ENROLLED
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ACT No. 830
Regular Session, 2012
HOUSE BILL NO. 1196 (Substitute for House Bill No. 868 by Representative Pearson)
BY REPRESENTATIVE PEARSON
AN ACT1
To amend and reenact R.S. 22:1046(B), (C), (F), and (G)(3) and (4) and to repeal R.S.2
22:1046(E), relative to group health plans; to provide for continuation of group3
health plans; and to provide for related matters.4
Be it enacted by the Legislature of Louisiana:5
Section 1. R.S. 22:1046(B), (C), (F), and (G)(3) and (4) are hereby amended and6
reenacted to read as follows:7
ยง1046. Group health insurance continuation8
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B. A group policy delivered or issued for delivery in this state which insures10
employees or members, and their eligible dependents, if they have elected to include11
them, for hospital, surgical or major medical insurance on an expense incurred or12
service basis, other than for specific diseases or for accidental injuries only, shall13
provide that employees or members whose insurance for these types of coverage14
under the group policy would otherwise terminate because of termination of active15
employment or membership, or termination of membership in the eligible class or16
classes under the policy death or divorce of the employee or member shall be entitled17
to continue their hospital, surgical, and medical insurance under that group policy,18
for themselves and or their eligible dependents with respect to whom they who were19
insured on the date of termination, subject to all of the group policy's terms and20
conditions applicable to those forms of insurance and to the conditions specified in21
this Section. The terms and conditions set forth in this Section are intended as22
minimum requirements and shall not be construed to impose additional or different23
requirements upon those group hospital, surgical, or major medical plans already in24 ENROLLEDHB NO. 1196
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force, or hereafter placed into effect, that provide continuation benefits equal to or1
better than those required in this Section.2
C. Continuation shall only be available to an under this Section only if the3
employee or member who has been continuously insured under the group policy, or4
for similar benefits under any other group policy that it replaced, during the period5
of three consecutive months immediately prior to the date of termination. The6
continued policy must cover all dependents covered under the group policy.7
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F. An employee or member electing continuation shall pay to the group9
policyholder or his employer, in advance, the amount of contribution required by the10
policyholder or employer, but not more than the full group rate for the insurance11
applicable to the employee or member under the group policy on the due date of each12
payment. The employee or member shall not be required to pay the amount of the13
contribution less often than monthly. In order to be eligible for continuation of14
coverage, the employee or member shall make a written election of continuation, on15
a form provided by the group policyholder, and pay the first contribution, in advance,16
to the policyholder or employer on or before the date on which the employee's or17
member's insurance would otherwise terminate. no later than the end of the month18
following the month in which the event that made the employee or member eligible19
for coverage under this Section occurs. Such form shall be as prescribed in this20
Section. If the dependent is eligible due to divorce, the event shall be deemed to have21
occurred on the date of the judgment of divorce.22
G. Continuation of insurance under the group policy for any person shall23
terminate on the earliest of the following dates:24
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(3) The date the employee or member becomes or is eligible to become26
covered for similar benefits under any arrangement of coverage for individuals in a27
group, whether insured or uninsured self-insured.28
(4) The date on which the group policy is terminated or, in the case of a29
multiple employer plan, the date his employer terminates participation under the30 ENROLLEDHB NO. 1196
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group master policy. When this occurs the employee or member shall have a1
conversion privilege if the date of termination precedes that on which his actual2
continuation of insurance under that policy would have terminated. The insurer that3
insured the group prior to the date of termination shall make a converted policy4
available to the employee or member.5
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Section 2. R.S. 22:1046(E) is hereby repealed in its entirety.7
Section 3. This Act shall become effective on January 1, 2013.8
SPEAKER OF THE HOUSE OF REPRESENTATI VES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: