1. (a) Policies or certificates providing expense benefits shall not use the term “actual charges” when the policy or certificate only pays up to a limited amount of expenses. Instead, the term “charge” or substantially similar language shall be used that does not have the misleading or deceptive effect of the phrase “actual charges”.
2. (b) No policy or certificate issued pursuant to this section shall contain a waiting or probationary period greater than 30 days. A specified disease policy or certificate may contain a waiting or probationary period following the issue or reinstatement date of the policy or certificate in respect to a particular insured person.
3. (c) Coverage for specified diseases shall not be excluded due to a preexisting condition for a period greater than 6 months following the effective date of coverage of an insured person unless the preexisting condition is specifically excluded.
4. (d) Benefits shall not be assignable to a health care provider but shall be paid directly to the insured. The policy and certificate shall contain a provision prohibiting assignment of the benefit to a health care provider.

Source. #13163, eff 1-25-21