2-18-808. Purpose
2-18-808. Purpose. The purpose of this part is to establish a program under which the state may provide state employees with adequate group hospitalization, health, medical, disability, life, and other related group benefits in an efficient manner and at an affordable cost. History: En. Sec. 1, Ch. 555, L. 1979.
2-18-809. Definitions
2-18-809. Definitions. As used in this part, the following definitions apply: (1) ”Advisory council” means the state employee group benefits advisory council provided for in 2-15-1016. (2) ”Department” means the department of administration provided for in 2-15-1001. (3) ”Flexible spending account” means a funding and accounting arrangement allowed by federal law that: (a) gives a state employee a choice between […]
2-18-810. Functions of advisory council
2-18-810. Functions of advisory council. (1) The department shall meet and consult with the advisory council before negotiating, contracting, or otherwise modifying state employee group benefit plans. (2) The advisory council shall meet quarterly to review the existing state employee group benefit plans, to review claims problems, and to advise the department on state employee group benefit […]
2-18-716. Hold harmless
2-18-716. Hold harmless. (1) If a covered person receives services from a non-Montana hospital-controlled out-of-network air ambulance service for an emergency medical condition, an insurer or health plan shall assume the covered person’s responsibility, if any, for amounts charged in excess of allowed amounts for covered services and supplies, applicable copayments, coinsurance, and deductibles. (2) An insurer […]
2-18-717. Disclosures by air ambulance service
2-18-717. Disclosures by air ambulance service. An out-of-network nonhospital-controlled air ambulance service must disclose by July 1 of each year any relationships or financial arrangements with health care providers, insurers, or health plans. This includes but is not limited to employment arrangements, ownership interests, first call agreements, and board memberships. This information must be filed with […]
2-18-718. Independent dispute resolution
2-18-718. Independent dispute resolution. (1) If an insurer or health plan and air ambulance service enter into dispute resolution, the procedure in 2-18-719 is to be used to determine the fair market price of the services that are the subject of the claim. (2) Payment of the fair market price calculated pursuant to 2-18-719 constitutes payment in […]
2-18-719. Independent dispute resolution procedure — exemptions
2-18-719. Independent dispute resolution procedure — exemptions. (1) To initiate a dispute resolution procedure under 2-18-715 through 2-18-720, the parties shall file a written notice of dispute with the insurance commissioner. (2) Except as provided in subsection (3), within 30 days after the date of receipt of the notice of dispute, and if no independent reviewer is […]
2-18-720. Insurance commissioner duties — independent reviewer qualifications
2-18-720. Insurance commissioner duties — independent reviewer qualifications. (1) The insurance commissioner shall: (a) approve any independent reviewer that is eligible to adjudicate disputes under 2-18-715 through 2-18-720; (b) maintain a list of independent reviewers eligible to adjudicate disputes under 2-18-715 through 2-18-720; (c) terminate approval of an independent reviewer and remove the independent reviewer from the list of […]
2-18-705. Terminated
2-18-705. Terminated. Sec. 14, Ch. 363, L. 2013. History: En. Sec. 6, Ch. 363, L. 2013.
2-18-706. through 2-18-710 reserved
2-18-706 through 2-18-710 reserved.