Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 1032 (February 24, 2024).

31 Pa. Code § 89.204. Inapplicability of preexisting condition limitation or waiting period limitation.

§ 89.204. Inapplicability of preexisting condition limitation or waiting period limitation.

 A form may not deny a claim for newborn coverage on the basis that the cause of the claim was a sickness or injury which existed on or prior to the effective date of the coverage or date of birth of the newborn. A form may not provide for a waiting period between the date of birth and provision of coverage for a newborn child, unless the waiting period is applicable to all insureds under the form, that is, the form provides coverage from the fourth day of hospitalization due to sickness, provided however, that upon newly issued forms a company, in order to prevent adverse selection against it by persons who may seek to buy coverage solely to have a newborn covered, may impose a limitation that the newborn child shall have been conceived on or after the effective date of coverage of the form.



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