Applicability. Notwithstanding any provision of Title 33 or other law to the contrary, it shall be lawful for an insurer and insured to agree to any terms in an insurance contract that provides more favorable terms for the benefit of the insured than authorized in Title 33 or other provisions of law.   History: En. Sec. 9, Ch. 579, L. 1981.
MT Code § 33-22-512 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-512. Coverage for well-child care

  33-22-512. Coverage for well-child care. (1) Each group disability policy or certificate of insurance that is delivered, issued for delivery, renewed, extended, or modified in this state by a disability insurer and that provides coverage for a family member of the insured or subscriber must provide coverage for well-child care for children from the moment of birth through 7 years of age. Benefits provided under this coverage are exempt from any deductible provision that may be in force in the policy or certificate issued under the policy.   (2) Coverage for well-child care under subsection (1) must include:   (a) a history, physical examination, developmental assessment, anticipatory guidance, and laboratory tests, according to the schedule of visits adopted under the early and periodic screening, diagnosis, and treatment services program provided for in 53-6-101; and   (b) routine immunizations according to the schedule for immunizations recommended by the immunization practices advisory committee of the U.S. department of health and human services.   (3) Minimum benefits may be limited to one visit payable to one provider for all of the services provided at each visit cited in this section.   (4) This section does not apply to disability income, specified disease, accident-only, medicare supplement, or hospital indemnity policies or certificates.   (5) For purposes of this section:   (a) "developmental assessment" and "anticipatory guidance" mean the services described in the Guidelines for Health Supervision II, published by the American academy of pediatrics; and   (b) "well-child care" means the services described in subsection (2) and delivered by a physician or a health care professional supervised by a physician.   (6) When a group disability policy or certificate of insurance issued under the policy provides coverage or benefits to a resident of this state, it is considered to be delivered in this state within the meaning of this section, whether the insurer that issued or delivered the policy or certificate is located inside or outside of this state.   History: En. Sec. 2, Ch. 199, L. 1991; amd. Sec. 40, Ch. 380, L. 2003; amd. Sec. 3, Ch. 390, L. 2007.
MT Code § 33-22-513 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-513. Limitation of eligibility on conversion

  33-22-513. Limitation of eligibility on conversion. An individual who purchases a policy of insurance under 33-22-508 ceases to be eligible for a conversion policy if the individual insured by the policy:   (1) fails to pay the premium on the policy purchased under 33-22-508; or   (2) enrolls under another major medical disability insurance policy or plan, except that the individual may maintain the conversion policy during any waiting period established under any new disability insurance policy or plan that the insured individual purchases.   History: En. Sec. 3, Ch. 200, L. 1991; amd. Sec. 15, Ch. 399, L. 2007.
MT Code § 33-22-514 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-514. Preexisting conditions relating to group market

  33-22-514. Preexisting conditions relating to group market. (1) A group health plan or a health insurance issuer offering group health insurance coverage may not exclude coverage for a preexisting condition unless:   (a) medical advice, diagnosis, care, or treatment was recommended or received by the participant or beneficiary within the 6-month period ending on the enrollment date;   (b) exclusion of coverage extends for a period of not more than 12 months or 18 months in the case of a late enrollee; and   (c) the period of the preexisting condition exclusion is reduced by the aggregate of the periods of creditable coverage applicable to the participant or beneficiary as of the enrollment date.   (2) Genetic information may not be excluded as a preexisting condition in the absence of a diagnosis of the condition related to the genetic information.   (3) Pregnancy may not be excluded as a preexisting condition.   History: En. Sec. 39, Ch. 416, L. 1997; amd. Sec. 44, Ch. 472, L. 1999.
MT Code § 33-22-516 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-516. through 33-22-520 reserved

  33-22-516 through 33-22-520 reserved.
MT Code § 33-22-521 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-521. Disclosure standards -- group policy

  33-22-521. Disclosure standards -- group policy. (1) In order to provide for full and fair disclosure in the sale of disability insurance, a group disability insurance policy may not be delivered or issued for delivery in this state unless an outline of coverage is filed with and approved by the insurance commissioner in accordance with 33-1-501 and is delivered to the applicant at the time the application is made.   (2) The outline of coverage must include:   (a) a general description of the principal benefits and coverages provided by the policy;   (b) a general description of the insured's financial responsibility under the policy, including, if applicable, the amount of the deductible, the amount or percentage of copayment, and the maximum annual out-of-pocket expenses to be paid by the insured;   (c) a statement of the maximum lifetime benefit available under the policy;   (d) a statement of the estimated periodic premium to be paid by the insured;   (e) a general description of the factors or case characteristics that the insurer may consider in establishing or changing the premiums and, if applicable, in determining the insurability of the applicant;   (f) a description of any preauthorization or other preapproval requirements for medical care;   (g) a prominently displayed statement of the insured's responsibility for payment of billed charges beyond those charges reimbursed by the insurer when the insured uses health care services from a health care provider who is outside a network of health care providers used by the insurer; and   (h) a general description of the trend of premium increases or decreases for comparable policies issued by the insurer during the preceding 5 years, if the trend data is available.   (3) If applicable, the outline of coverage must disclose that the policy does not contain coverage for mental illness or chemical dependency.   (4) The outline of coverage may include any other information that the insurer considers relevant to the applicant's selection of an appropriate group disability policy.   (5) An insurer or producer shall provide to an individual, upon request, an outline of coverage for any health benefit product marketed to the general public. The outline of coverage provided under this subsection may exclude the statement of the estimated periodic premium to be paid by the insured.   (6) An outline of coverage must also be sent to an employee when an employee is sent a certificate of insurance.   (7) Prior to issuance of a group disability insurance policy, written informational materials describing the policy's cancer screening coverages must be provided to a prospective applicant. The informational materials are not subject to filing with and approval of the insurance commissioner.   History: En. Sec. 6, Ch. 527, L. 1995; amd. Sec. 3, Ch. 336, L. 2001; amd. Sec. 4, Ch. 463, L. 2007; amd. Sec. 2, Ch. 207, L. 2009.
MT Code § 33-22-522 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-522. Repealed

  33-22-522. Repealed. Sec. 22, Ch. 169, L. 2013.   History: En. Sec. 9, Ch. 527, L. 1995; amd. Sec. 2, Ch. 504, L. 1997.
MT Code § 33-22-523 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-523. Special enrollment periods

  33-22-523. Special enrollment periods. (1) A group health plan and a health insurance issuer offering group health insurance coverage in connection with a group health plan shall permit an employee or a dependent of an employee who is eligible, but not enrolled, for coverage under the terms of the group health plan to enroll for coverage under the terms of the group health plan if:   (a) the employee or dependent was covered under a group health plan or had health insurance coverage at the time that coverage was previously offered to the employee or dependent;   (b) the employee stated in writing at the time that coverage under a group health plan or health insurance coverage was the reason for declining enrollment, but only if the plan sponsor or health insurance issuer required the statement at the time and provided the employee with notice of the requirement and the consequences of the requirement at the time;   (c) the employee's or dependent's coverage described in subsection (1)(a) was:   (i) under a COBRA continuation provision and was exhausted; or   (ii) not under a COBRA continuation provision and was terminated as a result of loss of eligibility for the coverage or because employer contributions toward the coverage were terminated; and   (d) under the terms of the group health plan, the employee requests the enrollment not later than 30 days after the date of exhaustion of coverage described in subsection (1)(c)(i) or termination of coverage or employer contribution described in subsection (1)(c)(ii).   (2) (a) A group health plan must provide for a dependent special enrollment period described in subsection (2)(b) during which a dependent may be enrolled under the group health plan as a dependent of the individual if the person becomes a dependent of the individual through marriage, birth, adoption, or placement for adoption. In the case of the birth or adoption of a child, the spouse of the individual may be enrolled as a dependent of the individual if the spouse is otherwise eligible for coverage.   (b) A dependent special enrollment period under this subsection (2) is a period of not less than 30 days that begins on the later of:   (i) the date dependent coverage is made available; or   (ii) the date of the marriage, birth, adoption, or placement for adoption.   (3) If an individual seeks to enroll a dependent during the first 30 days of the dependent special enrollment period, the coverage of the dependent becomes effective:   (a) in the case of marriage, not later than the first day of the first month beginning after the date on which the completed request for enrollment is received;   (b) in the case of a dependent's birth, as of the date of birth; or   (c) in the case of a dependent's adoption or placement for adoption, the date of the adoption or placement for adoption.   History: En. Sec. 35, Ch. 416, L. 1997; amd. Sec. 45, Ch. 472, L. 1999.
MT Code § 33-22-525 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-525. Guaranteed renewability in multiple employer welfare arrangements

  33-22-525. Guaranteed renewability in multiple employer welfare arrangements. A group health plan that is a multiple employer welfare arrangement, as defined by 29 U.S.C. 1002, may not deny an employer whose employees are covered under the group health plan continued access to the same or different coverage under the terms of the group health plan other than:   (1) for nonpayment of contributions;   (2) for fraud or other intentional misrepresentation of material fact by the employer;   (3) for noncompliance with material plan provisions;   (4) because the group health plan is ceasing to offer any coverage in a geographic area;   (5) in the case of a group health plan that offers benefits through a network plan, because there is no longer any individual enrolled through the employer who lives, resides, or works in the service area of the network plan and the group health plan applies to this section uniformly without regard to the claims experience of employers or any health status-related factor of those individuals or their dependents; or   (6) for failure to meet the terms of an applicable collective bargaining agreement, to renew a collective bargaining or other agreement requiring or authorizing contributions to the group health plan, or to employ employees covered by the agreement.   History: En. Sec. 42, Ch. 416, L. 1997.
MT Code § 33-22-526 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-526. Group health discrimination prohibited

  33-22-526. Group health discrimination prohibited. (1) (a) A group health plan or a health insurance issuer offering group health insurance coverage may not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of the group health plan based on any of the following health status-related factors of the individual or a dependent of the individual:   (i) health status;   (ii) medical condition, including both physical and mental illnesses;   (iii) claims experience;   (iv) receipt of health care;   (v) medical history;   (vi) genetic information;   (vii) evidence of insurability, including conditions arising out of acts of domestic violence; or   (viii) disability.   (b) This subsection does not:   (i) require a group health plan or group health insurance coverage to provide particular benefits other than those provided under the terms of the group health plan or group health insurance coverage; or   (ii) prevent the group health plan or group health insurance coverage from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the group health plan or group health insurance coverage.   (c) For purposes of subsection (1)(a), rules for eligibility to enroll under a group health plan include rules defining an applicable waiting period for the enrollment.   (2) (a) A group health plan and a health insurance issuer offering health insurance coverage in connection with a group health plan may not require an individual, as a condition of enrollment or continued enrollment under the group health plan, to pay a premium or contribution that is greater than the premium or contribution for a similarly situated individual enrolled in the group health plan on the basis of any health status-related factor of the individual or of an individual enrolled under the plan as a dependent of the individual.   (b) This subsection (2) does not:   (i) restrict the amount that an employer may be charged for coverage under a group health plan; or   (ii) prevent a group health plan and a health insurance issuer offering group health insurance coverage from establishing premium discounts or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.   History: En. Sec. 44, Ch. 416, L. 1997.
MT Code § 33-22-527 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-527. through 33-22-529 reserved

  33-22-527 through 33-22-529 reserved.
MT Code § 33-22-530 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 5. Group Disability Insurance|33-22-530. Notice required for cancellation for nonpayment of group health insurance

  33-22-530. Notice required for cancellation for nonpayment of group health insurance. (1) A health insurance issuer shall provide at least 15 days prior notification of cancellation for nonpayment of premium for group health insurance coverage.   (2) The notice must be sent to the policyholder at the policyholder's last-known address and must specify the date of cancellation of coverage. The insurer shall attach a properly executed proof of mailing to this notice and maintain a copy of the proof of mailing in its records.   (3) The health insurance issuer shall hold for processing of payment any claims for covered benefits incurred during the 15-day notification period for nonpayment of premium for group health insurance coverage. Upon receipt of the premium, claims held for the 15-day notification period must be processed for payment.   (4) The policy continues in full force and effect, subject to the requirements of subsection (3), until the proper 15-day notice has been given, unless the coverage has already been replaced.   (5) The 15-day period begins to run from the date of the proof of mailing.   (6) The issuer may collect premiums for any time period that the coverage remains in effect.   (7) When coverage is actually canceled, notice must also be mailed to all certificate holders at:   (a) their last-known home addresses if available; or   (b) the business address of the group policyholder.   (8) The notice of cancellation to certificate holders must be separate from the certificate of creditable coverage required in 33-22-142, although it may be mailed simultaneously with the certificate.   History: En. Sec. 2, Ch. 384, L. 2003; amd. Sec. 28, Ch. 271, L. 2009.
MT Code § 33-22-601 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 6. Blanket Disability Insurance|33-22-601. Blanket disability insurance defined

  33-22-601. Blanket disability insurance defined. Blanket disability insurance is hereby declared to be that form of disability insurance covering groups of persons as enumerated in one of the following subsections:   (1) under a policy or contract issued to any common carrier or to any operator, owner, or lessee of a means of transportation, who or which shall be deemed the policyholder, covering a group defined as all persons or all persons of a class who may become passengers on such common carrier or such means of transportation;   (2) under a policy or contract issued to an employer, who shall be deemed the policyholder, covering all employees, dependents, or guests, defined by reference to specified hazards incident to the activities or operations of the employer or any class of employees, dependents, or guests similarly defined;   (3) under a policy or contract issued to a school or other institution of learning, camp or sponsor thereof; or to the head or principal thereof, who or which shall be deemed the policyholder, covering students or campers. Supervisors and employees may be included.   (4) under a policy or contract issued in the name of any religious, charitable, recreational, educational, or civic organization, which shall be deemed the policyholder, covering participants in activities sponsored by the organization;   (5) under a policy or contract issued to a sports team or sponsors thereof, which shall be deemed the policyholder, covering members, officials, and supervisors;   (6) under a policy or contract issued in the name of any volunteer fire department, first aid, or other such volunteer group, or agency having jurisdiction thereof, which shall be deemed the policyholder, covering all of the members of such fire department or group;   (7) under a policy or contract issued to cover any other risk or class of risks which in the discretion of the commissioner may be properly eligible for blanket disability insurance. The discretion of the commissioner may be exercised on an individual risk basis or class of risks, or both.   History: En. Sec. 388, Ch. 286, L. 1959; R.C.M. 1947, 40-4104.
MT Code § 33-22-603 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 6. Blanket Disability Insurance|33-22-603. Application and certificates not required

  33-22-603. Application and certificates not required. An individual application shall not be required from a person covered under a blanket disability policy or contract, nor shall it be necessary for the insurer to furnish each person a certificate.   History: En. Sec. 390, Ch. 286, L. 1959; R.C.M. 1947, 40-4106.
MT Code § 33-22-604 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 6. Blanket Disability Insurance|33-22-604. Payment of claims -- discharge

  33-22-604. Payment of claims -- discharge. (1) (a) Subject to subsection (1)(b), all benefits under a blanket disability policy must be payable to:   (i) the person insured or to the person's designated beneficiary or beneficiaries or to the person's estate, except that if the person insured is a minor or is mentally incompetent, the benefits may be made payable to the parent, guardian, or other person actually supporting the person; or   (ii) the employer, if the entire cost of the insurance has been borne by the employer.   (b) The policy may provide that all or any portion of any indemnities provided by the policy on account of hospital, nursing, medical, or surgical services may, at the insurer's option, be paid directly to the hospital or person rendering the services, but the policy may not require that the service be rendered by a particular hospital or person.   (2) Payment made as provided in subsection (1) discharges the insurer's obligation with respect to the amount of insurance paid.   History: En. Sec. 391, Ch. 286, L. 1959; R.C.M. 1947, 40-4107; amd. Sec. 1230, Ch. 56, L. 2009.