renewal of that plan. Resources: ; 42 USC § Issuer may not rescind coverage with respect to an individual (including a group to which the Both Rescissions individual belongs or family coverage under which the individual is included) once the individual 45 CFR and Prohibited §147.128(a)(1) is covered, UNLESS: Individual (or someone seeking coverage on his behalf) performs an act, practice, or plans omission that constitutes fraud, or Makes an intentional misrepresentation of material fact, as prohibited by the terms of the plan or coverage. 45 CFR At least 30 days’ written notice must be provided to each affected participant. §147.128(a)(1) 45 CFR Rescission means cancellation or discontinuance of coverage that has retroactive effect; e.g., a §147.128(a)(2) cancellation that treats a policy as void from the time of the individual's or group's enrollment, or a cancellation that voids benefits paid up to a year before the cancellation. A cancellation or discontinuance of coverage is not a rescission if: 45 CFR The cancellation or discontinuance of coverage has only a prospective effect; or §147.128(a)(2)(i) The cancellation or discontinuance of coverage is effective retroactively to the extent it is 45 CFR §147.128(a)(2)(ii) attributable to a failure to timely pay required premiums or contributions towards the cost of coverage. See, also: Standard of RCW 48.43.545 Issuer may not attempt to waive, shift, or modify its responsibility to adhere to the accepted standard Care of care for health care providers when arranging for medically necessary health care for enrollees. Issuer is liable for any harm proximately caused by its failure to follow the standard of care when the failure results in denial, delay, or modification of the health care service recommended for, or furnished to, the enrollee. This includes all the issuer’s employees, agents, or ostensible agents. RCW 48.46.530(1) Does the group’s application form show that the issuer offered the group optional coverage for the
renewal of that plan. Resources: ; Rescissions Prohibited Both and plans 42 USC § 45 CFR §147.128(a)(1) 45 CFR §147.128(a)(1) 45 CFR §147.128(a)(2) 45 CFR §147.128(a)(2)(i) 45 CFR §147.128(a)(2)(ii) Issuer may not rescind coverage with respect to an individual (including a group to which the individual belongs or family coverage under which the individual is included) once the individual is covered, UNLESS: Individual (or someone seeking coverage on his behalf) performs an act, practice, or omission that constitutes fraud, or Makes an intentional misrepresentation of material fact, as prohibited by the terms of the plan or coverage. At least 30 days’ written notice must be provided to each affected participant. Rescission means cancellation or discontinuance of coverage that has retroactive effect; e.g., a cancellation that treats a policy as void from the time of the individual's or group's enrollment, or a cancellation that voids benefits paid up to a year before the cancellation. A cancellation or discontinuance of coverage is not a rescission if: The cancellation or discontinuance of coverage has only a prospective effect; or The cancellation or discontinuance of coverage is effective retroactively to the extent it is attributable to a failure to timely pay required premiums or contributions towards the cost of coverage. See, also: Standard of Care RCW 48.43.545 Issuer may not attempt to waive, shift, or modify its responsibility to adhere to the accepted standard of care for health care providers when arranging for medically necessary health care for enrollees. Issuer is liable for any harm proximately caused by its failure to follow the standard of care when the failure results in denial, delay, or modification of the health care service recommended for, or furnished to, the enrollee. This includes all the issuer’s employees, agents, or ostensible agents. RCW 48.46.530(1) Does the group’s application form show that the issuer offered the group optional coverage for the
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