Required provision concerning coverage for employee or member on leave without pay as result of total disability.
1. As used in this section, “total disability” and “totally disabled” mean the continuing inability of the employee or member, because of an injury or illness, to perform substantially the duties related to his employment for which he is otherwise qualified.
2. No group subscriber contract for hospital, medical or dental service may be delivered or issued for delivery in this state unless it provides continuing coverage for an employee or member and his dependents who are otherwise covered by the policy while the employee or member is on leave without pay as a result of a total disability. The coverage must be for any injury or illness suffered by the employee or member which is not related to the total disability or for any injury or illness suffered by his dependent. The coverage for such injury or illness must be equal to or greater than the coverage otherwise provided by the policy.
3. The coverage required pursuant to subsection 2 must continue until:
(a) The date on which the employment of the employee or member is terminated;
(b) The date on which the employee or member obtains another policy of health insurance;
�c) The date on which the group subscriber contract is terminated; or
(d) After a period of 12 months in which benefits under such coverage are provided to the employee or member,
Ê whichever occurs first.
Last modified: February 27, 2006