Sec. 21.51.330. Franchise health insurance.
(a) Health insurance on a franchise plan is that form of health insurance issued to (1) five or more employees of a corporation, copartnership, or individual employer or a governmental corporation, agency, or department of them; or (2) 10 or more members, employees, or employees of members of a trade or professional association or of […]
Sec. 21.51.400. Renewability and certification.
A health care insurer that offers a health care insurance plan in the individual market shall comply with the guaranteed renewability requirements established under 42 U.S.C. 300gg-42 and shall comply with the certification of coverage requirements established under 42 U.S.C. 300gg-43.
Sec. 21.51.405. Rate requirements; filings; regulations.
(a) Rates charged for a health insurance policy may not be excessive, inadequate, or unfairly discriminatory. (b) An insurer shall file with the director the premium rates charged for an individual health care insurance plan before using them. A premium rate or premium rate change must be on file with the director for a waiting […]
Sec. 21.51.500. Definitions.
In this chapter, (1) “health care exchange” means an American Health Benefit Exchange established under 42 U.S.C. 18031. (2) “health care insurance plan” has the meaning given in AS 21.54.500; (3) “health care insurer” has the meaning given in AS 21.54.500; (4) “individual market” means the market for health care insurance offered to individuals other […]
Sec. 21.51.220. Relation of earnings to insurance.
(a) There may be a provision as follows: “Relation of Earnings to Insurance: If the total monthly amount of loss of time benefits promised for the same loss under all valid loss of time coverage upon the insured, whether payable on a weekly or monthly basis, shall exceed the monthly earnings of the insured at […]
Sec. 21.51.230. Unpaid premiums.
There may be a provision as follows: “Unpaid Premiums: Upon the payment of a claim under this policy, a premium then due and unpaid or covered by a note or written order may be deducted from it.”
Sec. 21.51.240. Conformity with state statutes.
There may be a provision as follows: “Conformity with State Statutes: Any provision of this policy which, on its effective date, is in conflict with the statutes of the state in which the insured resides on that date is amended to conform to the minimum requirements of the statutes.”
Sec. 21.51.250. Illegal occupation.
There may be a provision as follows: “Illegal Occupation: The insurer shall not be liable for a loss to which a contributing cause was the insured’s commission of or attempt to commit a felony or to which a contributing cause was the insured’s being engaged in an illegal occupation.”
Sec. 21.51.260. Intoxicants and narcotics.
There may be a provision as follows: “Intoxicants and Narcotics: The insurer shall not be liable for a loss sustained or contracted in consequence of the insured’s being intoxicated or under the influence of a narcotic unless administered on the advice of a physician.”
Sec. 21.51.270. Renewal at option of insurer.
Health insurance policies, other than accident insurance only policies, in which the insurer reserves the right to refuse renewal on an individual basis, must provide in substance in a provision or in an endorsement or rider attached to it that, subject to the right to terminate the policy upon nonpayment of premium when due, the […]