Rule 120-2-81-.14 - Reduction of Coverage(1) Any assignment system policy or plan may provide for a reduction or coordination of coverage on any person upon eligibility for coverage under Medicare.(2) No assignment system policy or plan may provide for a reduction or coordination of coverage based upon a person's eligibility for coverage under the Medicaid program of the State of Georgia.(3) The benefits under the assignment system policy or plan shall be secondary to any group or blanket accident and sickness contract covering any person insured under the assignment system policy.(4) The assignment system policy or plan may provide that any hospital, surgical or medical benefits payable thereunder may be reduced by the amount of any such benefits payable under the continuation coverage after the termination of the individual's insurance thereunder.(5) A health insurer or managed care organization may request information in advance of any premium due date of such policy or plan of any person covered thereunder only as to whether: (a) The insured is covered for similar benefits under any arrangement of coverage for individuals in a group, whether on an insured or uninsured basis; or(b) Similar benefits are provided for or available to such person, pursuant to or in accordance with the requirements of Medicare.Ga. Comp. R. & Regs. R. 120-2-81-.14
O.C.G.A. Secs. 33-2-9, 33-29A-1, et seq.
ER. 120-2-81-0.8 adopted. F. Dec. 31, 1997; eff. Jan. 2, 1998, to remain in effect for a period of 120 days or until the effective date of a permanent Rule covering the same subject matter superseding the ER, is adopted, as specified by the Agency.Amended: Permanent Rule entitled "Reduction of coverage" adopted. F. Apr. 29, 1998; eff. May 19, 1998.