Chapter 244

2003 -- H 5707

Enacted 07/17/03

AN ACT

RELATING TO INSURANCE

Introduced By: Representatives Montanaro, S Anderson, Moura, and Williams

Date Introduced: February 11, 2003

It is enacted by the General Assembly as follows:

SECTION 1. Section 27-19.1-1 of the General Laws in Chapter 27-19.1 entitled

"Extended Medical Benefits" is hereby amended to read as follows:

27-19.1-1. Medical benefits for those who lose eligibility to participate. -- (a)

Whenever the employment of an insured member of a group hospital, surgical, or medical

insurance plan is terminated because of involuntary layoff or death, or as a result of the

workplace ceasing to exist, or the permanent reduction in size of the workforce, the benefits of

the plan may be continued as provided in this section for a period of up to eighteen (18) months

from the termination date of the insured member, but in any event not to exceed the shorter of the

period which represents the period of continuous employment preceding termination with the

employer under whose contract the member is insured or the time from the termination date of the

insured member until the member, surviving spouse~~, or~~ of a deceased member, and any other

dependent(s) of the member who were covered under the plan, becomes employed by another

group and eligible for benefits under another group plan.

(b) The extended coverage for the period defined in subsection (a) of this section shall be

available to the terminated member ~~or to~~ the surviving spouse ~~in case of his or her death,~~ of a

deceased member, and any other ~~member~~ dependent(s) of ~~his or her family~~ the member who were

covered under the plan, at the same monthly premium rate or subscription fee for the group in

which he or she was previously a member or at a monthly premium rate or subscription fee as

may be in effect from time to time for the same group subsequent to his or her qualification under

subsection (a) of this section. The terminated member, the surviving spouse of a deceased

member, and any other dependent(s) of the member who were covered under the plan, shall not

be required to pay more than a monthly premium rate or subscription fee per month at one time.

this section, or the surviving spouse of a deceased member, and any other dependent(s) of the

member who were covered under the plan, may elect to continue participation in the group plan

within thirty (30) days after the member's qualification under subsection (a) of this section. The

~~qualifying~~ involuntarily laid off member, or the surviving spouse of a deceased member, and any

other dependent(s) of the member who were covered under the plan shall be responsible for the

payment of monthly premiums rates or subscription fees directly to the carrier of the surgical,

hospital, or medical insurance plan, or the group plan's agent or insurance producer, throughout

the extended coverage period, if the member had been covered under a group plan consisting of

fifty (50) members or less. Those leaving group plans with more than fifty (50) members shall be

responsible directly to the employer for the payment of monthly premiums rates or subscription

fees, or directly to the carrier if the workplace ceases to exist. The terminated member, the

surviving spouse of a deceased member, and any other dependent(s) of the member who were

covered under the plan, shall not be required to pay more than a monthly premium rate or

subscription fee per month at one time.

(d) After timely receipt of the monthly premium ~~payment~~ rate or subscription fee, as

defined in this subsection, from the qualifying member, or the surviving spouse of a deceased

member, and any other dependent(s) of the member who were covered under the plan, if the

employer fails to make payment to the carrier with the result that coverage is terminated, the

employer shall be liable for benefits to the same extent as the carrier would have been liable if

coverage had not been terminated. "Timely receipt" of the monthly premium payment means the

employer's receipt of the monthly premium rate or subscription fee for the extended coverage

from the qualifying member, or the surviving spouse of a deceased member, and any other

dependent(s) of the member who were covered under the plan within the dates or by the date

indicated by the employer as a requirement of this chapter at the time of the election of the

extended coverage. This subsection shall not apply to an employer whose workplace ceases to

exist.

(e) Upon termination of the extended coverage period, the qualifying member, or the

surviving spouse of a deceased member, and any other dependent(s) of the member who were

covered under the plan shall be entitled to exercise any option which is provided in the group plan

to elect a converted policy.

(f) All employers who provide their employees a group hospital, surgical, or medical

insurance plan shall post a conspicuous notice to the employees of their options under the

provisions of this chapter.

(g) "Group hospital, surgical, or medical insurance plan" as used herein in this section

includes any service plan contract of a medical or health service plan corporation. "Carrier" as

used in this section means shall mean any insurance company which is the insurer of the group

hospital, surgical, or medical plan or the medical or health service plan corporation which

provides the group service plan contract, either of which an employer provides for his or her

employees.

(h) This chapter shall not apply to an employee who is employed in the construction

industry or his or her employer if the employee, at the time benefits could be selected under this

chapter, is a participant in, and the employer is a contributor to, a multi-employer welfare plan as

defined in 29 U.S.C. section 1301 et seq., and which the internal revenue service has determined

is tax exempt as to contributions received and as to benefits received by its participants.

SECTION 2. This act shall take effect upon passage.

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LC02022

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