Guaranteed availability of individual health insurance coverage to certain individuals with prior group coverage

42 U.S. Code § 300gg-41. Guaranteed availability of individual health insurance coverage to certain individuals with prior group coverage

(a) Guaranteed availability
(1) In generalSubject to the succeeding subsections of this section and section 300gg–44 of this title, each health insurance issuer that offers health insurance coverage (as defined in section 300gg–91(b)(1) of this title) in the individual market in a State may not, with respect to an eligible individual (as defined in subsection (b)) desiring to enroll in individual health insurance coverage—
(A)
decline to offer such coverage to, or deny enrollment of, such individual; or
(B)
impose any preexisting condition exclusion (as defined in section 2701(b)(1)(A)) [1] with respect to such coverage.
(2) Substitution by State of acceptable alternative mechanism
The requirement of paragraph (1) shall not apply to health insurance coverage offered in the individual market in a State in which the State is implementing an acceptable alternative mechanism under section 300gg–44 of this title.
(b) “Eligible individual” definedIn this part, the term “eligible individual” means an individual—
(1)
(A)
for whom, as of the date on which the individual seeks coverage under this section, the aggregate of the periods of creditable coverage (as defined in section 2701(c)) 1 is 18 or more months and (B) whose most recent prior creditable coverage was under a group health plan, governmental plan, or church plan (or health insurance coverage offered in connection with any such plan);
This document is only available to subscribers. Please log in or purchase access.