41-2201. SCOPE OF CHAPTER — SHORT TITLE. (1) This chapter applies only to group disability insurance contracts and to blanket disability insurance contracts as herein provided for. (2) This chapter may be cited as the "group or blanket disability insurance law". History: [41-2201, added 1961, ch. 330, sec. 527, p. 645.]
41-2202. "GROUP DISABILITY INSURANCE" DEFINED — ELIGIBLE GROUPS. "Group disability insurance" is hereby declared to be 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 […]
41-2203. REQUIRED PROVISIONS IN GROUP POLICIES. Each such group disability insurance policy shall contain in substance the following provisions: (1) A provision that, in the absence of fraud, all statements made by applicants or the policyholders or by an insured person shall be deemed representations and not warranties, and that no statement made for the […]
41-2204. 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 […]
41-2205. READJUSTMENT OF PREMIUMS — DIVIDENDS. Any contract of group disability insurance may provide for the readjustment of the rate of premium based upon the experience thereunder. If a policy dividend is hereafter declared or a reduction in rate is hereafter made or continued for the first or any subsequent year of insurance under any […]
41-2206. "BLANKET DISABILITY INSURANCE" DEFINED. "Blanket disability insurance" is hereby declared to be that form of disability insurance covering groups of persons as enumerated in one of the following subdivisions. (1) Under a policy or contract issued to any common carrier or to any operator, owner or lessee of a means of transportation, who or […]
41-2207. REQUIRED PROVISIONS IN BLANKET POLICIES. Any insurer authorized to write disability insurance in this state shall have the power to issue blanket disability insurance. No such blanket policy may be issued or delivered in this state unless a copy of the form thereof shall have been filed in accordance with section 41-1812. Every such […]
41-2208. APPLICATION AND CERTIFICATES NOT REQUIRED. An individual application shall not be required from a person covered under a blanket disability policy or contract, nor shall it be necessary for the insurer to furnish each such person a certificate of the insurance. History: [41-2208, added 1961, ch. 330, sec. 534, p. 645.]
41-2209. PAYMENT OF BENEFITS UNDER BLANKET POLICY. All benefits under any blanket disability policy shall be payable to the person insured, or to his designated beneficiary or beneficiaries, or to his estate; except, that if the person insured be a minor or mental incompetent, such benefits may be made payable to his parent, guardian, or […]
41-2210. REQUIRED PROVISION IN GROUP AND BLANKET POLICIES. (1) Any group disability insurance contract or blanket disability insurance contract, delivered or issued for delivery in this state which provides coverage for injury or sickness for newborn dependent children of subscribers or other members of the covered group, shall provide coverage for such newborn children, including […]
41-2210A. LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS. All policies, contracts, plans or certificates of group or blanket disability insurance delivered, issued for delivery or renewed in this state after the effective date of this section shall exclude coverage for elective abortions. Such exclusion may be waived by endorsement and the payment of a premium therefor. […]
41-2210D. CONVERSION PLAN — WHEN REQUIRED. Any group carrier doing business in the state of Idaho that does not have an individual product on file with the department of insurance shall provide a conversion plan to all group insureds. The conversion plan shall provide benefits at least equal to the standard health benefit plan developed […]
41-2211. SCOPE OF ACT — REPLACEMENT OF GROUP DISABILITY INSURANCE, GROUP NONPROFIT HOSPITAL AND MEDICAL SERVICE CONTRACTS AND HEALTH CARE SERVICE PLANS. The provisions of this act shall apply to all policies of group disability insurance issued in this state pursuant to the provisions of chapter 22, title 41, Idaho Code, and any group nonprofit […]
41-2212. DEFINITIONS. In this act, unless the context otherwise requires: (1) "Carrier" shall mean the insurance company, nonprofit hospital and medical service corporation, or other entity responsible for the payment of benefits or provision of services under a policy. (2) "Dependent" shall have the meaning set forth in a policy. (3) "Discontinuance" shall mean the […]
41-2213. POLICY STANDARDS — DISABLED INDIVIDUALS. Every policy containing the benefits described in subsections (1), (2) and (3) of this section must contain a provision which provides for a reasonable extension of benefits with respect to employees or dependents who become totally disabled after the effective date of this act and continue to be totally […]
41-2214. POLICY STANDARDS — MATERNITY BENEFITS. If a policy provides any benefits for pregnancy, childbirth or miscarriage and if an employee or dependent covered for such benefit is pregnant at the time of discontinuance and is not eligible for any replacement group coverage within sixty (60) days of discontinuance, the policy must provide that benefits […]
41-2215. POLICY STANDARDS — REPLACEMENT CONTRACTS. (1) Any carrier providing replacement coverage with respect to hospital, medical or surgical expense benefits within a period of sixty (60) days from the date of discontinuance of a prior policy providing such hospital, medical or surgical expense benefits shall immediately cover all employees and dependents validly covered under […]
41-2216. COORDINATION OF BENEFITS — COORDINATION WITH SOCIAL SECURITY BENEFITS. (1) Under the authority of this section and section 41-2141, Idaho Code, the director shall promulgate rules that are in accordance with the model regulations of the national association of insurance commissioners relating to coordination of benefits provisions in group and individual disability insurance policies. […]
41-2217. SERVICES PROVIDED BY GOVERNMENTAL ENTITIES. (1) From and after July 1, 1990, no group or blanket disability insurance policy shall be issued in Idaho which excludes from coverage services rendered the insured while a resident in an Idaho state institution, provided the services to the insured would be covered by the policy if rendered […]
41-2218. MAMMOGRAPHY COVERAGE. (1) From and after July 1, 1992, all group or blanket disability insurance policies which provide coverage for the surgical procedure known as a mastectomy which are delivered, issued for delivery, continued or renewed in this state shall provide minimum mammography examination or equivalent examination coverage. Such coverage shall include at least […]
