Download Minnesota Health Insurance Regulations: Coverage, Renewal, and Standard Provisions and more Exams Law in PDF only on Docsity!
MINNESOTA LAWS, RULES, AND
REGULATIONS PERTINENT TO HEALTH
INSURANCE ONLY ALREADY PASSED
Coverage of Disabled Children
Proof of the incapacity and dependency must be furnished to the insurer, HMO, or organization within ____ _______ of the child reaching the policy's limiting age and annually TWO YEARS after the limiting age was attained. ✔✔31 days
Coverage of Newborns and Adopted Children
All individual and group health insurance and health maintenance contracts must cover a newborn infant immediately from the _________ ____ ________ for illness, injury, congenital malformation, or premature birth. ✔✔moment of birth
Coverage of Newborns and Adopted Children
Benefits for individuals age ____ up to the limiting age for dependent coverage are limited to medical and dental treatment that was scheduled or initiated prior to the dependent turning age _____. (blanks are the same number) ✔✔ 19
Guaranteed Renewal
An individual policy or contract issued as a conversion policy prior to ________ ____ _______, will be renewable at the option of the covered person as long as the covered person is not covered under another qualified plan. ✔✔January 1, 2014
Survivors
If the survivor fails to make premium or fee payments within ____ _______ after payment notification, the insurer may terminate coverage without written consent. If the coverage is terminated for non-payment, written notice of cancellation must be mailed to the survivor's last known address at least 30 DAYS before the cancellation. ✔✔90 days
Continuation/Conversion of Benefits
Entire contract
Time limit on certain defenses
Grace period
Reinstatement
Notice of claim
Claim forms
Proof of loss
Time payment of claims
Payment of claims
Physical exam and autopsy
Legal actions
Change of beneficiary ✔✔required provisions
Standard Provisions (Grace period)
Grace period for weekly premium policies. ✔✔seven days
Standard Provisions (Grace period)
Grace period for monthly premium policies. ✔✔10 days
Standard Provisions (Grace period)
Grace period for all other policies. ✔✔31 days
Standard Provisions (Reinstatement)
The insurer may collect no more than _____ ________ of past due premiums with the reinstatement application, and will issue a conditional receipt. ✔✔60 days
Standard Provisions (Reinstatement)
The insured is automatically covered if the insurer has not rejected their reinstatement application within ____ ______. ✔✔45 days
Standard Provisions (Reinstatement)
Standard Provisions (Legal actions)
The insured must wait at least _____ _______ after furnishing written proof of loss to take legal action against the insurer to collect benefits. No legal action can be brought after THREE YEARS from the time written proof of loss is required. ✔✔60 days
Optional Provisions (Cancellation)
The insurer will promptly return the unearned portion of premium paid, calculated on a _____ _______ ________. ✔✔pro rata basis
This act established an insurance safety net for individuals who have been turned down for individual health insurance due to pre-existing conditions. ✔✔Comprehensive Health Insurance Act (CHIA)
Medicare Supplement Plans
The policy must cover preexisting conditions during the first SIX MONTHS of coverage if the insured was not diagnosed or treated for the particular condition during the ____ ______ immediately preceding the effective date of coverage. ✔✔90 days
Medicare Supplement Plans
At the request of the policyholder, benefits and premiums can be suspended for up to _____ ________ while the policyholder is entitled to medical assistance. The policyholder must notify the supplement policy issuer with 90 DAYS after the date the individual becomes entitled to medical assistance. ✔✔24 months
Medicare Supplement Plans
Policyholders have the right to return the Medicare supplement policy within ____ ______ of its delivery if, after reviewing the policy, the insured is not satisfied for any reason. ✔✔30 days
