Sec. 7.8. (a) As used in this section, "covered individual" means an individual who is:
(1) covered under a self-insurance program established under section 7(b) of this chapter to provide group health coverage; or
(2) entitled to services under a contract with a health maintenance organization (as defined in IC 27-13-1-19) that is entered into or renewed under section 7(c) of this chapter.
(b) A:
(1) self-insurance program established under section 7(b) of this chapter to provide health care coverage; or
(2) contract with a health maintenance organization that is entered into or renewed under section 7(c) of this chapter;
must provide coverage for colorectal cancer examinations and laboratory tests for cancer for any nonsymptomatic covered individual.
(c) For a covered individual who is:
(1) at least forty-five (45) years of age; or
(2) less than forty-five (45) years of age and at high risk for colorectal cancer;
the coverage required under this section must meet the requirements set forth in subsection (d), except as provided in subsection (e).
(d) A covered individual may not be required to pay an additional deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit required by this section that is greater than an annual deductible or coinsurance established for similar benefits under the self-insurance program or contract with a health maintenance organization under which the covered individual is covered or entitled to services. If the program or contract does not cover a similar benefit, a deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit may not be set at a level that materially diminishes the value of the colorectal cancer examination and laboratory testing benefit.
(e) The requirements imposed under this section do not apply to a high deductible health plan, as defined by Section 223 of the Internal Revenue Code. High deductible health plans described in this subsection may not excuse a deductible requirement with respect to colorectal cancer screening in a manner inconsistent with Section 223(c)(2)(C) of the Internal Revenue Code.
As added by P.L.54-2000, SEC.1. Amended by P.L.36-2020, SEC.1.
Structure Indiana Code
Title 5. State and Local Administration
Article 10. Public Employee Benefits
Chapter 8. Group Insurance for Public Employees
5-10-8-0.1. Application of Certain Amendments to Chapter
5-10-8-0.3. Use of Certain Accrued Benefits by State Employees
5-10-8-0.4. Legalization of Certain Payments of Deductible Portion of Group Health Insurance
5-10-8-2.2. Public Safety Employees; Surviving Spouses; Dependents
5-10-8-2.7. Insurance of Rostered Volunteers
5-10-8-4. Discrimination as to Form of Insurance Between Certain Employees; Exception
5-10-8-5. Establishment of Common and Unified Plan of Group Insurance
5-10-8-6.5. General Assembly Members and Former Members
5-10-8-6.7. Election of State Employee Health Care Program by School Corporation
5-10-8-7.1. Coverage for Autism Spectrum Disorder
5-10-8-7.3. Early Intervention Services for First Steps Children
5-10-8-7.5. Prostate Specific Antigen Test
5-10-8-7.7. Surgical Treatment for Morbid Obesity
5-10-8-7.8. Colorectal Cancer Testing Coverage; Exception for High Deductible Health Plans
5-10-8-8. Retired Employees; Ability of Employer to Pay Premiums; Eligibility
5-10-8-8.1. Retired Legislators
5-10-8-8.2. Former Legislators
5-10-8-8.3. Former State and Legislative Employees; Health Benefit Plans
5-10-8-8.4. Revocation or Alteration by Employer
5-10-8-8.5. Establishment of Retiree Health Benefit Trust Fund
5-10-8-9. Coverage of Services for Mental Illness
5-10-8-10. Examining Infants for Hiv; Payment
5-10-8-10.5. Dental Care Provisions Required
5-10-8-11. Use of Diagnostic or Procedure Codes
5-10-8-13. Mail Order or Internet Based Pharmacy
5-10-8-14. Coverage for Prosthetic Devices
5-10-8-14.8. Employee Health Plan Providing Coverage for Prescription Eye Drops
5-10-8-14.9. Coverage of Methadone
5-10-8-15. Coverage for Care Related to Cancer Clinical Trials
5-10-8-16. High Breast Density
5-10-8-16.5. Post-Mastectomy Coverage
5-10-8-17. Step Therapy Protocol
5-10-8-18. Prescription Drug Coverage
5-10-8-19. Prior Authorization
5-10-8-21. Coverage for Anatomical Gifts, Transplantation, or Related Health Care Services
5-10-8-22. Coverage for Chronic Pain Management
5-10-8-22.5. Amount Paid for Prescription Drug to Be Counted Against Deductible
5-10-8-23. Reimbursement for Emergency Medical Services
5-10-8-24. Coverage for Pediatric Neuropsychiatric Disorders