{"data":{"id":"us-ky/krs-304.18-114","jurisdiction":"us-ky","citation":"KRS 304.18-114","heading":"Conversion health insurance policy for member terminated under","body":"group policy -- Terms -- Situations in which conversion coverage need not be\ngranted.\n(1) As used in this section:\n(a) \"Conversion health insurance coverage\" means a health benefit plan  meeting\nthe requirements of this section and regulated in accordance with Subtitles 17\nand 17A of this chapter;\n(b) \"Group policy\" has the meaning provided in KRS 304.18-110; and\n(c) \"Medicare\" has the meaning provided in KRS 304.18-110.\n(2) An insurer pr oviding group health insurance coverage shall offer a conversion\nhealth insurance policy, by written notice, to any group member terminated under\nthe group policy for any reason. The insurer shall offer a conversion health\ninsurance policy substantially si milar to the group policy. The former group\nmember shall meet the following conditions:\n(a) The former group member had been a member of the group and covered under\nany health insurance policy offered by the group for at least three (3) months;\n(b) The for mer group member must make written application to the insurer for\nconversion health insurance coverage not later than thirty -one (31) days after\nnotice pursuant to subsection (5) of this section; and\n(c) The former group member must pay the monthly, quarte rly, semiannual, or\nannual premium, at the option of the applicant, to the insurer not later than\nthirty-one (31) days after notice pursuant to subsection (5) of this section.\n(3) An insurer shall offer the following terms of conversion health insurance coverage:\n(a) Conversion health insurance coverage shall be available without evidence of\ninsurability and may contain a pre -existing condition limitation in accordance\nwith KRS 304.17A-230;\n(b) The premium for conversion health insurance coverage shall be a ccording to\nthe insurer's table of premium rates in effect on the latter of:\n1. The effective date of the conversion policy; or\n2. The date of application when the premium rate applies to the class of\nrisk to which the covered persons belong, to their ages, and to the form\nand amount of insurance provided;\n(c) The conversion health insurance policy shall cover the former group member\nand eligible dependents covered by the group policy on the date coverage\nunder the group policy terminated.\n(d) The effective date of the conversion health insurance policy shall be the date\nof termination of coverage under the group policy; and\n(e) The co nversion health insurance policy shall provide benefits substantially\nsimilar to those provided by the group policy, but not less than the minimum\nstandards set forth in KRS 304.18 -120 and any administrative regulations\npromulgated thereunder.\n(4) Conversion health insurance coverage need not be granted in the following\nsituations:\n(a) On the effective date of coverage, the applicant is or could be covered by\nMedicare;\n(b) On the effective date of coverage, the applicant is or could be covered by\nanother group coverage (insured or uninsured) or, the applicant is covered by\nsubstantially similar benefits by another individual hospital, surgical, or\nmedical expenses insurance policy; or\n(c) The issuance of conversion health insurance coverage would cause the\napplicant to be overinsured according to the insurer's standards, taking into\naccount that the applicant is or could be covered by similar benefits pursuant\nto or in accordance with the requirements of any statute and the individual\ncoverage described in paragraph (b) of this subsection.\n(5) Notice of the right to conversion health insurance coverage shall be given as\nfollows:\n(a) For group policies delivered, issued for delivery, or renewed after July 15,\n2002, the insurer shall give written notice of the r ight to conversion health\ninsurance coverage to any former group member entitled to conversion\ncoverage under this section upon notice from the group policyholder that the\ngroup member has terminated membership in the group, upon termination of\nthe former group member's continued group health insurance coverage\npursuant to KRS 304.18 -110 or COBRA as defined in KRS 304.17A -005(7),\nor upon termination of the group policy for any reason. The written notice\nshall clearly explain the former group member's right to a conversion policy.\n(b) The thirty-one (31) day period of subsection (2)(b) of this section shall not\nbegin to run until the notice required by this subsection is mailed or delivered\nto the last known address of the former group member.\n(c) If a former  group member becomes entitled to obtain conversion health\ninsurance coverage, pursuant to this section, and the insurer fails to give the\nformer group member written notice of the right, pursuant to this subsection,\nthe insurer shall give written notice t o the former group member as soon as\npracticable after being notified of the insurer's failure to give written notice of\nconversion rights to the former group member and such former group member\nshall have an additional period within which to exercise his conversion rights.\nThe additional period shall expire sixty (60) days after written notice is\nreceived from the insurer. Written notice delivered or mailed to the last known\naddress of the former group member shall constitute the giving of notice for\nthe p urpose of this paragraph. If a former group member makes application\nand pays the premium, for conversion health insurance coverage within the\nadditional period allowed by this paragraph, the effective date of conversion\nhealth insurance coverage shall be the date of termination of group health\ninsurance coverage. However, nothing in this subsection shall require an\ninsurer to give notice or provide conversion coverage to a former group\nmember ninety (90) days after termination of the former group member's\ngroup coverage.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29445","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:49Z","sha256":"21e5b4aac981176f5bc21873497bcc013ab4998b8bd2e8ae892d0db947e88465","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.18-110","next":"us-ky/krs-304.18-115"},"notice":"GroundRules: Original legal text. Not legal advice."}