§ 4318. Pre-existing condition provisions. Every individual health\ninsurance contract and every group or blanket accident and health\ninsurance contract issued or issued for delivery in this state which\nincludes a pre-existing condition provision shall contain in substance\nthe following provision or provisions which in the opinion of the\nsuperintendent are more favorable to individuals, members of the group\nand their eligible dependents:\n (a) In determining whether a pre-existing condition provision applies\nto a covered person, the contract shall credit the time the covered\nperson was previously covered under creditable coverage, if the previous\ncreditable coverage was continuous to a date not more than sixty-three\ndays prior to the enrollment date of the new coverage. In the case of\nprevious health maintenance organization coverage, any affiliation\nperiod prior to that previous coverage becoming effective shall also be\ncredited pursuant to this subsection.\n (b) No pre-existing condition provision shall exclude coverage for a\nperiod in excess of twelve months following the enrollment date for the\ncovered person and may only relate to a condition (whether physical or\nmental), regardless of the cause of the condition for which medical\nadvice, diagnosis, care or treatment was recommended or received within\nthe six month period ending on the enrollment date. For purposes of this\nsection "enrollment date" means the first day of coverage of the\nindividual under the contract or, if earlier, the first day of the\nwaiting period that must pass with respect to an individual before the\nindividual is eligible to be covered for benefits. If an individual\nseeks and obtains coverage in the individual market, any period after\nthe date the individual files a substantially complete application for\ncoverage and before the first day of coverage is a waiting period. For\npurposes of this section, genetic information shall not be treated as a\npre-existing condition in the absence of a diagnosis of the condition\nrelated to such information. No pre-existing condition provision shall\nexclude coverage in the case of:\n (1) an individual who, as of the last day of the thirty-day period\nbeginning with the date of birth, is covered under creditable coverage\nas defined in subsection (c) of this section;\n (2) a child who is adopted or placed for adoption before attaining\neighteen years of age and who, as of the last day of the thirty-day\nperiod beginning on the date of the adoption or placement for adoption,\nis covered under creditable coverage as defined in subsection (c) of\nthis section;\n (3) pregnancy (except in an individual direct payment contract or a\nstudent blanket accident and health insurance contract in which a\ncorporation may exclude coverage, subject to a credit for previous\ncreditable coverage, for a period not to exceed ten months for a\npregnancy existing on the enrollment date); or\n (4) an individual, and any dependent of such individual, who is\neligible for a federal tax credit under the federal Trade Adjustment\nAssistance Reform Act of 2002 and who has three months or more of\ncreditable coverage.\n Paragraphs one and two of this subsection shall no longer apply to an\nindividual after the end of the first sixty-three day period during all\nof which the individual was not covered under any creditable coverage.\n (c) For purposes of this section, "creditable coverage" means, with\nrespect to an individual, coverage of the individual under any of the\nfollowing:\n (1) A group health plan;\n (2) Health insurance coverage;\n (3) Part A or B of title XVIII of the Social Security Act;\n (4) Title XIX of the Social Security Act, other than coverage\nconsisting solely of benefits under section 1928;\n (5) Chapter 55 of title 10, United States Code;\n (6) A medical care program of the Indian Health Service or of a tribal\norganization;\n (7) A state health benefits risk pool;\n (8) A health
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