§ 23-80-402. Definitions
As used in this subchapter: (1) “Commissioner” means the Insurance Commissioner; (2) “Covered person” means a person on whose behalf a health benefit plan is obligated to pay benefits pursuant to the health benefit plan; and (3) “Health benefit plan” means any individual, blanket, or group plan, policy, certificate, or contract for healthcare services issued […]
§ 23-80-203. Definitions
As used in this subchapter: (1) “Commissioner” means the Insurance Commissioner; (2) “Company” or “insurer” means any life or accident and health insurance company, fraternal benefit society, nonprofit health service corporation, nonprofit hospital service corporation, nonprofit medical service corporation, prepaid health plan, dental care plan, vision care plan, pharmaceutical plan, health maintenance organization, and all […]
§ 23-80-403. Exemptions
This subchapter shall not apply to: (1) Accidental injury insurance plans; (2) Dental insurance plans; (3) Vision insurance plans; (4) Specified disease insurance plans; (5) Disability income plans; (6) Credit insurance plans; (7) Insurance coverage issued as a supplement to liability insurance; (8) Medical payments under automobile or homeowners insurance plans; (9) Health benefit plans […]
§ 23-80-204. Applicability
(a) This subchapter shall apply to all policies delivered or issued for delivery in this state by any company on or after the date the forms must be approved under this subchapter. (b) However, nothing in this subchapter shall apply to: (1) Any policy which is a security subject to federal jurisdiction; (2) (A) Any […]
§ 23-80-404. Uniform card requirement
(a) Every health benefit plan that provides coverage for prescription drugs or devices and issues a card or other technology for claims processing and every administrator of such plans, including third-party administrators for self-insured plans, pharmacy benefit managers, and administrators of state plans, shall issue to all covered persons a uniform card or other technology […]
§ 23-80-205. Construction
Nothing in this subchapter shall be construed to negate any law of this state permitting the issuance of any policy form after it has been on file for the time period specified.
§ 23-80-405. Enrollment
(a) Upon enrollment of a covered person, a health benefit plan shall issue a uniform prescription drug information card or other technology in accordance with the requirements of § 23-80-404. (b) Upon any change in a covered person’s coverage that impacts in content or format any information contained on a uniform prescription drug information card […]
§ 23-80-206. Minimum standards
(a) In addition to any other requirements of law, no policy forms, except as stated in § 23-80-204, shall be delivered or issued for delivery in this state on or after the dates forms must be approved under this subchapter, unless: (1) The text achieves a minimum score of forty (40) on the Flesch reading […]
§ 23-80-406. Required fields
(a) This subchapter does not require a health benefit plan that provides coverage for prescription drugs or devices to issue a card or other technology separate from any identification card issued to a covered person to evidence coverage under the health benefit plan, if the card or other technology contains all of the required fields […]
§ 23-80-207. Authorization to use lower score
The Insurance Commissioner may authorize a lower score than the Flesch reading ease score required in § 23-80-206(a)(1) whenever, in the commissioner’s discretion, he or she finds that a lower score: (1) Will provide a more accurate reflection of the readability of a policy form; (2) Is warranted by the nature of a particular policy […]