NAC687B.263. Termination and replacement of coverage under group policy.

     1. If a group policy to supplement Medicare or a certificate is terminated by the group policyholder or certificate holder and is not replaced as provided in subsection 3, the issuer shall offer each certificate holder an individual policy to supplement Medicare or a certificate. The issuer shall offer the certificate holder an individual policy that provides for the continuation of the benefits contained in the group policy.

     2. If a certificate holder is provided coverage under a group policy to supplement Medicare or a certificate and the certificate holder terminates his or her membership in the group, the issuer shall:

     (a) Offer the certificate holder an individual policy to supplement Medicare pursuant to subsection 1; or

     (b) At the request of the group policyholder, continue coverage for the certificate holder under the group policy to supplement Medicare.

     3. If a group policy to supplement Medicare or a certificate is replaced by another group policy to supplement Medicare or certificate which is purchased by the same person, the issuer of the replacement policy or certificate shall offer coverage to all persons who are covered under the policy or certificate that is being replaced on the date it is terminated. The replacement policy or certificate may not provide for the exclusion of coverage for preexisting conditions that were covered under the policy or certificate that is being replaced.

     4. If a group policy to supplement Medicare eliminates an outpatient prescription drug benefit as a result of requirements imposed by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, 117 Stat. 2066, December 8, 2003, the modified policy shall be deemed to satisfy the guaranteed renewal requirements of this section.

     (Added to NAC by Comm’r of Insurance, eff. 11-16-90; A 7-16-92, eff. 7-30-92; 8-2-94; A by Div. of Insurance by R078-05, 11-17-2005, eff. 9-8-2005 for Plans K and L, and 1-1-2006 for Medicare Part D Prescription Drug Benefit)