§ 58-67-130. Replacement coverage. - North Carolina Statutes

§58‑67‑130.  Replacement coverage.

(a)        Any carrierproviding replacement coverage with respect to group hospital, medical, orsurgical expense or service benefits, within a period of 60 days from the dateof discontinuance of a prior HMO contract or policy providing such hospital,medical or surgical expense or service benefits, shall immediately cover allenrollees who were validly covered under the previous HMO contract or policy atthe date of discontinuance and who would otherwise be eligible for coverageunder the succeeding carrier's contract, regardless of any provisions of thecontract relating to active employment or hospital confinement or pregnancy.

(b)        Except to theextent benefits for the condition would have been reduced or excluded under theprior carrier's contract or policy, no provision in a succeeding carrier'scontract of replacement coverage that would operate to reduce or excludebenefits on the basis that the condition giving rise to benefits preceded theeffective date of the succeeding carrier's contract shall be applied withrespect to those enrollees validly covered under the prior carrier's contractor policy on the date of discontinuance. (1989, c. 776. s. 13.)