{"data":{"id":"us-ky/krs-304.32-310","jurisdiction":"us-ky","citation":"KRS 304.32-310","heading":"Benefits.","body":"(1) A converted policy issued pursuant to the conversion privilege provided in KRS\n304.32-300 providing hospital or surgical expense insurance shall provide on an\nexpense incurred basis, the following minimum benefits:\n(a) Hospital room and board benefits of t wenty-five dollars ($25) per day, for a\nminimum duration of seventy (70) days for any one period of hospital\nconfinement as defined in the converted policy.\n(b) Miscellaneous hospital expense benefits for any one (1) period of hospital\nconfinement in a min imum amount up to twenty (20) times the hospital room\nand board daily benefit provided under the converted policy.\n(c) Surgical operation expense benefits according to a relative value schedule, or\na minimum of two hundred fifty dollars ($250).\n(d) The opt ion to continue any existing benefits on account of pregnancy,\nchildbirth, or miscarriage.\n(2) The relative values in the surgical schedule shall be consistent with the schedule of\noperations generally offered by the insurer under group or individual healt h\ninsurance policies.  In the event that the insurer and the employer agree upon one\n(1) or more additional plans of benefits to be available for converted policies, the\napplicant for the converted policy may, at his option, elect such a plan in lieu of a\nconverted policy providing the benefits of paragraphs (a), (b), and (c) of subsection\n(1) of this section. In no event shall the benefits be less than the minimums set forth\nin subsection (1) of this section.\n(3) In no event need the insurer provide under the converted policy:\n(a) Benefits on account of abortion or complications thereof,\n(b) The benefits of paragraphs (a) and (b) of subsection (1) of this section, unless\nthe group policy from which conversion is made provided hospital expense\ninsurance benefits, or\n(c) The benefits of paragraph (c) of subsection (1) of this section, unless the\ngroup policy provided surgical expense insurance benefits. Furthermore, the\nconverted policy may contain any exclusion, reduction, or limitation contained\nin the group  policy and any exclusion, reduction, or limitation customarily\nused in individual policies issued by the insurer. With respect to any person\nwho was covered by the group policy, the period specified in the time limit on\ncertain defenses of the incontestab le provision of the converted policy shall\ncommence with the date the insurance on such person or member became\neffective under the group policy.\n(4) The converted policy may provide that any hospital, surgical, or medical expense\nbenefits otherwise payabl e thereunder with respect to any person covered\nthereunder may be reduced by the amount of any such benefits payable under the\ngroup policy for the same loss with respect to such person after termination of such\nperson's coverage thereunder. The insurer sh all not be entitled to use deterioration\nof health as the basis for refusing to renew a converted policy. The converted policy\nmay provide for termination of coverage thereunder on any person when he is or\ncould be covered by Medicare (Title XVIII of the U nited States Social Security Act\nas added by the Social Security Amendments of 1965 or as later amended or\nsuperseded).\n(5) A converted policy may include a provision whereby the insurer may request\ninformation in advance of any premium due date of such po licy of any person\ncovered thereunder as to whether:\n(a) He is covered for similar benefits by another hospital, surgical, or medical\nexpense insurance policy or hospital or medical service subscriber contract or\nmedical practice or other prepayment plan or by any other plan or program; or\n(b) Similar benefits are provided for, or available to, such person pursuant to, or\nin accordance with the requirements of, any statute.\nIf any such person is so covered or such statutory benefits are provided or available,\nand such person fails to furnish the insurer the details of such coverage within\nthirty-one (31) days after the date of such request, the benefits payable under the\nconverted policy may be based on the hospital or surgical or medical expenses\nactually incurred after excluding expenses to the extent of the amount of benefits\nprovided or available therefor from any of the sources referred to in paragraphs (a)\nand (b) of this subsection. A converted policy may contain any provisions permitted\nherein and may also include any other provisions not expressly prohibited by law;\nand any provision required to be permitted herein may be made a part of any such\npolicy by means of an endorsement or rider.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29811","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:54Z","sha256":"62804d7ebca23378dde6be58fdf9bdadcd1957e042335189ce372f4753068722","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.32-300","next":"us-ky/krs-304.32-315"},"notice":"GroundRules: Original legal text. Not legal advice."}