(a) A health maintenance organization shall offer to every enrollee a point-of-service plan option that would allow a covered person to receive covered services from an out-of-network health care provider without obtaining a referral or prior authorization from the health maintenance organization. The point-of-service plan option may require that an enrollee pay a higher deductible or copayment and higher premium for the plan.
(b) A health maintenance organization shall provide each enrollee with an opportunity at the time of enrollment and during the annual open enrollment period to enroll in the point-of-service plan option. The health maintenance organization shall provide written notice of the point-of-service plan option to each enrollee and shall include in that notice a detailed explanation of the financial costs to be incurred by an enrollee who selects that option.
Structure Alaska Statutes
Chapter 86. Health Maintenance Organizations
Sec. 21.86.010. Establishment of health maintenance organizations.
Sec. 21.86.020. Issuance of certificate of authority; approval of changes.
Sec. 21.86.030. Powers of a health maintenance organization.
Sec. 21.86.040. Governing body; enrollee participation.
Sec. 21.86.045. Biographical affidavits.
Sec. 21.86.050. Fiduciary responsibility.
Sec. 21.86.060. Provision of services.
Sec. 21.86.070. Evidence of coverage; charges for health care services.
Sec. 21.86.075. Chiropractic health care services.
Sec. 21.86.078. Choice of health care provider.
Sec. 21.86.080. Annual statement; additional reports.
Sec. 21.86.090. Information to enrollees.
Sec. 21.86.100. Complaint system; report.
Sec. 21.86.110. Recovery of health care costs.
Sec. 21.86.120. Return of agreement.
Sec. 21.86.140. Protection against insolvency.
Sec. 21.86.150. Prohibited practices.
Sec. 21.86.160. Regulation of agents.
Sec. 21.86.170. Powers of insurers and of hospital or medical service corporations.
Sec. 21.86.190. Suspension or revocation of certificate of authority.
Sec. 21.86.200. Administrative procedures.
Sec. 21.86.210. Rehabilitation, liquidation, or conservation.
Sec. 21.86.250. Penalties and enforcement.
Sec. 21.86.260. Statutory construction and relationship to other law.
Sec. 21.86.270. Filings and reports as public documents.
Sec. 21.86.290. Contract authority for commissioner of health.
Sec. 21.86.300. Acquisition of control or merger of a health maintenance organization.