(1) Except as otherwise
provided by this section, any group health care service contract
entered into or renewed on or after January 1, 1985, that
provides benefits for hospital or medical expenses shall contain
a provision granting a person covered by the group contract the
right to obtain a conversion contract from the contractor upon
termination of the person's eligibility for coverage under the
group contract.
(2) A contractor need not offer a conversion contract to:
(a) A person whose coverage under the group contract ended
when the person's employment or membership was terminated for
misconduct: PROVIDED, That when a person's employment or
membership is terminated for misconduct, a conversion policy
shall be offered to the spouse and/or dependents of the
terminated employee or member. The policy shall include in the
conversion provisions the same conversion rights and conditions
which are available to employees or members and their spouses
and/or dependents who are terminated for reasons other than
misconduct;
(b) A person who is eligible for federal medicare coverage;
or
(c) A person who is covered under another group plan,
policy, contract, or agreement providing benefits for hospital or
medical care.
(3) To obtain the conversion contract, a person must submit
a written application and the first premium payment for the
conversion contract not later than thirty-one days after the date
the person's eligibility for group coverage terminates. The
conversion contract shall become effective, without lapse of
coverage, immediately following termination of coverage under the
group contract.
(4) If a health care service contractor or group contract
holder does not renew, cancels, or otherwise terminates the group
contract, the health care service contractor shall offer a
conversion contract to any person who was covered under the
terminated contract unless the person is eligible to obtain group
hospital or medical expense coverage within thirty-one days after
such nonrenewal, cancellation, or termination of the group
contract.
(5) The health care service contractor shall determine the
premium for the conversion contract in accordance with the
contractor's table of premium rates applicable to the age and
class of risk of each person to be covered under the contract and
the type and amount of benefits provided.
[1984 c 190 § 6.]
NOTES:
Legislative intent -- Severability -- 1984 c 190: See notes following RCW 48.21.250.