Sec. 1. 24-A MRSA §2850, sub-§2, ¶¶A and B, as enacted by PL 1997, c. 445, §29 and affected by §32, are amended to read:

A. In a group contract, a preexisting condition exclusion may relate only to conditions for which medical advice, diagnosis, care or treatment was recommended or received during the 6 months immediately preceding the effective date of coverage. An exclusion may not be imposed relating to pregnancy or to pervasive development disorder as a preexisting condition.

B. In an individual contract not subject to paragraph C, a preexisting condition exclusion may relate only to conditions manifesting in symptoms that would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment or for which medical advice, diagnosis, care or treatment was recommended or received during the 12 months immediately preceding the effective date of coverage or to a pregnancy existing on the effective date of coverage. An exclusion may not be imposed relating to pervasive development disorder as a preexisting condition.

SUMMARY

This bill prohibits the imposition of a preexisting condition exclusion relating to pervasive development disorder in individual and group health insurance policies.