Health Insurance Contract Carrier And Policyholder

Health insurance - required contract provisions between a carrier and a health care provider - payment of premiums - provision of benefits. The act requires a contract for a health benefit plan between a carrier and a policyholder to state, as an alternative to existing premium payment requirements, that a policyholder must pay premiums to the carrier through the date that the individual covered under the policy is no longer eligible or covered if the policyholder notifies the carrier within 10 business days after the date of ineligibility or noncoverage because the individual left employment without notice to the employer or the employee was terminated for gross misconduct.

The act also clarifies that:

• If the policyholder notifies the carrier within the 10-day period, the carrier is not required to provide benefits to the individual after the date that the individual is no longer eligible or covered; and
• A carrier and a policyholder may agree to a different date where premium payments are not required.
  (Note: This summary applies to this bill as enacted.)