Sec. 16.5. (a) As used in this section, "delivery state" means any state other than Indiana in which a policy is delivered or issued for delivery.
(b) Except as provided in subsection (c), (d), or (e), a certificate may not be issued to a resident of Indiana pursuant to a group policy that is delivered or issued for delivery in a state other than Indiana.
(c) A certificate may be issued to a resident of Indiana pursuant to a group policy not described in subsection (d) that is delivered or issued for delivery in a state other than Indiana if:
(1) the delivery state has a law substantially similar to section 16 of this chapter;
(2) the delivery state has approved the group policy; and
(3) the policy or the certificate contains provisions that are:
(A) substantially similar to the provisions required by:
(i) section 19 of this chapter;
(ii) section 21 of this chapter; and
(iii) IC 27-8-5.6; and
(B) consistent with the requirements set forth in:
(i) section 24 of this chapter;
(ii) IC 27-8-6;
(iii) IC 27-8-14;
(iv) IC 27-8-23;
(v) 760 IAC 1-38.1; and
(vi) 760 IAC 1-39.
(d) A certificate may be issued to a resident of Indiana under an association group policy, a discretionary group policy, or a trust group policy that is delivered or issued for delivery in a state other than Indiana if:
(1) the delivery state has a law substantially similar to section 16 of this chapter;
(2) the delivery state has approved the group policy; and
(3) the policy or the certificate contains provisions that are:
(A) substantially similar to the provisions required by:
(i) section 19 of this chapter or, if the policy or certificate is described in section 2.5(b)(2) of this chapter, section 2.5 of this chapter;
(ii) section 19.3 of this chapter if the policy or certificate contains a waiver of coverage;
(iii) section 21 of this chapter; and
(iv) IC 27-8-5.6; and
(B) consistent with the requirements set forth in:
(i) section 15.6 of this chapter;
(ii) section 24 of this chapter;
(iii) section 26 of this chapter;
(iv) IC 27-8-6;
(v) IC 27-8-14;
(vi) IC 27-8-14.1;
(vii) IC 27-8-14.5;
(viii) IC 27-8-14.7;
(ix) IC 27-8-14.8;
(x) IC 27-8-20;
(xi) IC 27-8-23;
(xii) IC 27-8-24.3;
(xiii) IC 27-8-26;
(xiv) IC 27-8-28;
(xv) IC 27-8-29;
(xvi) 760 IAC 1-38.1; and
(xvii) 760 IAC 1-39.
(e) A certificate may be issued to a resident of Indiana pursuant to a group policy that is delivered or issued for delivery in a state other than Indiana if the commissioner determines that the policy pursuant to which the certificate is issued meets the requirements set forth in section 17(a) of this chapter.
(f) This section does not affect any other provision of Indiana law governing the terms or benefits of coverage provided to a resident of Indiana under any certificate or policy of insurance.
As added by P.L.185-1996, SEC.12. Amended by P.L.96-2002, SEC.1; P.L.211-2003, SEC.3; P.L.127-2006, SEC.2; P.L.11-2011, SEC.30.
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