20-821. Scope of article; rules; authority of director A. Hospital service corporations, medical service corporations, dental service corporations, optometric service corporations and hospital, medical, dental and optometric service corporations incorporated in this state are governed by this article and are exempt from all other provisions of this title, except as expressly provided by this article […]
20-822. Definitions In this article, unless the context otherwise requires, " hospital service corporations" , " medical service corporations" , " dental service corporations" , " optometric service corporations" and " hospital, medical, dental and optometric service corporations" mean corporations organized under the laws of this state for the purpose of establishing, maintaining and operating […]
20-823. Incorporation of hospital, medical, dental and optometric service corporations The corporation as defined in section 20-822 shall be organized under the laws of this state relating to private corporations not for pecuniary profit, insofar as such laws are not inconsistent with any of the provisions of this article.
20-824. Application for certificate; fee Such a corporation may issue contracts to its subscribers only when the director has, by certificate of authority, authorized it so to do. Application for a certificate of authority shall be made on forms supplied or approved by the director containing such information as the director deems necessary. Each application […]
20-825. Certificate of authority; requirements The director shall issue a certificate of authority authorizing the applicant to issue contracts to its subscribers when it is shown to the satisfaction of the director that: 1. The applicant is established as a bona fide, nonprofit hospital service corporation, medical service corporation, dental service corporation or optometric service […]
20-825.01. Minimum capital or surplus required; application A corporation that is exempt from the risk-based capital requirement prescribed in section 20-488.08 shall maintain unimpaired capital or surplus, or both, in the amount of at least twenty-five thousand dollars.
20-826. Subscription contracts; definitions A. A contract between a corporation and its subscribers shall not be issued unless the form of such contract is approved in writing by the director. B. Each contract shall plainly state the services to which the subscriber is entitled and those to which the subscriber is not entitled under the […]
20-826.01. Hospital or medical service corporations; clinical trials; cancer; definitions A. A hospital service corporation or medical service corporation is not obligated to pay any costs, other than covered patient costs, that are directly associated with a cancer clinical trial that is offered in this state and in which the subscriber participates voluntarily. A cancer […]
20-826.02. Subscription contracts; varying copayments and deductibles allowed A. Except as provided in sections 20-1379 and 20-2304, a corporation may offer one or more subscription contracts that contain a choice of deductibles, coinsurance, copayments, out-of-pocket and any other cost sharing levels. Plans offered under this section shall clearly disclose in marketing materials, certificates of coverage […]
20-826.03. Eosinophilic gastrointestinal disorder; formula A. Any contract that is offered by a hospital service corporation or medical service corporation and that contains a prescription drug benefit shall cover amino acid-based formula that is ordered by a physician or a registered nurse practitioner if: 1. The subscriber has been diagnosed with an eosinophilic gastrointestinal disorder. […]
20-826.04. Subscription contracts; autism spectrum disorder; coverage; exceptions; definitions A. A hospital service corporation or medical service corporation shall not: 1. Exclude or deny coverage for a treatment or impose dollar limits, deductibles and coinsurance provisions based solely on the diagnosis of autism spectrum disorder. For the purposes of this paragraph, " treatment" includes diagnosis, […]
20-828. Deposit for protection of members A. Corporations governed by this article shall at all times have on deposit with the state treasurer the following amounts: 1. If newly formed under this article, two hundred thousand dollars. 2. If formed under prior law, such amount as was so required under prior law. B. Every such […]
20-829. Directors The directors of a corporation governed by this article shall at all times include representatives of: 1. Dentists licensed to practice in this state who have contracted with the corporation to render dental service to subscribers, if the corporation is a dental service corporation. 2. Optometrists licensed to practice in this state who […]
20-830. Expenses and investments A. The operating and administrative expenses of any such corporation, including all costs in connection with solicitation of subscribers to the corporation and capital expenditures, shall not exceed thirty per cent of paid subscriptions during the first year of operation, twenty-five per cent of paid subscriptions during the second year of […]
20-831. Annual statement; examination A. Not later than March 31 of each year every corporation shall file with the director a statement of its financial condition, transactions and affairs as of the preceding December 31 as prescribed in sections 20-223 and 20-234 and shall pay the annual renewal fee prescribed in section 20-167. B. At […]
20-832. Limitation on salaries A corporation shall not: 1. Pay to any officer of the corporation any salary, compensation or emolument amounting in any year to more than $5, 000, unless the board of directors of the corporation first authorizes the salary, compensation or emolument. 2. Make any agreement with any officer whereby the corporation […]
20-833. Relationship of health care professional and patient; financial incentives; definition A. Nothing in this article alters the relationship of physician and patient, registered nurse practitioner and patient, dentist and patient or optometrist and patient. B. The corporation shall not in any way influence the subscriber in the subscriber’s free choice of hospital, physician, registered […]
20-834. Dissolution; unfair practices Such a corporation shall be subject to the provisions of article 4 of chapter 3 of this title (rehabilitation and liquidation) and article 6 of chapter 2 of this title (unfair practices).
20-835. Judicial review of decisions of director All orders of the director made pursuant to this article are subject to chapter 1, article 2 of this title, including the right of hearing, rehearing and appeal.
20-836. Limitation on liability No liability shall attach to any corporation holding a certificate of authority under this article by reason of the failure on the part of any of its participating hospitals, physicians, dentists or optometrists to render service, except as provided by this article, to any of its subscribers, nor for the negligence, […]
