Denial of converted contract because of overinsurance; notice concerning cancellation of other coverage.
1. The medical service corporation is not required to issue a converted contract to any person who:
(a) Is covered for similar benefits by another hospital, surgical, medical or major medical expense insurance policy, a hospital or medical service subscriber contract, a medical practice or other prepayment plan, or by any other kind of plan or program;
(b) Is eligible to be covered for similar benefits under any arrangement of coverage for individuals in a group, whether on an insured or uninsured basis; or
(c) Has similar benefits provided for or available under the requirements of any state or federal law,
Ê if any benefits provided under the sources listed in this subsection, together with the benefits to be provided by the converted contract, would result in overinsurance according to the medical service corporation’s standards.
2. Before denying a converted contract to an applicant because he has coverage as described in paragraph (a) of subsection 1, the medical service corporation shall notify him that the converted contract will be issued only if the other coverage is cancelled.
Last modified: February 27, 2006