North Carolina General Statutes
Article 50 - General Accident and Health Insurance Regulations.
§ 58-50-292 - Dental provider networks; confidential business information.

58-50-292. Dental provider networks; confidential business information.
(a) The following definitions apply in this section:
(1) Insurer. - As defined in G.S. 58-3-225(a).
(2) Provider network contract. - A contract between an insurer and a dental services provider specifying the rights and responsibilities of the insurer and the provider for the delivery of and payment for dental services.
(3) Third party. - A person or entity that enters into a contract with an insurer or with another entity to gain access to a dental provider network contract. Third party does not include an employer group or other group for which the insurer provides administrative services, including payment of claims.
(b) An insurer may grant access to its provider network contract to a third party if:
(1) At the time the provider network contract is entered into and at the time the provider network contract is renewed, the insurer allows any provider who is part of the carrier's provider network to choose not to participate in third party access to the provider network contract. The third party access provision of any provider network contract shall be clearly identified in the provider network contract. An insurer shall not grant third party access to the provider network contract of any provider who does not participate in third party access.
(2) The insurer includes on its Web site a listing identifying all third parties who have been granted such access.
(3) The third party accessing the provider network contract agrees to comply with all of the provider network contract's terms.
(c) This section shall not apply to the assignment of or access to a provider network contract to an entity operating under the same brand licensee program as the contracting entity or any affiliates of the contracting entity. (2019-26, s. 2.)

Structure North Carolina General Statutes

North Carolina General Statutes

Chapter 58 - Insurance

Article 50 - General Accident and Health Insurance Regulations.

§ 58-50-1 - Waiver by insurer.

§ 58-50-5 - Application.

§ 58-50-15 - Conforming to statute.

§ 58-50-20 - Age limit.

§ 58-50-25 - Nurses' services.

§ 58-50-26 - Physician services provided by physician assistants.

§ 58-50-30 - Right to choose services of certain providers.

§ 58-50-35 - Notice of nonpayment of premium required before forfeiture.

§ 58-50-40 - Willful failure to pay group insurance premiums; willful termination of a group health plan; notice to persons insured; penalty; restitution; examination of insurance transactions.

§ 58-50-45 - Group health or life insurers to notify insurance fiduciaries of obligations.

§ 58-50-46 - Recodified as G.S108A-55.4 by Session Laws 2006-221, s9(a), effective January 1, 2007.

§ 58-50-56 - Insurers, preferred provider organizations, and preferred provider benefit plans.

§ 58-50-56.1 - Exclusive provider organizations, exclusive provider benefit plans.

§ 58-50-56.2 - Exclusive provider organization continuity of care.

§ 58-50-57 - Offsets against provider reimbursement for workers' compensation payments forbidden.

§ 58-50-61 - Utilization review.

§ 58-50-62 - Insurer grievance procedures.

§ 58-50-63 - Expired pursuant to Session Laws 2005-453, s3, effective July 1, 2005.

§ 58-50-65 - Certain policies of insurance not affected.

§ 58-50-70 - Punishment for violation.

§ 58-50-75 - Purpose, scope, and definitions.

§ 58-50-77 - Notice of right to external review.

§ 58-50-79 - Exhaustion of internal grievance process.

§ 58-50-80 - Standard external review.

§ 58-50-82 - Expedited external review.

§ 58-50-84 - Binding nature of external review decision.

§ 58-50-85 - Approval of independent review organizations.

§ 58-50-87 - Minimum qualifications for independent review organizations.

§ 58-50-89 - Hold harmless for Commissioner and independent review organizations.

§ 58-50-90 - External review reporting requirements.

§ 58-50-92 - Funding of external review.

§ 58-50-93 - Disclosure requirements.

§ 58-50-94 - Selection of independent review organizations.

§ 58-50-100 - Title and reference.

§ 58-50-105 - Purpose and intent.

§ 58-50-110 - Definitions.

§ 58-50-112 - Affiliated companies; HMOs.

§ 58-50-115 - Health benefit plans subject to Act.

§ 58-50-125 - Health care plans; formation; approval; offerings.

§ 58-50-130 - Required health care plan provisions.

§ 58-50-131 - Premium rates for health benefit plans; approval authority; hearing.

§ 58-50-149 - Limit on cessions to the Reinsurance Pool.

§ 58-50-150 - North Carolina Small Employer Health Reinsurance Pool.

§ 58-50-151 - (Recodified as § 58-51-116 effective July 1, 2002) ERISA plans may not require Medicaid to pay first.

§ 58-50-270 - Definitions.

§ 58-50-275 - Notice contact provisions.

§ 58-50-280 - Contract amendments.

§ 58-50-285 - Policies and procedures.

§ 58-50-290 - Health benefit plans or insurers contracting for provision of dental services; no limitation on fees for noncovered services or on methods of claims payment.

§ 58-50-292 - Dental provider networks; confidential business information.

§ 58-50-295 - Prohibited contract provisions related to reimbursement rates.

§ 58-50-300 - Health benefit plans or insurers contracting for provision of vision services or materials; no limitation on fees for noncovered services or materials.