| Enrollment),
coverage must be effective no later than the next premium due date.
Coverage may be effective at an earlier date, as agreed on by the
large employer and the large employer carrier.
(k) A large employer health benefit plan may not, by
use of a rider or amendment applicable to a specific individual, limit
or exclude coverage by type of illness, treatment, medical condition,
or accident, except for a preexisting condition or affiliation period
permitted under Insurance Code §§1501.102 - 1501.106 and
1501.601 - 1501.609.
(l) To determine if preexisting conditions exist, a
carrier must determine the source of previous or existing coverage
of each eligible employee meeting the participation criteria at the
time the employee or dependent initially enrolls into the health benefit
plan provided by the large employer carrier. The large employer carrier
has the responsibility to contact the source of previous or existing
coverage to resolve any questions about the benefits or limitations
related to any previous or existing coverage in the absence of a creditable
coverage certification form.
|
| Source Note: The provisions of this §26.306 adopted to be effective March 5, 1998, 23 TexReg 2297; amended to be effective April 6, 2005, 30 TexReg 1931; amended to be effective May 17, 2017, 42 TexReg 2539 |
