Montana Health Insurance Group Plans

Montana health insurance is regulated by the state government in order to insure fair practices on the part of both the Montana health insurance company and insured individual or group. Group Montana health insurance plans differ slightly from individual insurance plans. The most notable difference is that in a Montana health insurance group plan, an individual cannot be denied a policy due to age, health or other risk factors. An employer cannot restrict an individual’s access to Montana health insurance group plans due to these factors, as well.

Also, with a Montana health insurance group plan, one individual cannot be charged more than another. This differs greatly from individual Montana health insurance law that states that each individual’s Montana health insurance policy premium is determined by his or her relative risk to the company. With group Montana health insurance policies, a Montana health insurance company raise the cost of the premiums for the entire group due to excessive filing of claims, but it cannot raise the premiums for just one individual.

Montana health insurance group plans have regular enrollment periods during which policyholders can make changes to their plans. However, if a Montana health insurance policyholder has a child or has other changes in his or her family situation, he or she is required by law to have a special enrollment period of thirty days during which he or she can change his or her Montana health insurance plan without penalty. As with Montana health insurance for individuals, group plans also guarantee that newborns and adopted children are covered for their first thirty-one days. In order to extend coverage to the new dependent, the Montana health insurance policyholder must formally add the individual to his or her plan within the thirty-one day grace period. Montana health insurance companies are also required to maintain coverage of disabled children beyond the regular dependent age limit that is typically enforced. A Montana health insurance company will cover a disabled dependent indefinitely if he or she relies on the Montana health insurance policyholder as his or her sole support resource. Documentation must be provided to the Montana health insurance company within thirty-one days of the dependents’ coverage expiration date.

In Montana health insurance law, a Montana health insurance company is not allowed impose a waiting period on a new member of a group policy. However, it is legal for an employer to impose a waiting periods before Montana health insurance eligibility as long as the period of time is standardized for all employees. HMO Montana health insurance companies are allowed to impose waiting periods, however, but these periods are limited to only two months.

Montana health insurance companies that provide group plans can exclude from coverage pre-existing conditions for which an individual received treatment during the six months prior to joining the new Montana health insurance policy. Montana health insurance companies are only allowed to exclude these conditions from coverage during the first year of an individual’s policy. However, pregnancy, maternity stays and genetic information cannot be included in the definition of a Montana health insurance pre-existing condition.

Montana Health Insurance Group Plans

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