Sec. 1. (a) The term "policy of accident and sickness insurance", as used in this chapter, includes any policy or contract covering one (1) or more of the kinds of insurance described in Class 1(b) or 2(a) of IC 27-1-5-1. Such policies may be on the individual basis under this section and sections 2 through 9 of this chapter, on the group basis under this section and sections 16 through 19 of this chapter, on the franchise basis under this section and section 11 of this chapter, or on a blanket basis under section 15 of this chapter and (except as otherwise expressly provided in this chapter) shall be exclusively governed by this chapter.
(b) No policy of accident and sickness insurance may be issued or delivered to any person in this state, nor may any application, rider, or endorsement be used in connection with an accident and sickness insurance policy, until a copy of the form of the policy and of the classification of risks and the premium rates, or, in the case of assessment companies, the estimated cost pertaining thereto, have been filed with and reviewed by the commissioner under section 1.5 of this chapter. This section is applicable also to assessment companies and fraternal benefit associations or societies.
(c) This chapter shall be applied in conformity with the requirements of the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), as in effect on September 23, 2010.
(d) A policy of accident and sickness insurance that is issued or delivered through a health benefit exchange established under the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), is subject to the requirements of this chapter. The commissioner may adopt rules under IC 4-22-2 to implement this subsection, including rules concerning:
(1) certification or decertification of a qualified health plan (as defined in IC 27-19-2-16); and
(2) open enrollment.
Formerly: Acts 1953, c.15, s.169.1; Acts 1975, P.L.281, SEC.1. As amended by P.L.257-1985, SEC.1; P.L.7-1987, SEC.154; P.L.173-2007, SEC.21; P.L.160-2011, SEC.17; P.L.278-2013, SEC.23.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 5. Accident and Sickness Insurance─policy Provisions
27-8-5-0.1. Application of Certain Amendments to Chapter
27-8-5-1. Policy of Accident and Sickness Insurance; Filing; Review; Conformity With Federal Act
27-8-5-1.5. Filing, Review, Approval, and Disapproval Process
27-8-5-2. Requirements for Issuance and Delivery of Policy
27-8-5-2.7. Individual Policy of Accident and Sickness Insurance; Waiver of Coverage
27-8-5-4. Effect of Other Policy Provisions or Policy Conflicting With Chapter
27-8-5-6. Defenses of Insurer; Acts Not Constituting Waiver
27-8-5-7. Acceptance of Premium for Period Beyond Termination Date; Effect; Misstatement of Age
27-8-5-9. Exemption of Certain Individual Policies
27-8-5-12. Supplementary Character of Chapter
27-8-5-14. Exception of Fraternal Benefit Associations
27-8-5-15.5. Inpatient Services for Treatment of Mental Illness or Substance Abuse
27-8-5-16. Policy of Group Accident and Sickness Insurance; Requirements
27-8-5-17. Exceptions; Discretionary Groups; Group Accident and Sickness Insurance
27-8-5-19. Contents; Group Accident and Sickness Insurance
27-8-5-20. Notice of Right to Return Policy
27-8-5-22. Refund of Unused Premiums
27-8-5-26. Post-Mastectomy Coverage
27-8-5-27. Dental Care Provisions Required
27-8-5-28. Coverage of Child to 26 Years of Age
27-8-5-29. Health Plans Offered Through Health Benefit Exchange