20-1401. Eligible groups A. Group disability insurance is that form of disability insurance covering groups of persons as defined below, with or without one or more members of their families or one or more of their dependents, or covering one or more members of the families or one or more dependents of persons in such […]
20-1401.01. Group disability insurers; notice; copies A. No person or insurer may deliver or issue for delivery to an employer in this state a certificate of insurance or other evidence of coverage of a group disability policy issued outside this state unless the certificate or other evidence of coverage contains the following notice, prominently displayed: […]
20-1402. Provisions of group disability policies; definitions A. Each group disability policy shall contain in substance the following provisions: 1. A provision that, in the absence of fraud, all statements made by the policyholder or by any insured person shall be deemed representations and not warranties, and that no statement made for the purpose of […]
20-1402.01. Group disability insurance; clinical trials; cancer; definitions A. A group disability insurer 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 insured participates voluntarily. A cancer clinical trial is a course of […]
20-1402.02. Eosinophilic gastrointestinal disorder; formula A. Any group disability policy that is offered by a group disability insurer 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 insured has been diagnosed with an eosinophilic gastrointestinal disorder. 2. The […]
20-1402.03. Group disability insurers; autism spectrum disorder; coverage; exceptions; definitions A. A group disability insurer 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, assessment and services. […]
20-1402.04. Contracts; dentists; covered services; definition A. A contract, entered into or renewed on or after January 1, 2011, between a group disability insurer 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 group disability policy based on a […]
20-1402.05. 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 a group disability insurer and an optometrist who is licensed to practice in this state shall not: 1. Require the optometrist to provide a service to […]
20-1403. Direct payment of hospital and medical services Any group disability policy may provide that all or any portion of any indemnities provided by any such policy on account of hospital, nursing, medical or surgical services may, at the insurer’s option, be paid directly to the hospital or person rendering such services, but the policy […]
20-1404. Blanket disability insurance; definitions A. Blanket disability insurance is that form of disability insurance covering special groups of persons as enumerated in one of the following paragraphs: 1. Under a policy or contract issued to any common carrier or to any operator, owner or lessee of a means of transportation, which shall be deemed […]
20-1404.01. Blanket disability insurance; clinical trials; cancer; definitions A. A blanket disability insurer is not obligated to pay any costs, other than patient costs, that are directly associated with a cancer clinical trial that is offered in this state and in which the insured participates voluntarily. A cancer clinical trial is a course of treatment […]
20-1404.02. Eosinophilic gastrointestinal disorder; formula A. Any policy or contract that is offered by a blanket disability insurer 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 insured has been diagnosed with an eosinophilic gastrointestinal disorder. 2. The […]
20-1404.03. Blanket disability insurers; autism spectrum disorder; coverage; exceptions; definitions A. A blanket disability insurer 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, assessment and services. […]
20-1404.04. Contracts; dentists; covered services; definition A. A contract, entered into or renewed on or after January 1, 2011, between a blanket disability insurer 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 blanket disability policy based on a […]
20-1404.05. 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 a blanket disability insurer and an optometrist who is licensed to practice in this state shall not: 1. Require the optometrist to provide a service to […]
20-1405. Provisions of group and blanket disability policy The provisions of article 4 of chapter 6 of this title shall not apply to group disability or blanket disability insurance policies, but no such policy of group or blanket disability insurance shall contain any provision relative to notice or proof of loss, or to the time […]
20-1406. Prohibiting denial of certain contract benefits A. Notwithstanding any provision of any group disability insurance contract or blanket disability insurance contract, benefits shall not be denied under the contract for any medical or surgical service performed by a holder of a license issued pursuant to title 32, chapter 7 or 11 or a registered […]
20-1406.01. Prohibiting denial of chiropractic contract benefits; direct reimbursement If a group disability insurance contract or blanket disability insurance contract provides for or offers reimbursement for any service which is within the lawful scope of the practice of a chiropractor holding a certificate or license issued by the state in which the services are rendered, […]
20-1406.02. Prohibiting denial of psychologist contract benefits If a group disability insurance contract or blanket disability insurance contract provides for or offers reimbursement for any service which is within the lawful scope of the practice of a psychologist holding a certificate or license issued by the state in which the services are rendered, a subscriber […]
20-1406.03. Prohibiting denial of contract benefits; nursing; reimbursement If a group disability or blanket disability insurance contract provides or offers reimbursement for any service which is within the scope of the practice of a registered nurse practitioner or a certified registered nurse qualified under the rules adopted by the state board of nursing regarding extended […]
