Idaho Code
Chapter 34 - HOSPITAL AND PROFESSIONAL SERVICE CORPORATIONS
Section 41-3413 - SERVICES AND BENEFITS WHICH MAY BE PROVIDED PROFESSIONAL SERVICE CORPORATIONS.

41-3413. SERVICES AND BENEFITS WHICH MAY BE PROVIDED PROFESSIONAL SERVICE CORPORATIONS. (1) A professional service corporation shall have the right to provide to its subscribers part or all of the following services and benefits only:
(a) Professional services furnished to the subscriber by one (1) or more specified categories of participant licensees, as such categories are referred to in section 41-3403(9), Idaho Code, and subject to the requirements of section 41-3408(3), Idaho Code, (qualifications for authority) as to each such category;
(b) Indemnity in reasonable amounts with respect to professional services and drugs (under subscribers’ contracts providing for services of participant licensee pharmacists) furnished to the subscriber by nonparticipant licensees of the same category or categories as participant licensees of the service corporation, but subject to section 41-3408(3), Idaho Code, (qualifications for authority);
(c) Indemnity in reasonable amounts with respect to hospital services furnished the subscriber while under the care and treatment of a licensee entitled to practice in such hospital;
(d) Indemnity in reasonable amounts with respect to appliances, prosthetics and similar devices and replacements, and ambulance, x-ray, physiotherapy, and similar services; and
(e) Indemnity in reasonable amounts with respect to services rendered to the subscriber by licensees of a category or categories specified in the subscriber’s contract including any category of licensee defined in section 41-3403(9), Idaho Code, or rendered by other persons specified in the subscriber’s contract, duly licensed by the state to engage in any health care profession or practice. The portion of the total charges to subscribers for such coverage as is authorized by this paragraph shall not exceed one-third (1/3) of the total charges to all subscribers made by the service corporation for all services and benefits rendered in any calendar year.
(2) This section shall not be deemed to prohibit such a corporation from acting as compensated servicing agent as to health care services to be provided by any public agency or under agreements between other parties not solicited by such corporation.

History:
[41-3413, added 1961, ch. 330, sec. 771, p. 645; am. 1971, ch. 252, sec. 8, p. 1008; am. 2021, ch. 321, sec. 31, p. 971.]

Structure Idaho Code

Idaho Code

Title 41 - INSURANCE

Chapter 34 - HOSPITAL AND PROFESSIONAL SERVICE CORPORATIONS

Section 41-3401 - SCOPE OF CHAPTER.

Section 41-3402 - PURPOSE AND INTERPRETATION.

Section 41-3403 - DEFINITIONS.

Section 41-3404 - PROVISIONS EXCLUSIVE.

Section 41-3405 - INCORPORATION — CERTIFICATE OF AUTHORITY REQUIRED.

Section 41-3406 - INCORPORATION — LAWS APPLICABLE — APPROVAL OF ARTICLES OF INCORPORATION — AMENDMENT.

Section 41-3407 - NAME OF CORPORATION.

Section 41-3408 - QUALIFICATIONS FOR CERTIFICATE OF AUTHORITY.

Section 41-3409 - APPLICATION FOR CERTIFICATE OF AUTHORITY.

Section 41-3410 - ISSUANCE OR REFUSAL OF CERTIFICATE OF AUTHORITY.

Section 41-3411 - CONTINUANCE OR EXPIRATION OF CERTIFICATE OF AUTHORITY.

Section 41-3412 - SUSPENSION OR REVOCATION OF CERTIFICATE OF AUTHORITY.

Section 41-3413 - SERVICES AND BENEFITS WHICH MAY BE PROVIDED PROFESSIONAL SERVICE CORPORATIONS.

Section 41-3414 - SERVICES AND BENEFITS WHICH MAY BE PROVIDED — HOSPITAL SERVICE CORPORATIONS.

Section 41-3415 - PROFESSIONAL SERVICE AGREEMENTS.

Section 41-3415A - PHARMACISTS’ SERVICE AGREEMENTS.

Section 41-3416 - HOSPITAL SERVICE AGREEMENTS.

Section 41-3417 - SUBSCRIBER’S CONTRACTS.

Section 41-3418 - SERVICE AGREEMENTS AND SUBSCRIBER’S CONTRACTS MUST PROVIDE SUBSTANTIAL SERVICE BENEFITS.

Section 41-3419 - FILING AND APPROVAL OF AGREEMENTS AND CONTRACTS.

Section 41-3420 - CHARGES AND RATES.

Section 41-3421 - RESERVES.

Section 41-3422 - SURPLUS FUND.

Section 41-3423 - INVESTMENTS.

Section 41-3424 - RECORDS AND ACCOUNTS.

Section 41-3425 - ANNUAL STATEMENT.

Section 41-3426 - EXAMINATION.

Section 41-3427 - TAXATION AND ANNUAL REPORT.

Section 41-3428 - JOINT OPERATIONS.

Section 41-3429 - COMBINED CORPORATION.

Section 41-3430 - CONTRACTS COVERING WORKMEN’S COMPENSATION RISKS.

Section 41-3431 - ANNUAL ADJUSTMENT OF SERVICE PAYMENTS — DISPOSITION OF EXCESS FUNDS.

Section 41-3432 - FIDELITY BOND.

Section 41-3433 - SERVICE CORPORATION FEES.

Section 41-3434 - OTHER PROVISIONS APPLICABLE.

Section 41-3435 - PRODUCER LICENSING.

Section 41-3436 - DEPENDENT’S COVERAGE — DEPENDENT’S TERMINATION OF COVERAGE, DISABILITY AND DEPENDENCY PROOF AND APPLICATION.

Section 41-3437 - REQUIRED PROVISIONS — INFANTS.

Section 41-3438 - COMPLICATIONS OF PREGNANCY.

Section 41-3439 - LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS.

Section 41-3440 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.

Section 41-3441 - MAMMOGRAPHY COVERAGE.

Section 41-3443 - BEST PRICE — MOST FAVORED NATIONS CLAUSE PROHIBITED.

Section 41-3444 - CONTRACTS WITH PROVIDERS OF DENTAL SERVICES.