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Obligation to provide health insurance.
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8.—The following section is substituted for section 8 of the Principal Act:
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“8.—(1) A registered undertaking, other than a restricted membership undertaking, shall not refuse to effect a health insurance contract with or for a person of whatever age or such a person and his or her dependants except in such cases (if any) or in such circumstances (if any) as may be prescribed.
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(2) A restricted membership undertaking shall not—
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(a) impose as a condition of qualification for membership of the undertaking a requirement as to age,
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(b) refuse to admit to membership of the undertaking a person who is qualified for such membership and requests to be so admitted, or
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(c) refuse to effect a health insurance contract with or for such a person as aforesaid or with or for such a person and his or her dependants,
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except in such cases (if any) or in such circumstances (if any) as may be prescribed.
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(3) The Minister may prescribe the maximum waiting periods for eligibility for payment under a health insurance contract which a registered undertaking may impose in respect of the person effecting the contract or his or her dependants and, in particular, but without prejudice to the generality of the foregoing, in respect of a person who—
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(a) is of or under a prescribed age,
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(b) is of or over a prescribed age,
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(c) is suffering from a medical condition when the contract is effected,
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(d) effects such a contract without previously having effected a health insurance contract in the State, or
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(e) effects such a contract with that undertaking having previously effected such a contract with the undertaking whether in respect of the same or different services.
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(4) (a) Subject to paragraph (b), where a health insurance contract effected by a person with a registered undertaking ceases to be in force for any reason, that or any other registered undertaking shall not refuse to effect another health insurance contract with the person, irrespective of his or her age, in respect of the same services except in such cases (if any) or in such circumstances (if any) as may be prescribed.
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(b) A restricted membership undertaking may refuse to effect a health insurance contract with a person referred to in paragraph (a) if the person is not entitled to membership of the undertaking.
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(5) Subject to subsection (6), where a health insurance contract effected with a registered undertaking (‘the first-mentioned contract’) ceases to be in force and a person who was a party to or named in that contract effects, within such period after that cesser as may be prescribed, such a contract with another registered undertaking (‘the second-mentioned contract’)—
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(a) the waiting period for eligibility for any payment under the second-mentioned contract to—
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(i) that person, or
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(ii) any other person who is named in that contract and was also a party to or named in the first-mentioned contract,
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shall not be any longer than it would have been if the second-mentioned contract had been effected at the time the first-mentioned contract had been effected, and
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(b) there shall be deemed to have expired so much of that period as is equal to so much of the like period under the first-mentioned contract as had expired at the time of the cesser aforesaid.
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(6) If a person referred to in subsection (5) is of or over the age of 23 years and the first-mentioned contract in that subsection was effected with a restricted membership undertaking of the kind referred to in subsection (2)(b) of section 12 that served on the Minister a notice under the provision of a scheme mentioned in that subsection (2)(b) before the date specified for the purposes of that subsection, then paragraphs (a) and (b) of subsection (5) shall not apply to that person.”.
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