Sec. 21.54.120. Creditable coverage.
(a) A health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall count a period of creditable coverage based on (1) the standard method authorized by 42 U.S.C. 300gg (Health Insurance Portability and Accountability Act of 1996) for determining creditable coverage […]
Sec. 21.54.130. Renewability, termination, and modification of coverage.
(a) Except for a multiple employer welfare arrangement, a health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall renew or continue in force the coverage under the plan at the option of the plan sponsor unless (1) the plan sponsor […]
Sec. 21.54.140. Renewability of coverage for a multiple employer welfare arrangement.
A health benefit plan that is a multiple employer welfare arrangement subject to this title may not deny an employer whose employees are covered under the plan continued access to the same or a different plan according to the terms of the plan, except (1) for nonpayment of contributions; (2) for fraud or other intentional […]
Sec. 21.54.151. Mental health or substance use disorder benefits.
A health care insurer that offers a health care insurance plan in the group market shall comply with the mental health or substance use disorder benefit requirements established under 42 U.S.C. 300gg-26.
Sec. 21.54.160. “Excepted benefits” defined.
“Excepted benefits” means benefits under one or more or any combination of the following: (1) benefits under (A) coverage only for accident, disability income insurance, or both; (B) coverage issued as a supplement to liability insurance; (C) liability insurance, including general liability insurance and automobile liability insurance; (D) workers’ compensation or substantially similar insurance; (E) […]
Sec. 21.54.170. Determination of size of employer.
The determination of whether an employer is a large or small employer is subject to the following: (1) the size of an employer that was not in existence throughout the preceding calendar year must be based on the average number of employees that the employer is reasonably expected to employ on the business days in […]
Sec. 21.54.500. Definitions.
In this chapter, (1) “aggregate lifetime limit” means a dollar limit on the total amount that may be paid for benefits under a health care insurance plan offered in the group market with respect to an individual or unit of coverage; (2) “annual limit” means a dollar limit on the total amount that may be […]
Sec. 21.54.020. Direct payment to providers.
(a) On the written request of a covered person, a health care insurer shall pay amounts due under a health insurance policy directly to the provider of medical care services. A health insurance policy may not contain a provision that requires services be provided by a particular hospital or person, except as applicable to a […]
Sec. 21.54.030. Required provisions of blanket policies.
An insurer authorized to write health insurance in this state shall have the power to issue blanket health insurance. A blanket policy may not be issued or delivered in this state unless a copy of the form of the policy has been filed in accordance with AS 21.42.120. Each blanket policy must contain provisions that […]
Sec. 21.54.040. Application and certificates not required.
An individual application may not be required from a person covered under a blanket health insurance policy or contract, nor is it necessary for the insurer to furnish each person a certificate.