{"data":{"id":"us-ky/krs-304.17b-019","jurisdiction":"us-ky","citation":"KRS 304.17B-019","heading":"Types of health benefit plans to be issued under Kentucky Access.","body":"(1) Kentucky Access shall offer at least three (3) health benefit plans to enrollees,\nwhich shall be similar to the health benefit plans currently being marketed to\nindividuals in the individual market.\n(2) At least one (1) plan shall be offered in a traditio nal fee-for-service form. At least\none (1) plan may be offered in a managed -care form at such time as the Office of\nHealth Data and Analytics can establish an appropriate provider network in\navailable service areas.\n(3) The office shall provide for utiliza tion review and case management for all health\nbenefit plans issued under Kentucky Access.\n(4) The office shall review and compare health benefit plans provided under Kentucky\nAccess to health benefit plans provided in the individual market. Based on the\nreview, the office may amend or replace the health benefit plans issued under\nKentucky Access.\n(5) Individuals who apply and are determined eligible for health benefit plans issued\nunder Kentucky Access shall have coverage effective the first day of the month after\nthe application month.\n(6) For eligible individuals, health benefit plans issued under Kentucky Access shall\nnot impose any pre -existing condition exclusions. In all other cases, a pre -existing\ncondition exclusion may be imposed in accordance with KRS 304.17A-230.\n(7) Health benefit plans issued under Kentucky Access shall be guaranteed renewable\nexcept as otherwise specified in KRS 304.17B-015 and KRS 304.17A-240.\n(8) All health benefit plans issued under Kentucky Access shall provide that, upon t he\ndeath or divorce of the individual in whose name the contract was issued, every\nother person covered in the contract may elect within sixty -three (63) days to\ncontinue under the same or a different contract.\n(9) Health benefit plans issued under Kentuck y Access shall coordinate benefits with\nother health benefit plans and be the payor of last resort.\n(10) Health benefit plans issued under Kentucky Access shall pay covered benefits up to\na lifetime limit of two million dollars ($2,000,000) per covered ind ividual. The\nmaximum limit under this subsection may be increased by the office.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=48820","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:48Z","sha256":"7f409dc5abe0981acdc16f67b64ba86446eb6c1dad8eece055050795f5241b3d","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17b-017","next":"us-ky/krs-304.17b-021"},"notice":"GroundRules: Original legal text. Not legal advice."}