Late enrollment/creditable coverage

[RLG]

If a group health insurance company that claims to comply with HIPAA offers an otherwise eligible dependent late enrollment, may the insurance company accept the dependent for enrollment with the condition that a pre-existing condition exclusion apply, EVEN IF valid creditable coverage is demonstrated? In other words, can the insurance company make late enrollment conditional on pre-existing exclusion even if there is creditable coverage?

 

[CIAA]

RLG,

In some cases "open enrollment" date requirements may be overcome by requesting in writing from the plan administrator a "special enrollment" that may be available if dependent coverage under another group plan was lost.

 

[RLG]

Late enrollee/pre-existing

Sorry, but that does not answer the question, which I will re-state: can insurance company impose a waiting period due to pre-existing condition even if there is valid creditable coverage, just because enrollee was accepted as a late enrollee.

 

[CIAA]

The answer is no, a new group carrier must honor "valid credible coverage".

However, this only applies if the new coverage becomes effective within 63 days of termination of the previous group coverage.