Ask a question on the site
Questions
Lawyers
Blogs
Legislation
Contacts
Become a lawyer
Login Registration
Section 58-17-1 - Requirements for all health insurance policies delivered in state. - 58-17-1. Requirements for all health insurance policies delivered in state....
Section 58-17-1.1 - Grandfathered plans required to cover low-dose mammography--Extent of coverage. - 58-17-1.1. Grandfathered plans required to cover low-dose mammography--Extent of coverage....
Section 58-17-1.2 - Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations. - 58-17-1.2. Policies to provide coverage for diabetes supplies, equipment and...
Section 58-17-1.3 - Diabetes coverage not required of certain plans and policies. - 58-17-1.3. Diabetes coverage not required of certain plans and policies....
Section 58-17-1.4 - Policies required to cover occult breast cancer screening. - 58-17-1.4.Policies required to cover occult breast cancer screening. Each policy...
Section 58-17-2 - Persons covered by policy. - 58-17-2. Persons covered by policy. A policy of health insurance...
Section 58-17-2.1 - Health insurance on a franchise plan. - 58-17-2.1. Health insurance on a franchise plan. Health insurance on...
Section 58-17-2.2 - Conversion privileges of insured's spouse upon divorce. - 58-17-2.2. Conversion privileges of insured's spouse upon divorce. No accident...
Section 58-17-2.3 - Dependent coverage termination--Age--Full-time students. - 58-17-2.3. Dependent coverage termination--Age--Full-time students. No insurer or health carrier...
Section 58-17-3 - Time of commencement and termination to be set out in policy. - 58-17-3. Time of commencement and termination to be set out...
Section 58-17-4 - Consideration for policy to be stated. - 58-17-4. Consideration for policy to be stated. The entire money...
Section 58-17-4.1 - Filing and approval of individual policy premium rates. - 58-17-4.1. Filing and approval of individual policy premium rates. Premium...
Section 58-17-4.2 - Premium rates required to be reasonable--Rules to establish minimum standards promulgated by director. - 58-17-4.2. Premium rates required to be reasonable--Rules to establish minimum...
Section 58-17-5 - Identification of forms, riders and endorsements--Form number, location. - 58-17-5. Identification of forms, riders and endorsements--Form number, location. Each...
Section 58-17-6 - Style and arrangement of policy provisions--Printing, size of type. - 58-17-6. Style and arrangement of policy provisions--Printing, size of type....
Section 58-17-7 - Documents forming part of policy--Setting forth in full, rates and classifications excepted. - 58-17-7. Documents forming part of policy--Setting forth in full, rates...
Section 58-17-8 - Exceptions and reductions of coverage to be clearly set out. - 58-17-8. Exceptions and reductions of coverage to be clearly set...
Section 58-17-9 - Renewal of policy at option of insurer--Statement in policy so informing the policyholder. - 58-17-9. Renewal of policy at option of insurer--Statement in policy...
Section 58-17-10.1 - Reduction of benefits because of increase in statutory disability benefits prohibited. - 58-17-10.1. Reduction of benefits because of increase in statutory disability...
Section 58-17-10.2 - Individual policy for insured's spouse required in policies covering spouse--Eligibility--Coverage--Waiting periods. - 58-17-10.2. Individual policy for insured's spouse required in policies covering...
Section 58-17-11 - Return of policy by purchaser--Refund of premium paid--Dissatisfaction with terms after examination. - 58-17-11. Return of policy by purchaser--Refund of premium paid--Dissatisfaction with...
Section 58-17-11.1 - Issuance of policies by insurance company, nonprofit hospital service plan, medical service corporation, or fraternal benefit society--Delivery receipts--Certificates of mailing--Term of retention. - 58-17-11.1. Issuance of policies by insurance company, nonprofit hospital service...
Section 58-17-12 - Required provisions--Captions--Substitutes, approval by director. - 58-17-12. Required provisions--Captions--Substitutes, approval by director. Except as provided in...
Section 58-17-13 - Omission from policy of inapplicable provision--Approval of director--Modification of inconsistent provision. - 58-17-13. Omission from policy of inapplicable provision--Approval of director--Modification of...
Section 58-17-14 - Entire contract and change clauses required--Signed acceptance required for endorsements. - 58-17-14. Entire contract and change clauses required--Signed acceptance required for...
Section 58-17-15 - Time limit on certain defenses--Application of section. - 58-17-15. Time limit on certain defenses--Application of section. There shall...
Section 58-17-17 - Grace period on premiums required in policy. - 58-17-17. Grace period on premiums required in policy. There shall...
Section 58-17-18 - Renewal of policy--Restriction on company's right to refuse. - 58-17-18. Renewal of policy--Restriction on company's right to refuse. A...
Section 58-17-19 - Reinstatement when premium not paid within grace period. - 58-17-19. Reinstatement when premium not paid within grace period. There...
Section 58-17-20 - Omission of provision as to application of premiums accepted in connection with reinstatement--Right of insured to continue policy in force by payment of premiums. - 58-17-20. Omission of provision as to application of premiums accepted...
Section 58-17-21 - Notice of claim--Provision required in policy. - 58-17-21. Notice of claim--Provision required in policy. There shall be...
Section 58-17-22 - Notice of claim--Loss of time benefit--Optional provision, insertion by insurer. - 58-17-22. Notice of claim--Loss of time benefit--Optional provision, insertion by...
Section 58-17-23 - Claim forms--Furnishing by insurer. - 58-17-23. Claim forms--Furnishing by insurer. There shall be a provision...
Section 58-17-24 - Proofs of loss--Provision required in policy. - 58-17-24. Proofs of loss--Provision required in policy. There shall be...
Section 58-17-25 - Time of payment of claims--Provision required in policy. - 58-17-25. Time of payment of claims--Provision required in policy. There...
Section 58-17-26 - Payment of claims--Persons to whom benefits payable--Provision required in policy. - 58-17-26. Payment of claims--Persons to whom benefits payable--Provision required in...
Section 58-17-27 - Payment of claims--Optional provisions, insertion by insurer. - 58-17-27. Payment of claims--Optional provisions, insertion by insurer. The following...
Section 58-17-28 - Physical examination of insured--Autopsy in death claims--Provision required in policy. - 58-17-28. Physical examination of insured--Autopsy in death claims--Provision required in...
Section 58-17-29 - Action to recover under policy--Time for beginning. - 58-17-29. Action to recover under policy--Time for beginning. There shall...
Section 58-17-30.1 - Continuation of coverage for child with intellectual or physical disability--Proof of dependency. - 58-17-30.1. Continuation of coverage for child with intellectual or physical...
Section 58-17-30.2 - Family coverage to include newborn or newly adopted children--Payment of claim not to be withheld during bonding period of adopted child. - 58-17-30.2. Family coverage to include newborn or newly adopted children--Payment...
Section 58-17-30.3 - Premature birth and congenital defects covered--Applicability. - 58-17-30.3. Premature birth and congenital defects covered--Applicability. The coverage for...
Section 58-17-30.4 - Notice of birth or adoption required for continued coverage. - 58-17-30.4. Notice of birth or adoption required for continued coverage....
Section 58-17-30.5 - Coverage for inpatient alcoholism treatment required. - 58-17-30.5. Coverage for inpatient alcoholism treatment required. Any insurer which...
Section 58-17-30.6 - Alcoholism benefits provided--Days of care. - 58-17-30.6. Alcoholism benefits provided--Days of care. The alcoholism coverage to...
Section 58-17-30.7 - Policies excluded from alcoholism coverage requirements. - 58-17-30.7. Policies excluded from alcoholism coverage requirements. Sections 58-17-30.5 and...
Section 58-17-30.8 - Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony. - 58-17-30.8. Exclusion of benefits for injury while under the influence...
Section 58-17-30.9 - Notice that dependent is no longer eligible for coverage--Premium adjustment. - 58-17-30.9. Notice that dependent is no longer eligible for coverage--Premium...
Section 58-17-31 - Optional policy provisions. - 58-17-31. Optional policy provisions. Except as provided in §58-17-13, no...
Section 58-17-32 - Occupational change--Policy provision for adjustment of premium or benefits. - 58-17-32. Occupational change--Policy provision for adjustment of premium or benefits....
Section 58-17-33 - Misstatement of age--Policy provision for adjustment of benefits. - 58-17-33. Misstatement of age--Policy provision for adjustment of benefits. There...
Section 58-17-34 - Earnings of insured--Policy provision for adjustment of benefits. - 58-17-34. Earnings of insured--Policy provision for adjustment of benefits. There...
Section 58-17-35 - Earnings adjustment clause to be coupled with insured's right to continue policy in force. - 58-17-35. Earnings adjustment clause to be coupled with insured's right...
Section 58-17-36 - Option of insurer to define "valid loss of time coverage". - 58-17-36. Option of insurer to define "valid loss of time...
Section 58-17-37 - Unpaid premiums--Deduction from benefits. - 58-17-37. Unpaid premiums--Deduction from benefits. There may be a provision...
Section 58-17-38 - Conformity with state statutes of insured. - 58-17-38. Conformity with state statutes of insured. There may be...
Section 58-17-39 - Illegal occupation of insured. - 58-17-39. Illegal occupation of insured. There may be a provision...
Section 58-17-40 - Renewal of policy at option of insurer. - 58-17-40. Renewal of policy at option of insurer. Health insurance...
Section 58-17-41 - Order of policy provisions. - 58-17-41. Order of policy provisions. The provisions which are the...
Section 58-17-42 - Age limit in policy--Effect of acceptance of premiums or misstatement of age. - 58-17-42. Age limit in policy--Effect of acceptance of premiums or...
Section 58-17-43 - Third parties taking policy covering insured. - 58-17-43. Third parties taking policy covering insured. The word "insured,"...
Section 58-17-44 - Foreign or alien insurer--Policy provision required by home state. - 58-17-44. Foreign or alien insurer--Policy provision required by home state....
Section 58-17-45 - Policy of domestic insurer delivered in other state--Compliance with laws of other state. - 58-17-45. Policy of domestic insurer delivered in other state--Compliance with...
Section 58-17-46 - Policy provisions not subject to chapter--Conforming to statute required. - 58-17-46. Policy provisions not subject to chapter--Conforming to statute required....
Section 58-17-47 - Nonconforming and conflicting provisions construed in conformity with statute. - 58-17-47. Nonconforming and conflicting provisions construed in conformity with statute....
Section 58-17-48 - Liability and workers' compensation insurance--Inapplicability of health insurance provisions. - 58-17-48. Liability and workers' compensation insurance--Inapplicability of health insurance provisions....
Section 58-17-49 - Health insurance provisions inapplicable to group or blanket policy. - 58-17-49. Health insurance provisions inapplicable to group or blanket policy....
Section 58-17-50 - Life insurance, endowment or annuity contracts not subject to health insurance provisions. - 58-17-50. Life insurance, endowment or annuity contracts not subject to...
Section 58-17-51 - Health insurance provisions inapplicable to reinsurance. - 58-17-51. Health insurance provisions inapplicable to reinsurance. Nothing in §§58-17-1...
Section 58-17-52 - Prior contracts or policies excepted. - 58-17-52. Prior contracts or policies excepted. The provisions of §§58-17-1...
Section 58-17-53 - Optometric services--Reimbursement, exceptions. - 58-17-53. Optometric services--Reimbursement, exceptions. If an insurer provides by contract,...
Section 58-17-54 - Reimbursement provisions applicable to all healing arts licensees--Self-insurance plans for public employees--Restrictions on policy limitations. - 58-17-54. Reimbursement provisions applicable to all healing arts licensees--Self-insurance plans...
Section 58-17-54.1 - Copayment or coinsurance amounts for chiropractic, physical therapy, or occupational therapy services. - 58-17-54.1. Copayment or coinsurance amounts for chiropractic, physical therapy, or...
Section 58-17-55 - Reimbursement provisions applicable to licensed hospitals. - 58-17-55. Reimbursement provisions applicable to licensed hospitals. Notwithstanding any provision...
Section 58-17-56 - Reimbursement for service rendered or supervised by qualified mental health professional. - 58-17-56. Reimbursement for service rendered or supervised by qualified mental...
Section 58-17-57 - "Abuse of health insurance" defined--Violation as misdemeanor. - 58-17-57. Abuse of health insurance as misdemeanor. A person who...
Section 58-17-58 - Waiver of required deductible or co-payment for charitable purposes permitted. - 58-17-58. Waiver of required deductible or co-payment for charitable purposes...
Section 58-17-59 - When waiver presumed. - 58-17-59. When waiver presumed. Any person who provides health care...
Section 58-17-60 - Certain payments exempt. - 58-17-60. Certain payments exempt. Payments made pursuant to federal medicare...
Section 58-17-61 - Assignment of health insurance proceeds to certain hospitals authorized. - 58-17-61. Assignment of health insurance proceeds to certain hospitals authorized....
Section 58-17-62 - Coverage for phenylketonuria. - 58-17-62. Coverage for phenylketonuria. Every policy of health insurance that...
Section 58-17-63 - "Health benefit plan" defined. - 58-17-63. Health benefit plan defined. For the purposes of §§58-17-64,...
Section 58-17-64 - Minimum loss ratio for individual health benefit plans. - 58-17-64. Minimum loss ratio for individual health benefit plans. Premium...
Section 58-17-65 - Individual health insurance plan used in conjunction with managed care plan or utilization review organization. - 58-17-65. Individual health insurance plan used in conjunction with managed...
Section 58-17-66 - Definitions for 58-17-66 through 58-17-87. - 58-17-66. Definitions for 58-17-66 through 58-17-87. Terms used in §§58-17-66...
Section 58-17-67 - "Professional association" defined. - 58-17-67. Professional association defined. For purposes of §§58-17-66 to 58-17-87,...
Section 58-17-68 - "Professional association plan" defined. - 58-17-68. Professional association plan defined. For purposes of §§58-17-66 to...
Section 58-17-69 - "Creditable coverage" defined. - 58-17-69. Creditable coverage defined. For purposes of §§58-17-66 to 58-17-87,...
Section 58-17-70 - Application of 58-17-66 to 58-17-87, inclusive. - 58-17-70. Application of 58-17-66 to 58-17-87, inclusive. Sections 58-17-66 to...
Section 58-17-71 - Separate classes of individual business--Reasons--Number. - 58-17-71. Separate classes of individual business--Reasons--Number. A carrier may establish...
Section 58-17-72 - Transitional period when additional class of business acquired. - 58-17-72. Transitional period when additional class of business acquired. The...
Section 58-17-73 - Director approval required to establish additional classes of business--Rates or rating methodologies. - 58-17-73. Director approval required to establish additional classes of business--Rates...
Section 58-17-74 - Provisions for premium rates for individual health benefit plans. - 58-17-74. Provisions for premium rates for individual health benefit plans....
Section 58-17-74.1 - Premium rate limitations. - 58-17-74.1. Premium rate limitations. Any health benefit plan issued before...
Section 58-17-75 - Promulgation of rules for rates charged for individual health benefit plans. - 58-17-75. Promulgation of rules for rates charged for individual health...
Section 58-17-76 - Transfer into or out of class of business. - 58-17-76. Transfer into or out of class of business. No...
Section 58-17-77 - Temporary suspension of premium rates for individual health insurance--Reasons. - 58-17-77. Temporary suspension of premium rates for individual health insurance--Reasons....
Section 58-17-78 - Required disclosure when offering individual health benefit plan. - 58-17-78. Required disclosure when offering individual health benefit plan. In...
Section 58-17-79 - Documentation of rating methods and practices. - 58-17-79. Documentation of rating methods and practices. Each carrier shall...
Section 58-17-81 - Availability of information on rating methods and practices of carriers offering individual health benefit plans. - 58-17-81. Availability of information on rating methods and practices of...
Section 58-17-82 - Renewal of individual health benefit plans--Exceptions. - 58-17-82. Renewal of individual health benefit plans--Exceptions. An individual health...
Section 58-17-83 - Election not to renew individual health benefit plan--Future business restricted. - 58-17-83. Election not to renew individual health benefit plan--Future business...
Section 58-17-84 - Provisions for carriers providing individual coverage other than excepted benefits. - 58-17-84. Provisions for carriers providing individual coverage other than excepted...
Section 58-17-84.1 - (Text of section effective until the first plan year, policy year, or renewal date on or after January 1, 2019) Anesthesia and hospitalization for dental care to be provided certain covered persons. - 58-17-84.1.(Text of section effective until the first plan year, policy...
Section 58-17-87 - Director to promulgate rules for individual health insurance--Scope of rules. - 58-17-87. Director to promulgate rules for individual health insurance--Scope of...
Section 58-17-88 - Minimum inpatient care coverage following delivery. - 58-17-88. Minimum inpatient care coverage following delivery. If a health...
Section 58-17-89 - Shorter hospital stay permitted--Follow-up visit within forty-eight hours required. - 58-17-89. Shorter hospital stay permitted--Follow-up visit within forty-eight hours required....
Section 58-17-90 - Notice to policyholders--Disclosures. - 58-17-90. Notice to policyholders--Disclosures. The health insurer shall provide notice...
Section 58-17-97 - Provisions covering preexisting conditions. - 58-17-97. Provisions covering preexisting conditions. Any accident and sickness policy...
Section 58-17-98 - Health insurance policies to provide coverage for biologically-based mental illnesses. - 58-17-98. Health insurance policies to provide coverage for biologically-based mental...
Section 58-17-99 - Application of § 58-17-98--Exemptions. - 58-17-99. Application of §58-17-98--Exemptions. The provisions of §58-17-98 do not...
Section 58-17-100 - Definitions. - 58-17-100. Definitions. Terms used in §§58-17-100 to 58-17-106, inclusive, mean:...
Section 58-17-101 - Insurer may not exclude certain off-label uses of prescription drugs. - 58-17-101. Insurer may not exclude certain off-label uses of prescription...
Section 58-17-102 - Exceptions. - 58-17-102. Exceptions. No coverage is required under §§58-17-100 to 58-17-106,...
Section 58-17-103 - Provisions limited to cancer or life threatening diseases. - 58-17-103. Provisions limited to cancer or life threatening diseases. The...
Section 58-17-104 - Deductibles, copayments, and managed care review not affected. - 58-17-104. Deductibles, copayments, and managed care review not affected. Nothing...
Section 58-17-105 - Drugs used in research trials not covered. - 58-17-105. Drugs used in research trials not covered. The following...
Section 58-17-106 - No reduction or limitation of coverage otherwise required by law. - 58-17-106. No reduction or limitation of coverage otherwise required by...
Section 58-17-107 - Health insurance policies to provide coverage for prostate cancer screening. - 58-17-107. Health insurance policies to provide coverage for prostate cancer...
Section 58-17-108 - "Disability income insurance" defined. - 58-17-108. Disability income insurance defined. For the purposes of §§58-17-108...
Section 58-17-109 - Exclusion or reduction of benefits. - 58-17-109. Exclusion or reduction of benefits. Any disability income insurance...
Section 58-17-110 - Commencement of loss. - 58-17-110. Commencement of loss. No disability income insurance policy may...
Section 58-17-111 - Minimum standards--Exceptions. - 58-17-111. Minimum standards--Exceptions. Except for overhead expense, buy-sell coverage, or...
Section 58-17-112 - Promulgation of rules regarding disability income policies--Content. - 58-17-112. Promulgation of rules regarding disability income policies--Content. The director...
Section 58-17-142 - Maximum premium rates for plans issued prior to August 1, 2003--Rate provisions of § 58-17-75 to apply upon carrier's discontinuance of active marketing. - 58-17-142. Maximum premium rates for plans issued prior to August...
Section 58-17-145.1 - Deadline for submission of health claim under risk pool. - 58-17-145.1. Deadline for submission of health claim under risk pool....
Section 58-17-146 - Dental insurers prohibited from setting fees for noncovered service. - 58-17-146. Dental insurers prohibited from setting fees for noncovered service....
Section 58-17-146.1 - Certain contract terms voidable by dentist. - 58-17-146.1. Certain contract terms voidable by dentist. Any assignment or...
Section 58-17-147 - Elective abortion coverage prohibited in qualified health plan offered through health insurance exchange. - 58-17-147. Elective abortion coverage prohibited in qualified health plan offered...
Section 58-17-148 - Qualified health plan sold through exchange to provide for placement through licensed insurance producer--Commissions. - 58-17-148. Qualified health plan sold through exchange to provide for...
Section 58-17-149 - Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period. - 58-17-149. Definitions regarding retrospective payment of clean claims for covered...
Section 58-17-150 - Retrospective payment of clean claims for covered services provided by health care professional during credentialing period--Requirements. - 58-17-150. Retrospective payment of clean claims for covered services provided...
Section 58-17-151 - Applications to be credentialed. - 58-17-151. Applications to be credentialed. Within ten business days of...
Section 58-17-152 - Application of §§ 58-17-149 to 58-17-151. - 58-17-152. Application of §§58-17-149 to 58-17-151. Nothing in §§58-17-149 to...
Section 58-17-153 - Coverage for treatment of hearing impairment for persons under age nineteen. - 58-17-153. Coverage for treatment of hearing impairment for persons under...
Section 58-17-154 - Definitions for §§ 58-17-155 to 58-17-162. - 58-17-154. Definitions for §§58-17-155 to 58-17-162. Terms used in §§58-17-155...
Section 58-17-155 - Exceptions to application of §§ 58-17-154 to 58-17-162. - 58-17-155. Exceptions to application of §§58-17-154 to 58-17-162. Nothing in...
Section 58-17-156 - Policies, contracts, certificates, and plans subject to §§ 58-17-154 to 58-17-162. - 58-17-156. Policies, contracts, certificates, and plans subject to §§58-17-154 to...
Section 58-17-157 - Coverage for applied behavior analysis for treatment of autism spectrum disorders. - 58-17-157. Coverage for applied behavior analysis for treatment of autism...
Section 58-17-158 - Authorization, prior approval, and other care management requirements--Annual maximum benefit. - 58-17-158. Authorization, prior approval, and other care management requirements--Annual maximum...
Section 58-17-159 - Qualifications of person performing or supervising applied behavior analysis. - 58-17-159. Qualifications of person performing or supervising applied behavior analysis....
Section 58-17-160 - Review of treatment. - 58-17-160. Review of treatment. A health carrier or plan provider...
Section 58-17-161 - Services under individualized service plan, family service plan, or education program. - 58-17-161. Services under individualized service plan, family service plan, or...
Section 58-17-162 - Effective date of §§ 58-17-154 to 58-17-161. - 58-17-162. Effective date of §§58-17-154 to 58-17-161. The effective date...
Section 58-17-163 - Dental care insurers to honor assignment of benefits. - 58-17-163. Dental care insurers to honor assignment of benefits. Any...
Section 58-17-164 - Revocation of assignment of dental insurance benefits. - 58-17-164. Revocation of assignment of dental insurance benefits. A person...
Section 58-17-165 - Reimbursement of payment from insured following receipt of payment from insurer. - 58-17-165. Reimbursement of payment from insured following receipt of payment...
Section 58-17-166 - Scope of benefits not affected--Medical benefits not included . - 58-17-166. Scope of benefits not affected--Medical benefits not included ....
Section 58-17-167 - Definitions pertaining to telehealth coverage. - 58-17-167. Definitions pertaining to telehealth coverage. Terms used in §§58-17-167...
Section 58-17-168 - Coverage for health care services provided through telehealth. - 58-17-168. Coverage for health care services provided through telehealth. No...
Section 58-17-169 - Discrimination between coverage for services provided in person and through telehealth prohibited. - 58-17-169. Discrimination between coverage for services provided in person and...
Section 58-17-170 - Application of telehealth coverage requirements. - 58-17-170. Application of telehealth coverage requirements. The requirements of §§58-17-168...
Section 58-17-171 - Payment for dental services--Credit card requirement prohibited. - 58-17-171. Payment for dental services--Credit card requirement prohibited. No plan...