§ 20-843 – Eligibility; prohibiting cancellation because of eligibility for certain benefits
20-843. Eligibility; prohibiting cancellation because of eligibility for certain benefits A. Except as specifically provided in sections 20-1379 and 20-1380, with respect to the determination of whether a person is an eligible individual, a hospital and medical service corporation shall not consider the availability of or a person’s eligibility for medical assistance pursuant to title […]
§ 20-844 – Right to open enrollment period; subscribers; definition
20-844. Right to open enrollment period; subscribers; definition A. With respect to subscribers who are members of a group with more than one carrier, if there is an insolvency of a hospital service corporation, medical service corporation, dental service corporation, optometric service corporation or hospital, medical, dental and optometric service corporation, all other carriers that […]
§ 20-845 – Suspension or revocation of certificate of authority; civil penalties
20-845. Suspension or revocation of certificate of authority; civil penalties A. The director may suspend or revoke a certificate of authority issued to a corporation pursuant to this article if the director finds that any of the following conditions exist: 1. The corporation is operating significantly in contravention of its basic organizational documents or in […]
§ 20-846 – Individual health insurance policies; mandatory coverage exemption; definitions
20-846. Individual health insurance policies; mandatory coverage exemption; definitions A. A hospital service corporation, medical service corporation or hospital and medical service corporation may issue a subscription contract to an uninsured individual that is not subject to the requirements of any of the following: 1. Section 20-461, subsection A, paragraph 17 and subsection B. 2. […]
§ 20-847 – Contracts; dentists; covered services; definition
20-847. Contracts; dentists; covered services; definition A. A contract, entered into or renewed on or after January 1, 2011, between a dental service corporation and a dentist who is licensed to practice in this state shall not require the dentist to provide services to an individual covered under a subscription contract based on a fee […]
§ 20-848 – Prescriptions; cost sharing; refills; dispensing fees; definition
20-848. Prescriptions; cost sharing; refills; dispensing fees; definition A. A subscription contract that is issued or renewed on or after January 1, 2017 and that provides coverage for prescription drugs: 1. May not deny coverage and shall prorate the cost sharing rate for a prescription drug covered by the contract that is dispensed by a […]
§ 20-849 – Contracts; optometrists; covered services; definition
20-849. Contracts; optometrists; covered services; definition A. Except as provided in subsection C of this section, a contract, entered into or renewed on or after January 1, 2022, between an optometric service corporation and an optometrist who is licensed to practice in this state shall not: 1. Require the optometrist to provide a service to […]
§ 20-841.10 – Cancer treatment medications; cost sharing; definition
20-841.10. Cancer treatment medications; cost sharing; definition A. A contract that is issued, delivered or renewed by a corporation on or after January 1, 2016 and that provides coverage both for cancer treatment medications that are injected or intravenously administered by a health care provider and for patient-administered cancer treatment medications, including medications that are […]
§ 20-836 – Limitation on liability
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, […]
§ 20-841.11 – Prescription eyedrops; refills
20-841.11. Prescription eyedrops; refills A. Beginning January 1, 2018, any contract that is issued, delivered or renewed by a corporation and that provides coverage for prescription eyedrops to treat glaucoma or ocular hypertension may not deny coverage for a refill of a prescription for eyedrops to treat glaucoma or ocular hypertension if all of the […]