Coverage for the Newly Insured

(1) A carrier shall provide coverage for health services to a newly insured provided by a provider who is not a participating provider in the carrier's network for up to 30 days from the effective date of coverage if: (a) the insured's employer only offers the insured a choice of carriers in which said provider is not a participating provider; and (b) said provider is providing the insured with an ongoing course of treatment or is the insured's primary care provider. (2) With respect to an insured pregnant woman who is in her second or third trimester, coverage pursuant to 958 CMR 3.503(1) shall apply to services rendered through the insured's first postpartum visit. (3) With respect to an insured with a terminal illness, coverage pursuant to 958 CMR 3.503(1) shall apply to services rendered until the insured's death.