What is the provision in a group health policy that postpones coverage for a covered illness after the policy's effective date?

The provision in a group health policy that postpones coverage for a covered illness after the policy's effective date is known as a waiting period. This waiting period is designed to prevent adverse selection by ensuring that individuals do not enroll in a group health plan only when they know they need medical care or will incur significant healthcare costs.

During the waiting period, any claims related to the pre-existing conditions or illnesses may not be covered, allowing the insurer to manage risks associated with individuals who may have existing health issues. This provision is standard practice in many health insurance plans, and it helps ensure that the insurer can maintain a balance between premium income and claims expenditure.

While similar terms might be used in the insurance industry, such as exclusion period, suspension period, or deferred coverage, they refer to other specific aspects of insurance coverage or claims management. The waiting period specifically addresses the gap between the policy's effective date and the time when coverage for certain illnesses begins, making it a key aspect of the policy's structure.