2018 Wyoming Statutes
TITLE 26 - INSURANCE CODE
CHAPTER 19 - GROUP AND BLANKET DISABILITY INSURANCE
ARTICLE 2 - GROUP COVERAGE REPLACEMENT ACT
SECTION 26-19-203 - Continuance of coverage where one carrier's contract replaces a plan of similar benefits of another carrier.
26-19-203. Continuance of coverage where one carrier's contract replaces a plan of similar benefits of another carrier.
(a) In those instances in which one (1) carrier's contract replaces a plan of similar benefits of another carrier:
(i) The prior carrier remains liable only to the extent of its accrued liabilities and extensions of benefits. The position of the prior carrier shall be the same whether the group policy holder or other entity secures replacement coverage from a new carrier, self-insures or foregoes the provision of coverage;
(ii) The succeeding carrier is liable under the following circumstances:
(A) Each person covered under the prior carrier's plan shall be eligible for complete coverage in accordance with the succeeding carrier's plan of benefits, which shall include coverage for ninety (90) days for any complication caused as a result of a condition for which benefits were paid under the prior plan within ninety (90) days prior to termination of that plan. Copayment and deductible levels for coverage required under this subparagraph may be applied in a manner consistent with those provided by the succeeding carrier's plan;
(B) In the case of a preexisting conditions limitation included in the succeeding carrier's plan, the level of benefits applicable to preexisting conditions of persons becoming covered by the succeeding carrier's plan in accordance with this paragraph during the period of time this limitation applies under the new plan shall be the lesser of:
(I) The benefits of the new plan determined without application of the preexisting conditions limitations; or
(II) The benefits of the prior plan.
(C) In any situation where a determination of the prior carrier's benefit is required by the succeeding carrier, at the succeeding carrier's request the prior carrier shall furnish a statement of the benefits available or pertinent information, sufficient to permit verification of the benefit determination or the determination itself by the succeeding carrier. For the purposes of this section, benefits of the prior plan will be determined in accordance with all of the definitions, conditions and covered expense provisions of the prior plan rather than those of the succeeding plan. The benefit determination will be made as if coverage had not been replaced by the succeeding carrier.
