A group health policy in Pennsylvania can exclude coverage for preexisting conditions for no longer than what duration?

A group health policy in Pennsylvania can exclude coverage for preexisting conditions for no longer than what duration?

• A. 6 months after the enrollment date
• B. 12 months after the enrollment date
• C. 18 months after the enrollment date
• D. 24 months after the enrollment date

Answer: (B)

In Pennsylvania, group health policies are subject to specific regulations concerning preexisting conditions. The law allows for exclusions related to preexisting conditions for a maximum duration of 12 months after the enrollment date. This means that if an individual has a health condition that was diagnosed or treated prior to joining the plan, the insurer may deny coverage for that condition but cannot extend that exclusion beyond 12 months. This regulation is designed to balance the interests of insurance providers in managing risk while ensuring that individuals are not indefinitely penalized for their prior health issues. Given this framework, the selected answer reflects the legal requirements within Pennsylvania’s health insurance regulations concerning preexisting conditions.

In Pennsylvania, group health policies are subject to specific regulations concerning preexisting conditions. The law allows for exclusions related to preexisting conditions for a maximum duration of 12 months after the enrollment date. This means that if an individual has a health condition that was diagnosed or treated prior to joining the plan, the insurer may deny coverage for that condition but cannot extend that exclusion beyond 12 months.

This regulation is designed to balance the interests of insurance providers in managing risk while ensuring that individuals are not indefinitely penalized for their prior health issues. Given this framework, the selected answer reflects the legal requirements within Pennsylvania’s health insurance regulations concerning preexisting conditions.