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Section 58-41-1 - Definition of terms. - 58-41-1. Definition of terms. Terms used in this chapter mean:...
Section 58-41-2 - Organizations subject to chapter. - 58-41-2. Organizations subject to chapter. As used in this chapter...
Section 58-41-3 - Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor. - 58-41-3. Certificate of authority required for health maintenance organization or...
Section 58-41-4 - Application for certificate of authority required. - 58-41-4. Application for certificate of authority required. Notwithstanding any law...
Section 58-41-6 - Verification and form of application--Contents. - 58-41-6. Verification and form of application--Contents. Each application for a...
Section 58-41-7 - Financial statements required with application. - 58-41-7. Financial statements required with application. Each application for a...
Section 58-41-8 - Copies of forms required with application. - 58-41-8. Copies of forms required with application. Each application for...
Section 58-41-9 - Marketing, charges, and financial plans required with application. - 58-41-9. Marketing, charges, and financial plans required with application. Each...
Section 58-41-10 - Appointment to receive process required of foreign applicant. - 58-41-10. Appointment to receive process required of foreign applicant. Each...
Section 58-41-11 - Surety bond or deposit required--Waiver. - 58-41-11. Surety bond or deposit required--Waiver. Each health maintenance organization...
Section 58-41-12 - Determination of health care qualifications. - 58-41-12. Determination of health care qualifications. The director shall determine...
Section 58-41-13 - Coordination with federal professional standards review. - 58-41-13.Coordination with federal professional standards review. To the extent that...
Section 58-41-15 - Health maintenance not considered practice of healing arts. - 58-41-15. Health maintenance not considered practice of healing arts. Any...
Section 58-41-15.1 - Certain healing arts practitioners to participate in alternate health care delivery systems. - 58-41-15.1. Certain healing arts practitioners to participate in alternate health...
Section 58-41-17 - Issuance or denial of certificate--Fee--Conditions for issuance. - 58-41-17. Issuance or denial of certificate--Fee--Conditions for issuance. The director...
Section 58-41-18 - Factors considered in determining financial responsibility. - 58-41-18. Factors considered in determining financial responsibility. In making a...
Section 58-41-19 - Insurance arrangements permitted. - 58-41-19. Insurance arrangements permitted. The requirement of subdivision 58-41-17(5) shall...
Section 58-41-20 - Corporation operating after certification. - 58-41-20. Corporation operating after certification. Any corporation may, upon obtaining...
Section 58-41-21 - Foreign corporations qualifying--Exemption from other requirements. - 58-41-21. Foreign corporations qualifying--Exemption from other requirements. A foreign corporation...
Section 58-41-22 - Filing of notice of modification of operation--Approval if not disapproved--Exemptions. - 58-41-22. Filing of notice of modification of operation--Approval if not...
Section 58-41-23 - Composition of governing body--Consumer representation. - 58-41-23. Composition of governing body--Consumer representation. The governing body of...
Section 58-41-24 - Mechanisms for enrollee participation in policy and operation of governing body. - 58-41-24. Mechanisms for enrollee participation in policy and operation of...
Section 58-41-25 - Fiduciary responsibilities to enrollees. - 58-41-25. Fiduciary responsibilities to enrollees. Any director, officer, or partner...
Section 58-41-25.1 - Investments. - 58-41-25.1. Investments. The funds of any corporation subject to the...
Section 58-41-26 - Exemption from insurance laws--Exceptions--Taxation. - 58-41-26. Exemption from insurance laws--Exceptions--Taxation. Any health maintenance organization is...
Section 58-41-28 - Solicitation of enrollment not deemed professional advertising. - 58-41-28. Solicitation of enrollment not deemed professional advertising. Solicitation of...
Section 58-41-29 - Contracts and necessary activities. - 58-41-29. Contracts and necessary activities. A health maintenance organization may...
Section 58-41-29.1 - Notice required for rate increase in health maintenance contract by a health maintenance organization. - 58-41-29.1. Notice required for rate increase in health maintenance contract...
Section 58-41-30 - Sources of payment for enrollee services--Application by medical assistance recipient. - 58-41-30. Sources of payment for enrollee services--Application by medical assistance...
Section 58-41-31 - Direct payments to enrollees prohibited. - 58-41-31. Direct payments to enrollees prohibited. No health maintenance organization...
Section 58-41-32 - Use of words descriptive of insurance, casualty, or surety business as misdemeanor--Exception. - 58-41-32. Use of words descriptive of insurance, casualty, or surety...
Section 58-41-33 - Trade practice laws applicable. - 58-41-33. Trade practice laws applicable. Each health maintenance organization, health...
Section 58-41-34 - Evidence of coverage issued to enrollees. - 58-41-34. Evidence of coverage issued to enrollees. Every enrollee residing...
Section 58-41-35 - Contents required in evidence of coverage. - 58-41-35. Contents required in evidence of coverage. An evidence of...
Section 58-41-35.1 - Alcoholism coverage to be offered at time contract is negotiated. - 58-41-35.1. Alcoholism coverage to be offered at time contract is...
Section 58-41-35.5 - Grandfathered contracts required to cover low-dose mammography--Extent of coverage. - 58-41-35.5. Grandfathered contracts required to cover low-dose mammography--Extent of coverage....
Section 58-41-35.6 - Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony. - 58-41-35.6. Exclusion of benefits for injury while under the influence...
Section 58-41-35.7 - Contracts required to cover occult breast cancer screening. - 58-41-35.7.Contracts required to cover occult breast cancer screening. Each health...
Section 58-41-36 - Unfair and misleading information in evidence of coverage as misdemeanor. - 58-41-36. Unfair and misleading information in evidence of coverage as...
Section 58-41-37 - Deceptive advertising or evidence of coverage as misdemeanor. - 58-41-37. Deceptive advertising or evidence of coverage as misdemeanor. No...
Section 58-41-38 - Statements deemed untrue. - 58-41-38. Statements deemed untrue. For the purposes of this chapter,...
Section 58-41-39 - Statements deemed misleading. - 58-41-39. Statements deemed misleading. For the purposes of this chapter,...
Section 58-41-40 - Evidence of coverage deemed deceptive. - 58-41-40. Evidence of coverage deemed deceptive. For the purposes of...
Section 58-41-41 - Issuance to enrollees of change in evidence of coverage. - 58-41-41. Issuance to enrollees of change in evidence of coverage....
Section 58-41-42 - Evidence of coverage to be approved before use--Violation as misdemeanor. - 58-41-42. Evidence of coverage to be approved before use--Violation as...
Section 58-41-43 - Filing and approval requirements applicable. - 58-41-43. Filing and approval requirements applicable. A copy of the...
Section 58-41-44 - Charges to enrollees--Fairness--Actuary's certificate. - 58-41-44. Charges to enrollees--Fairness--Actuary's certificate. Charges for comprehensive health maintenance...
Section 58-41-45 - Discrimination as misdemeanor. - 58-41-45. Discrimination as misdemeanor. No health maintenance organization or representative...
Section 58-41-50 - Authorized expenses. - 58-41-50. Authorized expenses. Authorized expenses of health maintenance organizations include:...
Section 58-41-51.1 - Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods. - 58-41-51.1. Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods....
Section 58-41-51.2 - Conversion privileges of insured's spouse upon divorce. - 58-41-51.2. Conversion privileges of insured's spouse upon divorce. No accident...
Section 58-41-51.3 - Continuation and conversion coverage to be offered. - 58-41-51.3. Continuation and conversion coverage to be offered. At the...
Section 58-41-52 - Contracts with providers of health care services. - 58-41-52. Contracts with providers of health care services. A health...
Section 58-41-52.1 - Collection for covered services prohibited. - 58-41-52.1 . Collection for covered services prohibited. Except for coinsurance,...
Section 58-41-52.2 - Contracts--Hold harmless provision. - 58-41-52.2 . Contracts--Hold harmless provision. All contracts among health maintenance...
Section 58-41-52.3 - Hold harmless provision--Language of provision. - 58-41-52.3 . Hold harmless provision--Language of provision. The requirements of...
Section 58-41-54 - Contracts with insurance companies and nonprofit health service plan corporations authorized--Limitations. - 58-41-54. Contracts with insurance companies and nonprofit health service plan...
Section 58-41-55 - Insurance contracts authorized--Group coverage--Benefit payments. - 58-41-55. Insurance contracts authorized--Group coverage--Benefit payments. Notwithstanding any law to...
Section 58-41-56 - Contracts for management and administrative services authorized. - 58-41-56. Contracts for management and administrative services authorized. A health...
Section 58-41-57 - Payment of unreasonably high expenses as misdemeanor. - 58-41-57. Payment of unreasonably high expenses as misdemeanor. No health...
Section 58-41-63 - General annual report required--Form and contents. - 58-41-63. General annual report required--Form and contents. Every health maintenance...
Section 58-41-65 - Applications, filings and reports as public documents. - 58-41-65. Applications, filings and reports as public documents. All applications,...
Section 58-41-66 - Annual summary for enrollees required--Contents. - 58-41-66. Annual summary for enrollees required--Contents. Every health maintenance organization...
Section 58-41-67 - Promulgation of rules. - 58-41-67. Promulgation of rules. The director may, pursuant to chapter...
Section 58-41-73 - Physician-patient privileges. - 58-41-73. Physician-patient privileges. A health maintenance organization shall be entitled...
Section 58-41-74 - Confidential data--Exceptions. - 58-41-74. Confidential data--Exceptions. Any data or information pertaining to the...
Section 58-41-78 - Cease and desist orders. - 58-41-78. Cease and desist orders. The director may issue an...
Section 58-41-79 - Hearing on cease and desist order--Procedure--Judicial review. - 58-41-79. Hearing on cease and desist order--Procedure--Judicial review. Within twenty...
Section 58-41-80 - Injunctive relief against violations--Venue. - 58-41-80. Injunctive relief against violations--Venue. In the event of any...
Section 58-41-81 - Suspension or revocation of certificate of authority on findings by director. - 58-41-81. Suspension or revocation of certificate of authority on findings...
Section 58-41-82 - Additional grounds for suspension or revocation. - 58-41-82. Additional grounds for suspension or revocation. The director may...
Section 58-41-83 - Voluntary conference before commencing actions for violation. - 58-41-83. Voluntary conference before commencing actions for violation. If the...
Section 58-41-84 - Informality in voluntary conferences. - 58-41-84. Informality in voluntary conferences. Proceedings under §58-41-83 are not...
Section 58-41-85 - Money penalty in lieu of suspension or revocation. - 58-41-85. Money penalty in lieu of suspension or revocation. The...
Section 58-41-86 - Requirements for suspension or revocation. - 58-41-86. Requirements for suspension or revocation. A certificate of authority...
Section 58-41-86.1 - Suspension without notice or hearing. - 58-41-86.1. Suspension without notice or hearing. The director of the...
Section 58-41-87 - Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted. - 58-41-87. Notice of grounds for denial, suspension, or revocation of...
Section 58-41-88 - Administrative procedure and rules. - 58-41-88. Administrative procedure and rules. The provisions of chapter 1-26,...
Section 58-41-90 - Action of director after hearing--Written findings. - 58-41-90. Action of director after hearing--Written findings. After hearing pursuant...
Section 58-41-91 - Judicial review. - 58-41-91. Judicial review. The action of the director is subject...
Section 58-41-92 - Activities prohibited during suspension of certificate. - 58-41-92. Activities prohibited during suspension of certificate. When the certificate...
Section 58-41-93 - Winding up after revocation of certificate--Continued operation to protect enrollees. - 58-41-93. Winding up after revocation of certificate--Continued operation to protect...
Section 58-41-94 - Summary proceeding to reorganize organization--Grounds. - 58-41-94. Summary proceeding to reorganize organization--Grounds. The director may apply...
Section 58-41-95 - Rehabilitation, liquidation, or conservation under insurance company laws. - 58-41-95. Rehabilitation, liquidation, or conservation under insurance company laws. Any...
Section 58-41-96 - Severability of provisions. - 58-41-96. Severability of provisions. If a part of this chapter...
Section 58-41-97 - Citation of chapter. - 58-41-97. Citation of chapter. This chapter may be cited as...
Section 58-41-98 - Coverage for phenylketonuria. - 58-41-98. Coverage for phenylketonuria. Every health maintenance contract that is...
Section 58-41-99 - Formation of voluntary health insurance purchasing organizations. - 58-41-99. Formation of voluntary health insurance purchasing organizations. Notwithstanding the...
Section 58-41-100 - Membership of voluntary health insurance purchasing organizations. - 58-41-100. Membership of voluntary health insurance purchasing organizations. Any organization...
Section 58-41-101 - Purchasing organization's responsibility for negotiating terms and conditions. - 58-41-101. Purchasing organization's responsibility for negotiating terms and conditions. The...
Section 58-41-102 - Purchasing organization's notice of premium charge. - 58-41-102. Purchasing organization's notice of premium charge. The organization may...
Section 58-41-103 - Additional chapters applicable to purchasing organization. - 58-41-103. Additional chapters applicable to purchasing organization. Any organization is...
Section 58-41-104 - Approval of purchasing organization by Division of Insurance. - 58-41-104. Approval of purchasing organization by Division of Insurance. Any...
Section 58-41-105 - Premiums held in trust by purchasing organization. - 58-41-105. Premiums held in trust by purchasing organization. The organization...
Section 58-41-106 - Rates for group health insurance issued to purchasing organizations. - 58-41-106. Rates for group health insurance issued to purchasing organizations....
Section 58-41-107 - Reasonable participation requirements for group members of purchasing organizations. - 58-41-107. Reasonable participation requirements for group members of purchasing organizations....
Section 58-41-108 - Purchasing organizations exempt from antitrust provisions. - 58-41-108. Purchasing organizations exempt from antitrust provisions. Any organization formed...
Section 58-41-109 - Promulgation of rules for purchasing organizations. - 58-41-109. Promulgation of rules for purchasing organizations. The director may...
Section 58-41-110 - Application of chapter to provider contracting with state. - 58-41-110. Application of chapter to provider contracting with state. Nothing...
Section 58-41-111 - Application of chapter to provider contracting with licensed health maintenance organization. - 58-41-111. Application of chapter to provider contracting with licensed health...
Section 58-41-112 - Minimum inpatient care coverage following delivery. - 58-41-112. Minimum inpatient care coverage following delivery. If a health...
Section 58-41-113 - Shorter hospital stay permitted--Follow-up visit within forty-eight hours required. - 58-41-113. Shorter hospital stay permitted--Follow-up visit within forty-eight hours required....
Section 58-41-114 - Notice to enrollees--Disclosures. - 58-41-114. Notice to enrollees--Disclosures. The health maintenance organization shall provide...
Section 58-41-115 - Health insurance policies to provide coverage for biologically-based mental illnesses. - 58-41-115. Health insurance policies to provide coverage for biologically-based mental...
Section 58-41-116 - Application--Exemptions. - 58-41-116. Application--Exemptions. The provisions of §58-41-115 do not apply to...
Section 58-41-117 - Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations. - 58-41-117. Policies to provide coverage for diabetes supplies, equipment, and...
Section 58-41-118 - Diabetes coverage not required of certain plans and policies. - 58-41-118. Diabetes coverage not required of certain plans and policies....
Section 58-41-119 - Contracts to provide coverage for prostate cancer screening. - 58-41-119. Contracts to provide coverage for prostate cancer screening. Every...
Section 58-41-120 - Annual report on risk bearing entities. - 58-41-120. Annual report on risk bearing entities. A health maintenance...
Section 58-41-121 - Documents provided to risk bearing entity by health maintenance organization. - 58-41-121. Documents provided to risk bearing entity by health maintenance...
Section 58-41-122 - Documents provided to health maintenance organization by risk bearing entity. - 58-41-122.Documents provided to health maintenance organization by risk bearing entity....
Section 58-41-123 - Notice by risk bearing entity of change in conditions--Assignment of contract. - 58-41-123. Notice by risk bearing entity of change in conditions--Assignment...
Section 58-41-124 - Notice to director that risk bearing entity has materially failed to perform contract. - 58-41-124. Notice to director that risk bearing entity has materially...
Section 58-41-125 - Confidentiality of information. - 58-41-125. Confidentiality of information. Any information provided to the director...
Section 58-41-126 - Nontransferable responsibilities of health maintenance organization. - 58-41-126. Nontransferable responsibilities of health maintenance organization. Notwithstanding any agreement...
Section 58-41-127 - Coverage for treatment of hearing impairment for persons under age nineteen. - 58-41-127. Coverage for treatment of hearing impairment for persons under...