33-22-530. Notice required for cancellation for nonpayment of group health insurance. (1) A health insurance issuer shall provide at least 15 days prior notification of cancellation for nonpayment of premium for group health insurance coverage.

Terms Used In Montana Code 33-22-530

  • Creditable coverage: means coverage of the individual under any of the following:

    (i)a group health plan;

    (ii)health insurance coverage;

    (iii)Title XVIII, part A or B, of the Social Security Act, 42 U. See Montana Code 33-22-140

  • Group health insurance coverage: means health insurance coverage offered in connection with a group health plan or health insurance coverage offered to an eligible group as described in 33-22-501. See Montana Code 33-22-140
  • Health insurance coverage: means benefits consisting of medical care, including items and services paid for as medical care, that are provided directly, through insurance, reimbursement, or otherwise, under a policy, certificate, membership contract, or health care services agreement offered by a health insurance issuer. See Montana Code 33-22-140
  • Health insurance issuer: means an insurer, a health service corporation, or a health maintenance organization. See Montana Code 33-22-140

(2)The notice must be sent to the policyholder at the policyholder’s last-known address and must specify the date of cancellation of coverage. The insurer shall attach a properly executed proof of mailing to this notice and maintain a copy of the proof of mailing in its records.

(3)The health insurance issuer shall hold for processing of payment any claims for covered benefits incurred during the 15-day notification period for nonpayment of premium for group health insurance coverage. Upon receipt of the premium, claims held for the 15-day notification period must be processed for payment.

(4)The policy continues in full force and effect, subject to the requirements of subsection (3), until the proper 15-day notice has been given, unless the coverage has already been replaced.

(5)The 15-day period begins to run from the date of the proof of mailing.

(6)The issuer may collect premiums for any time period that the coverage remains in effect.

(7)When coverage is actually canceled, notice must also be mailed to all certificate holders at:

(a)their last-known home addresses if available; or

(b)the business address of the group policyholder.

(8)The notice of cancellation to certificate holders must be separate from the certificate of creditable coverage required in 33-22-142, although it may be mailed simultaneously with the certificate.