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Group Coverage Discontinuance and Replacement Model Regulation
Edition and licensing notes
Publisher. National Association of Insurance Commissioners (NAIC)
Edition. NAIC model (edition per source)
Status. NAIC model, © NAIC. Brief quotations under fair use; not the enacted law of any state until adopted.
What this document is
Group Coverage Discontinuance and Replacement Model Regulation is a naic model law published by National Association of Insurance Commissioners (NAIC). It is one of the documents that insurance license exam questions are written from, including life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.
Sections cited in practice questions
Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.
- NAIC Group Coverage Discontinuance and Replacement Model Regulation, Section 6B (extension of benefits, group life disability extension)
“In the case of a group life plan that contains a disability benefit extension of any type (e.g., premium waiver extension, extended death benefit in event of total disability, or payment of income for a specified period during total disability), the discontinuance of the group policy, contract or...”
- NAIC Group Coverage Discontinuance and Replacement Model Regulation § 7C(2)(b) (minimum level of benefits of the succeeding carrier)
“The minimum level of benefits to be provided by the succeeding carrier shall be the applicable level of benefits of the prior carrier’s plan reduced by any benefits payable by the prior plan.”
- NAIC Group Coverage Discontinuance and Replacement Model Regulation § 2 (Scope)
“This regulation is applicable to all insurance policies and subscriber contracts issued or provided by a carrier on a group or group-type basis covering persons as employees of employers or as members of unions or associations.”
- NAIC Group Coverage Discontinuance and Replacement Model Regulation § 6C (extension of benefits, loss of time and hospital confinement indemnity)
“In the case of a group plan providing benefits for loss of time from work or specific indemnity during hospital confinement, discontinuance of the group policy, contract or certificate during a disability shall have no effect on benefits payable for that disability or confinement.”
- NAIC Group Coverage Discontinuance and Replacement Model Regulation § 7B (liability of the prior carrier)
“After discontinuance of the policy, contract or certificate, the prior carrier remains liable only to the extent of its accrued liabilities and extensions of benefits. The position of the prior carrier shall be the same whether the group policyholder or other entity secures replacement coverage...”
- NAIC Group Coverage Discontinuance and Replacement Model Regulation § 7.C(1)(b) (succeeding carrier, nonconfinement rules for health insurance coverage)
“(b) In the case of health insurance coverage: (i) A succeeding carrier shall not have any nonconfinement rules in its plan of benefits;”
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