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§2763.__Exemption from mandates |
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| | Except as provided in this chapter, any statutory provision in | this Title applicable to individual health insurance that | mandates medical benefits or coverage for certain specific health | services or diseases or certain providers of health care services | does not apply to basic care medical plans issued pursuant to | this chapter. |
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| §2764.__Applicability of certain provisions relating to |
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| individual health insurance |
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| | The provisions of section 2736-C, including, but not limited | to, those provisions relating to community rating, guaranteed | issuance and guaranteed renewal, apply to basic care medical | plans issued pursuant to this chapter. |
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| | 1. Statement to insured. On the application for coverage, the | carrier shall provide potential enrollees with a written | statement containing at least the following: |
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| A. An explanation of the terms and conditions for benefits | under the plan, including information about covered | services, deductibles, coinsurance and out-of-pocket maximum | limits; |
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| B. An explanation of those mandated benefits and providers | that are not covered by the plan pursuant to section 2763; | and |
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| C. An explanation of the managed care and cost control | features of the plan. |
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| | 2. Statement from enrollee. Before issuing a plan to an | eligible enrollee, a carrier shall obtain from the eligible | enrollee a signed written statement in which the eligible | enrollee: |
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| A. Certifies that the enrollee and all dependents are | eligible for coverage under the plan; |
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| B. Acknowledges the limited nature of the coverage and an | understanding of the managed care and cost control features | of the plan; and |
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| C. Acknowledges that, if misrepresentations are made regarding | eligibility for coverage, the person making the |
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