Section 89.402. Approval

(a) A preexisting condition limitation will not be approved for use with a policy or contract which is more restrictive than the following definition: A preexisting condition is a disease or physical condition for which medical advice or treatment has been received within 90 days immediately prior to becoming covered under the group contract. The condition shall be covered after the individual has been covered for more than 12 months under the group contract.

(b) Long-term disability benefit provisions may require that the total disability resulting from a preexisting condition commence after the individual has been covered for more than 12 months under the group contract.

The provisions of this § 89.402 amended August 24, 1979, effective November 23, 1979, 9 Pa.B. 2891. Immediately preceding text appears at serial page (39800).

Notation

Cross References

This section cited in 31 Pa. Code § 89.404 (relating to preexisting condition).