KRS 304.18-127: Transfer of liability when policy replaced by that of succeeding insurer.

(1) This section shall indicate the insurer responsible for liability in those instances in

which one (1) insurer's group policy replaces the group policy of another insurer.

(2) The prior insurer shall remain liable only to the extent of its accrued liabilities,

extension of benefits, and for persons who are under continued group health

insurance coverage pursuant to KRS 304.18 -110 at the time the group policy

terminates. The position of the prior insurer shall be the same whether the group

policyholder secures replacement coverage from a new insurer, self insures, or

forgoes the provision of a group policy, except that termination of continued group

health insurance coverage shall occur in accordance with KRS 304.18 -110 and

304.18-114.

(3) The liability of a succeeding insurer shall be as follows:

(a) Each person who is eligible for coverage shall be covered by that insurer's

plan on the effective date of coverage and in accor dance with KRS 304.17A -

200.

(b) If a person, who is eligible for coverage, is confined as of the effective date of

coverage under the succeeding insurer's plan and the succeeding insurer has a

nonconfinement rule, the succeeding insurer is not responsible for the cost of

the person's confinement to the extent that the confinement is covered by a

prior insurer's extension of benefits provision, in accordance with KRS

304.18-126.

(c) The succeeding insurer, in applying any deductibles or waiting periods in it s

plan, shall give credit for the satisfaction or partial satisfaction of the same or

similar provisions under a prior group policy. In the case of deductible

provisions, the credit shall apply for the same or overlapping benefit periods

and shall be given for expenses actually incurred and applied against the

deductible provisions of the prior insurer's group policy during the ninety (90)

days preceding the effective date of the succeeding insurer's group policy, but

only to the extent these expenses are r ecognized under the terms of the

succeeding insurer's group policy and are subject to similar deductible

provisions.

(d) If a determination of the prior insurer's benefit is required by the succeeding

insurer, at the succeeding insurer's request the prior insurer shall furnish a

statement of the benefits available or pertinent information sufficient to permit

verification of the benefit determination or the determination itself by the

succeeding insurer. For purposes of this section, benefits of the prior i nsurer's

group policy shall be determined in accordance with all of the definitions,

conditions, and covered expense provisions of the prior insurer's group policy

rather than those of the succeeding insurer's group policy. The benefit

determination shall be made as if coverage had not been replaced by the

succeeding insurer.