2005 Idaho Code - 41-2146 — COVERAGE PROVIDED TO PERSONS HAVING INSURANCE

                                  TITLE  41
                                  INSURANCE
                                  CHAPTER 21
                        DISABILITY INSURANCE POLICIES
    41-2146.  COVERAGE PROVIDED TO PERSONS HAVING INSURANCE. An insurer
providing individual disability insurance coverage in this state shall make
available to citizens of this state major medical disability policies under
the terms set forth in this section. An insurer providing only accident-only,
credit, dental, vision, long-term care or disability income insurance,
coverage issued as a supplement to liability insurance, worker's compensation,
or automobile medical payment insurance is not required to comply with the
provisions of this section. An insurer providing only specified disease or
hospital confinement indemnity insurance in this state shall not be required
to comply with the provisions of this section, provided the insurance is
marketed as supplemental health insurance and not as a substitute for hospital
or major medical expense insurance, and the insurer certifies annually to the
director that the insurance is being marketed in a manner consistent with the
provisions of this subsection.
    (2)  As used in this section, the term "major medical disability policies"
means policies, including medicare supplement insurance policies, contracts or
certificates which are issued to provide hospital and medical-surgical
coverage.
    (3)  Each insurer offering or maintaining individual major medical
disability policies in this state shall make current individual policies
available to an individual or dependent of an individual currently insured by
the insurer, without imposition by the insurer of underwriting criteria
whereby coverage of an individual or a dependent of an individual is denied or
subject to cancellation or nonrenewal, in whole or in part because of the
individual's age, health or medical history or employment status, or, if
employed, industry or job classification if the individual is insured with
that insurer and wishes to convert coverage to another policy, plan or
contract. When offering benefits pursuant to this section, the insurer shall
be required to offer equal or lesser benefits than the insured has under the
existing policy or plan. If the insurer offers benefits in excess of what was
included in the insurer's contract to the insured, the insurer may impose
health underwriting criteria and a preexisting condition clause which will
waive all or a portion of benefits offered for the first twelve (12) months of
the policy for a condition which has occurred during the preceding twelve (12)
months. The preexisting condition clause herein authorized may not be applied
to the transfer from one (1) medicare supplement policy, contract or
certificate to another where benefits are increased. As used herein, "benefits
in excess of what was included in the insured's contract" shall include but
not be limited to lower deductibles, lower coinsurance or copayments or lower
maximum out-of-pocket expenditure for health care. The addition of pharmacy
cards to replace existing prescription drug benefits, supplemental accident
insurance, chiropractic services or vision services shall not constitute
"benefits in excess of what was included in the insured's contract."
    In implementing the provisions of this section, the director shall provide
that insurers shall provide insureds with a simplified application that shall
not exceed one (1) page in length and which shall not exceed six (6) medical
questions.