In Health News.....   July/1997

Beginning on or after July 7, 1997 in accordance with President Clinton's Health Care Reform Pre-existing conditions for Group Health insurance will be redefined as follows: 


PRE-EXISTING CONDITIONS

The Maximum Pre-Existing Exclusion Period is twelve months and may be applied only to conditions for which an individual has had medical care in the six months immediately preceding the earlier of enrollment, or the beginning of the eligibility waiting period. 

Exclusion Periods must be reduced by the time that an individual had either Individual, or Group Insurance Coverage, as long as there was not a break in coverage of more than sixty three days.

No Pre-Existing exclusion may be applied to pregnancy, newborn or adopted children under the age of eighteen, who are covered within thirty days of becoming eligible for coverage. 

Prior Carrier Certification must be provided by insureds to validate an individual's coverage history for up to twenty four months after cessation of coverage. 


MEDICAL 

Health related information may not be the basis for excluding an individual , or dependent from coverage.  Nor, may it be used to charge higher premiums for the individual, or dependent.  Group rates may be affected.