Section 27-52-3 – Additional Powers; Guidelines.
Section 27-52-3 Additional powers; guidelines. (a) The commissioner shall, by regulation, establish additional powers and duties of the plan and may adopt such rules as are necessary and proper to implement this article. For the purpose of this section, the term “insurer” means any entity covered by the Health Insurance Portability Act, including, but not […]
Section 27-54-6 – Cost Report.
Section 27-54-6 Cost report. Every issuer of a group health benefit plan subject to this chapter shall provide a cost report for each calendar year to the Commissioner of Insurance no later than April 30th of the following year. The report shall be in a form prescribed by the commissioner and shall include certification of […]
Section 27-56-4 – Prohibited Activities.
Section 27-56-4 Prohibited activities. An insurance policy, plan, or contract providing for third-party payment or prepayment of health or medical expenses shall not do any of the following: (1) Impose a practice restriction for optometrists which is inconsistent with or more restrictive than provided by law. (2) Discriminate between classes of eye care providers with […]
Section 27-52-4 – Coverage.
Section 27-52-4 Coverage. The plan shall offer health care coverage consistent with major medical expense coverage to every eligible person who is not eligible for Medicare. The coverage to be issued by the plan, its schedule of benefits, exclusions, and other limitations shall be established by the plan, which plan benefits shall be inclusive of […]
Section 27-54-7 – Conflicting Laws Superseded.
Section 27-54-7 Conflicting laws superseded. This chapter shall supersede subsection (c), Section 27-1-18, and any other conflicting laws to the extent there is a conflict with this chapter. (Act 2000-386, p. 605, §8.)
Section 27-56-5 – Third-Party Payment.
Section 27-56-5 Third-party payment. (a) No insurance policy, plan, or contract providing for third-party payment or prepayment of health or medical expenses that provides coverage for eye care services shall be issued or renewed after August 1, 2001, unless such insurance policy, plan, or contract does the following: (1) Provides a covered person direct access […]
Section 27-52-5 – Liability of Plan.
Section 27-52-5 Liability of plan. Neither the establishment of rates, forms, or procedures nor any other joint or collective action required by this article shall be the basis of any legal action, criminal or civil liability, or penalty against the plan. (Acts 1997, No. 97-713, p. 1476, §5.)
Section 27-54A-1 – Short Title.
Section 27-54A-1 Short title. This chapter may be known and cited as the Riley Ward Act. (Act 2012-298, p. 647, §1.)
Section 27-56-6 – When Provisions Applicable.
Section 27-56-6 When provisions applicable. This chapter shall apply to services provided under a policy, plan, or contract providing for third-party payment or prepayment of health or medical expenses delivered, continued, or renewed in this state on or after August 1, 2001, and to any such existing policy, plan, or contract, on its anniversary or […]
Section 27-52-6 – Exemptions.
Section 27-52-6 Exemptions. The plan established pursuant to this article shall be exempt from payment of all fees and all taxes levied by this state or any of its subdivisions. If the Commissioner of Insurance enters into a contract with one or more third parties to provide any or all of the services in the […]