Health Insurance Coverage; Blood and Blood

Derivatives, Mandate Established.

(a)No health insurance company or health care provider contracted to provide health care to employees in a small group or large group plan may deny coverage to the employee or dependent on the basis of blood or blood derivatives. Blood and blood derivatives shall be covered and may be subject to COL6/24/2021 CH. 18 THE CONTRACT OF INSURANCE maximum limitations per annum.

(1)Guaranteed Availability.

(A)Prohibition of Preexisting Condition Exclusions or Other Discrimination Based on Health Status. As a condition of conducting health insurance coverage on Guam, a group health plan and a health insurance issuer offering group or individual health insurance coverage shall not impose any preexisting condition exclusion with respect to such plan or coverage, pursuant to Subsection 2 of this Section.

(B)Definition, for the purposes of this Part. The term “preexisting condition exclusion” means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact the condition was present before the date of enrollment for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date.

(2)Prohibition on Rescissions. For the purposes of this Section, and in conformance with SEC. 2712 [42 U.S.C. 300gg–12] Prohibition On Rescissions, a group health plan and a health insurance issuer offering group or individual health insurance coverage shall not rescind such plan or coverage with respect to an enrollee once the enrollee is covered under such plan or coverage involved, except that this Section shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage. Such plan or coverage may not be cancelled except with prior notice to the enrollee, and only as permitted under Sections 2702(c), 2703(b) or 2742(b) of the Public Health Service Act.