Section 21.54.120. Creditable coverage.

   (a) A health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall count a period of creditable coverage based on
        (1) the standard method authorized by 42 U.S.C. 300gg (Health Insurance Portability and Accountability Act of 1996) for determining creditable coverage without regard to the specific benefits covered during the period; or
        (2) an alternative method based on coverage of benefits within each of several classes or categories of benefits specified in federal regulation if
             (A) made on a uniform basis for all participants and beneficiaries; and
             (B) the insurer counts a period of creditable coverage with respect to any class or category of benefits if any level of benefits is covered within the class or category.
   (b) A health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall provide a certification of coverage
        (1) at the time an individual ceases to be covered under a health care insurance plan or becomes covered under a federal continuation provision;
        (2) at the time an individual ceases to be covered under a federal continuation provision; and
        (3) upon request by an individual or on behalf of an individual within 24 months after the date coverage under the health care insurance plan or a federal continuation provision ceases.
   (c) A health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall establish periods of creditable coverage with respect to an individual through certification under (b) of this section or as specified in federal regulation.
   (d) A health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall prominently state and describe the effect of the health care insurer's election to count a period of creditable coverage using a permissible alternative method
        (1) in any disclosure statement concerning the health care insurance plan or coverage;
        (2) to each enrollee at the time of enrollment; and
        (3) to each employer at the time of offer or sale of coverage.
   (e) A health care insurer issuing a certification under (b) of this section shall disclose information regarding coverage of classes and categories of health benefits available under the health care insurer's plan at the request of an entity that
        (1) enrolls an individual who has provided the certification of coverage;
        (2) elects to count a period of creditable coverage according to a permissible alternative method under (a)(2) of this section; and
        (3) pays the health care insurer for the reasonable cost, if any, of disclosing the information described in this subsection.

Authorities

21.54.110;21.54.500

Notes

References

AS 21.54.110 Preexisting condition exclusion.
AS 21.54.500 Definitions.

History

(Sec. 59 ch 81 SLA 1997; am Sec. 27 ch 41 SLA 2009)