Sec. 0.1. The following amendments to this chapter apply as follows: (1) The amendments made to section 2 of this chapter (before its repeal) and section 3 of this chapter (before its repeal) by P.L.46-1985 do not affect contracts: (A) entered into before; and (B) in effect on; July 1, 1986. (2) The addition of […]
Sec. 0.3. The benefits accrued by an employee under 31 IAC 1-9-5 (before its repeal) or 31 IAC 2-11-6 (before its repeal) that are unused after June 30, 1989, may be used by the employee after June 30, 1989, in accordance with the rules required by section 7(d) of this chapter, as amended by P.L.27-1988. […]
Sec. 0.4. Payment of the deductible portion of group health insurance by a public employer before July 1, 1989, is legalized. As added by P.L.220-2011, SEC.67.
As added by P.L.220-2011, SEC.68. Repealed by P.L.91-2014, SEC.8.
Sec. 1. The following definitions apply in this chapter: (1) “Employee” means: (A) an elected or appointed officer or official, or a full-time employee; (B) if the individual is employed by a school corporation, a full-time or part-time employee; (C) for a local unit public employer, a full-time or part-time employee or a person who […]
Sec. 10. (a) The state shall cover the testing required under IC 16-41-6-4 and the examinations required under IC 16-41-17-2 under a: (1) self-insurance program established or maintained under section 7(b) of this chapter to provide group health coverage; and (2) contract entered into or renewed under section 7(c) of this chapter to provide health […]
Sec. 10.5. (a) As used in this section, “child” means an individual who is less than nineteen (19) years of age. (b) As used in this section, “covered individual” means a child or an individual: (1) with a physical or mental impairment that substantially limits one (1) or more of the major life activities of […]
Sec. 11. (a) As used in this section, “administrator” means: (1) the state personnel department; (2) an entity with which the state contracts to administer health coverage under section 7(b) of this chapter; or (3) a prepaid health care delivery plan with which the state contracts under section 7(c) of this chapter. (b) As used […]
Sec. 12. (a) As used in this section, “covered individual” means an individual who is covered under an employee health plan. (b) As used in this section, “employee health plan” means: (1) a self-insurance program established under section 7(b) of this chapter; or (2) a contract with a prepaid health care delivery plan entered into […]
Sec. 13. (a) As used in this section, “covered individual” means an individual who is entitled to coverage under an employee health benefit plan. (b) As used in this section, “employee health benefit plan” means a group plan of self-insurance, policy, or contract that: (1) provides coverage for prescription drugs; and (2) is established, purchased, […]
Sec. 14. (a) As used in this section, “covered individual” means an individual who is entitled to coverage under a state employee health plan. (b) As used in this section, “orthotic device” means a medically necessary custom fabricated brace or support that is designed as a component of a prosthetic device. (c) As used in […]
Sec. 14.8. (a) This section applies to an employee health plan that provides coverage for prescription eye drops. (b) As used in this section, “covered individual” means an individual who is entitled to coverage under a state employee health plan. (c) As used in this section, “state employee health plan” means one (1) of the […]
Sec. 14.9. (a) This section applies to an employee health plan that is established, entered into, amended, or renewed after June 30, 2015. (b) As used in this section, “state employee health plan” means one (1) of the following: (1) A self-insurance program established under section 7(b) of this chapter to provide group health coverage. […]
Sec. 15. (a) As used in this section, “care method” means the use of a particular drug or device in a particular manner. (b) As used in this section, “clinical trial” means a Phase I, II, III, or IV research study: (1) that is conducted: (A) using a particular care method to prevent, diagnose, or […]
Sec. 16. (a) As used in this section, “covered individual” means an individual who is entitled to coverage under a state employee health plan. (b) As used in this section, “high breast density” means a condition in which there is a greater amount of breast and connective tissue in comparison to fat in the breast. […]
Sec. 16.5. (a) As used in this section, “covered individual” means an individual who is entitled to coverage under a state employee health plan. (b) As used in this section, “mastectomy” means the removal of all or part of a breast for reasons that are determined by a licensed physician to be medically necessary. (c) […]
Sec. 17. (a) As used in this section, “covered individual” means an individual entitled to coverage under a state employee health plan. (b) As used in this section, “preceding prescription drug” means a prescription drug that, according to a step therapy protocol, must be: (1) first used to treat a covered individual’s condition; and (2) […]
Sec. 18. (a) The definitions in section 17 of this chapter apply throughout this section. (b) This section applies to a state employee health plan that uses a formulary, cost sharing, or utilization review for prescription drug coverage. (c) A state employee health plan shall not remove a prescription drug from the state employee health […]
Sec. 19. A self-insurance program established under section 7(b) of this chapter to provide health care coverage shall comply with the prior authorization requirements that apply to a health plan under IC 27-1-37.5. As added by P.L.77-2018, SEC.1.
[Pre-Local Government Recodification Citations: 4-15-5-2; 19-10-4-2.] As added by Acts 1980, P.L.8, SEC.41. Amended by P.L.28-1983, SEC.49. Repealed by P.L.24-1985, SEC.25(c).
