Haw. Code R. § 16-12-6.2 - Open enrollment
(a) No issuer shall
deny or condition the issuance or effectiveness of any Medicare supplement
policy or certificate available for sale in this State, nor discriminate in the
pricing of a policy or certificate because of the health status, claims
experience, receipt of health care, or medical condition of an applicant in the
case of an application for a policy or certificate that is submitted prior to
or during the six month period beginning with the first day of the first month
in which an individual is enrolled for benefits under Medicare Part B. Each
Medicare supplement policy and certificate currently available from an issuer
shall be made available to all applicants who qualify under this subsection
without regard to age.
(b)
(1) If an applicant qualifies under
subsection (a) and submits an application during the time period referenced in
subsection (a) and, as of the date of application, has had a continuous period
of creditable coverage of at least six months, the issuer shall not exclude
benefits based on a preexisting condition.
(2) If the applicant qualifies under
subsection (a) and submits an application during the time period referenced in
subsection (a) and, as of the date of application, has had a continuous period
of creditable coverage that is less than six months, the issuer shall reduce
the period of any preexisting condition exclusion by the aggregate of the
period of creditable coverage applicable to the applicant as of the enrollment
date. The Secretary shall specify the manner of the reduction under this
subsection.
(c) Except as
provided for in subsection (b) and in sections
16-12-6.3 and
16-12-12.8,
subsection (a) shall not be construed as preventing the exclusion of benefits
under a policy, during the first six months, based on a preexisting condition
for which the policyholder or certificate holder received treatment or was
otherwise diagnosed during the six months before the coverage became
effective.
Notes
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