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304.32-300 Conversion health insurance policy -- Rights of employee's
surviving spouse.
(1)
(2)
(3)
(4)
(5)
Any private employer doing business in this state who provides for his
employees on a self-insured basis, hospital or surgical benefits, other than for
specific diseases or accidental injury only, shall purchase a conversion health
insurance policy. Upon the termination of the employment of any employee
who has been continuously employed for not less than six (6) months
immediately preceding the termination, the employee shall be entitled to have
issued to him by the insurer, without evidence of insurability, a health insurance
policy on a form then available for conversion from the health benefit plan
provided by the employer by making written application therefor, accompanied
by the first quarterly, semiannual or annual premium, at the option of the
employee to the employer not later than thirty-one (31) days after such
termination.
The individual health insurance policy available as provided in subsection (1)
shall cover the employee and his dependents for whom the employer provided
health or surgical benefits on the date the employment was terminated. The
effective date of any such individual policy shall be the date of the termination
of the employment.
The employee shall not be entitled to be issued a converted policy upon
termination of employment if he is or could be covered by Medicare (Title XVIII
of the United States Social Security Act as added by the social security
amendments of 1965 or as later amended or superseded). Furthermore, the
employee shall not be entitled to be issued a converted policy if (a) such
person is covered for similar benefits by another hospital or surgical or medical
expense insurance policy or hospital or medical service subscriber contract or
medical practice or other prepayment plan or by any other plan or program or
(b) similar benefits are provided for, or are available to, such person pursuant
to, or in accordance with the requirements of any statute, and the benefits
provided or available under any of the sources referred to in (a) and (b) above
for such employee, together with the converted policy, would result in over
insurance according to the employer's standards relating to policies converted
from the hospital or surgical benefits provided by the employer.
The surviving spouse, at the death of an employee, shall be entitled to be
issued a converted policy with respect to the spouse and such children whose
coverage under the employer's hospital or surgical benefits terminates by
reason of the death of an employee.
If an employee or employee's spouse becomes entitled to obtain a converted
policy pursuant to the foregoing provisions, and if such person has not been
given written notice of the existence of the conversion privilege stated above,
within thirty-one (31) days of termination of the group coverage, then in such
event the person shall have an additional period within which to exercise the
conversion privilege. This additional period shall expire fifteen (15) days after
the person shall have been given said notice but in no event shall the
additional period extend beyond sixty (60) days after the expiration of the
thirty-one (31) day conversion period stated above. Written notice presented to
the person or mailed by the employer to the last known address of the person
or mailed by the insurer to the last known address of the person as furnished
by the employer shall constitute the giving of notice for the purpose of this
paragraph. If an additional period is allowed the person for exercise of the
conversion privilege as provided herein, and if written application for the
converted policy, accompanied by the first quarterly or semiannual or annual
premium, is made after the expiration of the thirty-one (31) day conversion
period stated above, but within the additional period allowed an employee or
spouse in accordance with this paragraph, the effective date of the converted
policy shall be the date of termination of employment.
Effective:June 17, 1978
History: Created 1978 Ky. Acts ch. 158, sec. 1, effective June 17, 1978.
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