Idaho State Statutes - Idaho Attorney Directory

(1) Any carrier
providing replacement coverage with respect to hospital, medical or surgical
expense benefits within a period of sixty (60) days from the date of
discontinuance of a prior policy providing such hospital, medical or surgical
expense benefits shall immediately cover all employees and dependents validly
covered under the previous policy at the date of discontinuance who are within
the definitions of eligibility and who would otherwise be eligible for
coverage under the succeeding carrier's policy, regardless of any limitations
or exclusions relating to active employment or nonconfinement.
(2) With respect to an employee or dependent who was totally disabled on
the date of discontinuance of the prior carrier's policy and required to be
covered under subsection (1) of this section, the succeeding carrier shall be
entitled to deduct from any benefits becoming payable under its policy the
amount of benefits payable by the prior carrier pursuant to an extension of
benefits provision.
(3) An employee or dependent entitled to coverage under a succeeding
carrier's policy pursuant to subsection (1) or (2) of this section shall
continue to be covered by the succeeding carrier until the earlier of the
following:
(a) The date coverage would terminate for an employee or dependent in
accordance with the provisions of the succeeding carrier's policy; or
(b) In the case of an employee or dependent who was totally disabled on
the date of discontinuance of the prior carrier's policy and entitled to
an extension of benefits pursuant to subsection (2) of section 41-2213,
the date the period of extension of benefits terminates or, if the prior
carrier's policy is not subject to this act, the date to which benefits
would have been extended had the prior carrier's policy been subject to
this act.
(4) No provision in a succeeding carrier's policy of replacement coverage
which would operate to reduce or exclude benefits on the basis that the
condition giving rise to benefits preexisted the effective date of the
succeeding carrier's policy shall be applied with respect to those employees
and dependents validly insured under the prior carrier's policy on the date of
discontinuance, if benefits for such condition would have been payable under
the prior carrier's policy.
(5) In a situation where a determination of the prior carrier's benefit
is required by the succeeding carrier, at the succeeding carrier's request,
the prior carrier shall furnish a statement of benefits available or pertinent
information, sufficient to permit verification of the benefit determination by
the succeeding carrier, at no cost.

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