(a) This section applies to all grandfathered plans except grandfathered plans that are individual plans and to every health benefit plan that is not a grandfathered plan. (b) A carrier may not: (1) exclude or limit benefits because a health condition was present before the effective date of coverage; or (2) deny coverage because a health condition was present before or on the date of denial. (c) The prohibition in subsection (b) of this section applies whether or not: (1) any medical advice, diagnosis, care, or treatment was recommended or received for the condition; or (2) the health condition was identified as a result of: (i) a pre-enrollment questionnaire or physical examination given to an individual; or (ii) a review of records relating to the pre-enrollment period.
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