The Vermont Statutes Online

Title 8 : Banking and Insurance

Chapter 107 : Health Insurance

Subchapter 002 : CONTINUATION AND CONVERSION OF GROUP HEALTH INSURANCE POLICIES

• § 4090f. Exemptions; termination

  (a) The insurer shall not be required to issue a converted policy if:

  (1) termination under the group policy occurred because the person:

  (A) was not entitled to continuation of group coverage under section 4090a of this title; or

  (B) failed to elect continuation as provided in section 4090b of this title;

  (2) the person is or could be covered by Medicare;

  (3) the person is covered for similar benefits by another individual policy; or

  (4) the person is or could be covered for similar benefits under any arrangement of coverage for individuals in a group, whether insured or uninsured or similar benefits are provided for or available to such person, by reason of any state or federal law and together with the converted policy’s benefits, would result in overinsurance according to the insurer’s standards for overinsurance.

  (b) The converted policy may provide that as of any premium due date the insurer may refuse to renew or to cancel the policy if the person:

  (1) would be overinsured or the person fails to provide the insurer with information upon which it can make a determination as to overinsurance;

  (2) would be eligible for coverage under Medicare or under any other state or federal law providing for benefits similar to those provided by the converted policy; or

  (3) is in default of any required contribution.

  (c) Notice of the conversion privilege shall be included in each certificate of coverage. (Added 1983, No. 165 (Adj. Sess.), § 1.)