Guam § 18901 - Health Insurance Coverage; Blood and Blood

§ 18901. Health Insurance Coverage; Blood and Blood

Derivatives, Mandate Established.

(a) No health insurance company or health care provider

contracted to provide health care to employees in a small group

or large group plan may deny coverage to the employee or

dependent on the basis of blood or blood derivatives. Blood and

blood derivatives shall be covered and may be subject to

COL6/24/2021

maximum limitations per annum.

(1) Guaranteed Availability.

(A) Prohibition of Preexisting Condition

Exclusions or Other Discrimination Based on Health

Status. As a condition of conducting health insurance

coverage on Guam, a group health plan and a health

insurance issuer offering group or individual health

insurance coverage shall not impose any preexisting

condition exclusion with respect to such plan or

coverage, pursuant to Subsection 2 of this Section.

(B) Definition, for the purposes of this Part. The

term “preexisting condition exclusion” means, with

respect to coverage, a limitation or exclusion of

benefits relating to a condition based on the fact the

condition was present before the date of enrollment for

such coverage, whether or not any medical advice,

diagnosis, care, or treatment was recommended or

received before such date.

(2) Prohibition on Rescissions. For the purposes of

this Section, and in conformance with SEC. 2712 [42

U.S.C. 300gg–12] Prohibition On Rescissions, a group

health plan and a health insurance issuer offering group or

individual health insurance coverage shall not rescind such

plan or coverage with respect to an enrollee once the

enrollee is covered under such plan or coverage involved,

except that this Section shall not apply to a covered

individual who has performed an act or practice that

constitutes fraud or makes an intentional misrepresentation

of material fact as prohibited by the terms of the plan or

coverage. Such plan or coverage may not be cancelled

except with prior notice to the enrollee, and only as

permitted under Sections 2702(c), 2703(b) or 2742(b) of the

Public Health Service Act.