Section 2.39.370. Pre-existing condition limitation.

	(a)  If major medical insurance coverage is elected during an open enrollment period, the new law benefit recipient and any eligible dependents are subject to a pre-existing condition limitation. Under this limitation, only the first $1,000 of covered medical expenses relating to a pre-existing condition will be paid by the insurer. After a person has been covered for 12 consecutive months, the limitation no longer applies.  
	(b)  The pre-existing condition limitation does not apply to  
		(1) a new law benefit recipient who makes an election of major medical insurance under 2 AAC 39.310(a);  
		(2) a benefit recipient appointed to a disability benefit;  
		(3) a new law benefit recipient eligible due to reaching the age of 65; or  
		(4) an alternate payee.  
	(c)  In this section "pre-existing condition" means a condition for which an individual has received diagnosis, tests, or treatment, including the taking of medication, during the three month period before the effective date of coverage.  

Authorities

14.25.168;14.25.170;22.25.027;22.25.090;39.30.090;39.35.535

Notes

Authority

AS 14.25.168 AS 14.25.170 AS 22.25.027 AS 22.25.090 AS 39.30.090 AS 39.35.535

History

Eff. 2/1/93, Register 125