§ 83-9-103. Regulations to be issued by commissioner
The commissioner shall adopt reasonable regulations to establish specific standards for policy provisions of Medicare supplement policies and certificates. Such standards shall be in addition to and in accordance with applicable laws of this state including Sections 83-9-1 through 83-9-21, Mississippi Code of 1972. No requirement of the insurance code relating to minimum required policy […]
§ 83-9-105. Adoption of minimum standards for benefits; claim payments, etc.
The commissioner shall adopt reasonable regulations to establish minimum standards for benefits, claims payment, marketing practices and compensation arrangements and reporting practices for Medicare supplement policies and certificates.
§ 83-9-106. Minimum reserves for accident and health insurance companies
The Commissioner of Insurance shall establish regulations setting forth standards to provide minimum reserves for accident and health insurance companies, including nonprofit hospital, medical and surgical service corporations.
§ 83-9-107. Minimum standards for loss ratios
Medicare supplement policies shall return to policyholders benefits which are reasonable in relation to the premium charged. The commissioner shall issue reasonable regulations to establish minimum standards for loss ratios of Medicare supplement policies on the basis of incurred claims experience, or incurred health care expenses when coverage is provided by a health maintenance organization […]
§ 83-9-33. Coverage for newly born children
All individual and group health insurance policies providing coverage on an expense incurred basis and individual and group service or indemnity type contracts issued after January 1, 1980, by an insurer or nonprofit corporation which provides coverage for a family member of the insured or subscriber shall, as to such family members’ coverage, also provide […]
§ 83-9-34. Child immunizations; optional coverage; written acceptance or rejection; application of section
In this section, “health benefit plan” means a plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident or sickness and that is offered by any insurance company, group hospital service corporation or health maintenance organization that delivers or issues for delivery an individual, group, blanket or […]
§ 83-9-35. Replacement of group or blanket health and accident policy or plan; succeeding carrier’s plan to continue certain benefits and provisions
This section shall apply to any health benefit plan that provides coverage to two (2) or more employees of an employer in this state if any of the following conditions are satisfied: Any portion of the premium or benefits is paid by or on behalf of the employer; An eligible employee or dependent is reimbursed, […]
§ 83-9-36. Process by which prescribing practitioner may request override of restriction on medication restricted for use by insurer step therapy or fail-first protocol; circumstances under which insurer to grant override
When medications for the treatment of any medical condition are restricted for use by an insurer by a step therapy or fail-first protocol, the prescribing practitioner shall have access to a clear and convenient process to expeditiously request an override of that restriction from the insurer.An override of that restriction shall be expeditiously granted by […]
§ 83-9-37. Definitions
As used in Sections 83-9-37 through 83-9-43, Mississippi Code of 1972: “Alternative delivery system” means a health maintenance organization (HMO), preferred provider organization (PPO), exclusive provider organization (EPO), individual practice association (IPA), medical staff hospital organization (MESH), physician hospital organization (PHO), and any other plan or organization which provides health care services through a mechanism […]
§ 83-9-39. Coverage
Except as otherwise provided herein, all alternative delivery systems and all group health insurance policies, plans or programs regulated by the State of Mississippi shall provide covered benefits for the treatment of mental illness, except for policies which only provide coverage for specified diseases and other limited benefit health insurance policies and negotiated labor contracts. […]