31.10.09.05

.05 Prohibited Exclusions and Limitations.

A. The hospice care benefit may not be subject to a lifetime maximum which is separate from the lifetime maximum applicable to other benefits in the contract.

B. The hospice care benefit may not be subject to an annual maximum benefit which is separate from the annual maximum applicable to other benefits in the contract.

C. A carrier may not exclude immediate family members or family caregivers of the insured from the family counseling benefit or the bereavement counseling benefit because the immediate family member or family caregiver is not otherwise covered under the contract which provides coverage to the insured.

D. A carrier may not exclude the siblings of a terminally ill child from the family counseling benefit or the bereavement counseling benefit, even if the siblings are not otherwise covered under the same contract as the terminally ill child.

E. A hospice care benefit may not exclude inpatient benefits if the hospice care benefit appears in a contract which includes other inpatient benefits.

F. The benefits provided as part of the hospice care benefit may not be subject to separate dollar maximum limits, except as provided in this chapter.

G. The carrier may not condition the inpatient hospice care benefits on a prior hospital confinement.