BILL NO. 40

2 In this Act,

(a) "insurance plan" means an individual health insurance plan, a group health insurance plan or other health insurance arrangement in effect in the Province, but does not include a short-term health insurance policy issued on a non-renewable basis for a period of six months or less, if the insurance plan, its application form or sales brochure discloses that pre-existing conditions are not covered;

(b) "insured person" means a person covered under an insurance plan and includes any dependants of that person covered under the insurance plan;

(c) "insurer" means a person, partnership or cooperative that provides an insurance plan;

(d) "pre-existing condition provision" means a provision in an insurance policy that, in relation to an insured person, limits or excludes benefits under the insurance policy based on the existence of a condition for which medical advice, diagnosis or treatment was recommended or received six months before the effective date of coverage under the insurance policy, but does not include

(i) routine follow-up care to determine whether breast cancer has recurred in a person, unless evidence of breast cancer is found during or as a result of the follow-up,

(ii) genetic information, in the absence of a diagnosis of the condition related to that information, or

(iii) pregnancy.

3 No insurer shall impose a pre-existing condition provision in an insurance plan that continues more than twelve months after the effective date of the commencement of the coverage under the insurance plan if no medical advice, diagnosis, care or treatment was recommended or received in relation to the pre-existing condition during that twelve months.

4 Every insurer shall ensure that a person who is accepted under an insurance plan, who had been covered under an insurance plan immediately preceding the new plan, is covered under the new plan for purposes of a pre-existing condition under the same terms and conditions as under the preceding insurance plan, if the insured person applied for the new plan within thirty days of the end of the coverage under the preceding plan.

5 Every insurer shall, upon

(a) the death of an insured person;

(b) the loss of employment of an insured person; or

(c) the divorce of an insured person,

notify the insured person, the insured person's dependants and the spouse or former spouse of the insured person, as the case may be, of their rights under this Act.

6 Every insurer shall, for a period of thirty days after the date of the end of an insured person's coverage under an insurance policy, allow the insured person to apply to continue to be insured under an insurance policy on the same terms and conditions as the preceding policy.

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