(1) (a) A health maintenance organization may include
in its contract and evidence of coverage a provision setting forth exclusions
or limitations of services for preexisting conditions at the time of enrollment
as permitted under 33-22-246, 33-22-514, or 33-22-1811, MCA.
(b) A
health maintenance organization may not exclude or limit services for a
preexisting condition when the enrollee transfers coverage from one individual
contract to another ox when the enrollee converts coverage under his conversion
option, except to the extent of a preexisting condition limitation or exclusion
remaining unexpired under the prior contract, unless it clearly discloses that
exclusion or limitation in the evidence of coverage.
(2) A
health maintenance organization may not unfairly discriminate against any
enrollee or applicant for enrollment on the basis of the age, sex, race, color,
creed, national origin, ancestry, religion, marital status, or lawful
occupation of an enrollee, because of the frequency of utilization of services
of an enrollee, or for any reason prohibited by 33-22-526, MCA.
(3) Representing as a group contract a contract that refuses, within the
eligibility period, to enroll an individual member of a group on the basis of
the health status or health care needs of the individual enrollee or member is
deceptive and misleading and violative of 33-18-203, MCA.