Sec. 7. (a) The electronic data base by which a health maintenance organization or by which a third party administrator of benefits and health care services offered under a health maintenance organization contract allows an enrollee or a provider to verify an enrollee's coverage or benefits under a health maintenance organization contract must include the following information for each enrollee:
(1) Whether benefits and health care services under the health maintenance organization contract are provided by:
(A) the health maintenance organization; or
(B) a third party administrator.
(2) Whether the health maintenance organization contract is a self-funded or fully-funded plan.
(b) The department shall adopt rules under IC 4-22-2 to ensure compliance with this section.
As added by P.L.111-2020, SEC.15.
Structure Indiana Code
Article 13. Health Maintenance Organizations
Chapter 9. Information to Enrollees or Subscribers
27-13-9-2. Notice of Change in Operation of Health Maintenance Organization
27-13-9-3. Termination of Provider
27-13-9-4. Information on Services and Filing Grievances; Telephone Number
27-13-9-5. Prescription Drug Information Card
27-13-9-6. "Health Plan Information Card"; Indication of Benefits and Health Care Services
27-13-9-7. Electronic Data Base Requirements; Rulemaking Authority