The Vermont Statutes Online

Title 8 : Banking and Insurance

Chapter 107 : Health Insurance

Subchapter 002 : CONTINUATION AND CONVERSION OF GROUP HEALTH INSURANCE POLICIES

• § 4090e. Conversion; notice; terms

  (a) Written application and the first premium payment for the converted policy shall be made to the insurer not later than 30 days prior to the date termination of the continuation of the group policy under section 4090a of this title would have occurred due to the death or termination of the employee or member. Its effective date shall be the day following the termination of the continued insurance under the group policy under subdivision 4090c(1) of this title.

  (b) The premium for the converted policy shall be determined in accordance with the insurer’s table of premium rates applicable to the age and class of risk of each person to be covered under that policy and to the type and amount of insurance provided.

  (c) The converted policy shall cover any person who was covered by the continued group policy. At the option of the insurer, a separate converted policy may be issued to cover any dependent. Qualified beneficiaries could be charged premiums up to 102 percent of the group rate.

  (d) The converted policy shall not exclude as a preexisting condition any condition covered by the group policy.

  (e) The converted policy may provide:

  (1) for a reduction of its hospital and medical benefits by the amount of any such benefits payable under the group policy;

  (2) that during the first policy year, the benefits payable under the converted policy, together with the benefits payable under the group policy, shall not exceed those that would have been payable had the person’s insurance under the group policy remained in force and effect.

  (f) The insurer may elect to provide group insurance coverage in lieu of the issuance of a converted individual policy. (Added 1983, No. 165 (Adj. Sess.), § 1; amended 1985, No. 184 (Adj. Sess.), § 5.)