Section 1399.62 Of Article 10. Discontinuance And Replacement Of Group Health Care Service Plan Contracts From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 10.
1399.62
. (a) Every contract containing hospital, medical, or
surgical expense benefits or service benefits shall contain a
reasonable extension of such benefits upon discontinuance of the
contract with respect to employees or dependents who become totally
disabled while enrolled under the contract on or after the date this
article becomes applicable to such contract and who continue to be
totally disabled at the date of discontinuance of the contract.
(b) Every contract providing hospital, medical or surgical expense
benefits or service benefits shall be deemed to include a reasonable
extension of such benefits upon discontinuance of the contract if it
provides benefits for covered services directly relating to the
condition causing total disability existing at the time dues payments
cease for the employee or dependent and incurred during a period of
not less than 12 months thereafter, which period shall not be
interrupted by discontinuance of the contract.
That extension of benefits may be terminated at such time as the
employee or dependent is no longer totally disabled or at such time
as a succeeding carrier may elect to provide replacement coverage to
that employee or dependent without limitation as to the disabling
condition.
(c) The services provided during any extension of benefits may be
subject to all limitations or restrictions contained in the contract.