HEALTH INSURANCE POLICIES
58-17-1 Requirements for all health insurance policies delivered in state.
58-17-1.1 Grandfathered plans required to cover low-dose mammography--Extent of coverage.
58-17-1.2 Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.
58-17-1.3 Diabetes coverage not required of certain plans and policies.
58-17-1.4 Policies required to cover occult breast cancer screening.
58-17-2 Persons covered by policy.
58-17-2.1 Health insurance on a franchise plan.
58-17-2.2 Conversion privileges of insured's spouse upon divorce.
58-17-2.3 Dependent coverage termination--Age--Full-time students.
58-17-3 Time of commencement and termination to be set out in policy.
58-17-4 Consideration for policy to be stated.
58-17-4.1 Filing and approval of individual policy premium rates.
58-17-4.2 Premium rates required to be reasonable--Rules to establish minimum standards promulgated by director.
58-17-5 Identification of forms, riders and endorsements--Form number, location.
58-17-6 Style and arrangement of policy provisions--Printing, size of type.
58-17-7 Documents forming part of policy--Setting forth in full, rates and classifications excepted.
58-17-8 Exceptions and reductions of coverage to be clearly set out.
58-17-9 Renewal of policy at option of insurer--Statement in policy so informing the policyholder.
58-17-10.1 Reduction of benefits because of increase in statutory disability benefits prohibited.
58-17-10.2 Individual policy for insured's spouse required in policies covering spouse--Eligibility--Coverage--Waiting periods.
58-17-11 Return of policy by purchaser--Refund of premium paid--Dissatisfaction with terms after examination.
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.
58-17-12 Required provisions--Captions--Substitutes, approval by director.
58-17-13 Omission from policy of inapplicable provision--Approval of director--Modification of inconsistent provision.
58-17-14 Entire contract and change clauses required--Signed acceptance required for endorsements.
58-17-15 Time limit on certain defenses--Application of section.
58-17-17 Grace period on premiums required in policy.
58-17-18 Renewal of policy--Restriction on company's right to refuse.
58-17-19 Reinstatement when premium not paid within grace period.
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.
58-17-21 Notice of claim--Provision required in policy.
58-17-22 Notice of claim--Loss of time benefit--Optional provision, insertion by insurer.
58-17-23 Claim forms--Furnishing by insurer.
Proofs of loss--Provision required in policy. 58-17-25
Time of payment of claims--Provision required in policy. 58-17-26
Payment of claims--Persons to whom benefits payable--Provision required in policy. 58-17-27
Payment of claims--Optional provisions, insertion by insurer. 58-17-28
Physical examination of insured--Autopsy in death claims--Provision required in policy. 58-17-29
Action to recover under policy--Time for beginning. 58-17-30
Beneficiary--Changes reserved to insured. 58-17-30.1
Continuation of coverage for child with intellectual or physical disability--Proof of dependency. 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. 58-17-30.3
Premature birth and congenital defects covered--Applicability. 58-17-30.4
Notice of birth or adoption required for continued coverage. 58-17-30.5
Coverage for inpatient alcoholism treatment required. 58-17-30.6
Alcoholism benefits provided--Days of care. 58-17-30.7
Policies excluded from alcoholism coverage requirements. 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. 58-17-30.9
Notice that dependent is no longer eligible for coverage--Premium adjustment. 58-17-31
Optional policy provisions. 58-17-32
Occupational change--Policy provision for adjustment of premium or benefits. 58-17-33
Misstatement of age--Policy provision for adjustment of benefits. 58-17-34
Earnings of insured--Policy provision for adjustment of benefits. 58-17-35
Earnings adjustment clause to be coupled with insured's right to continue policy in force. 58-17-36
Option of insurer to define "valid loss of time coverage". 58-17-37
Unpaid premiums--Deduction from benefits. 58-17-38
Conformity with state statutes of insured. 58-17-39
Illegal occupation of insured. 58-17-40
Renewal of policy at option of insurer. 58-17-41
Order of policy provisions. 58-17-42
Age limit in policy--Effect of acceptance of premiums or misstatement of age. 58-17-43
Third parties taking policy covering insured. 58-17-44
Foreign or alien insurer--Policy provision required by home state. 58-17-45
Policy of domestic insurer delivered in other state--Compliance with laws of other state. 58-17-46
Policy provisions not subject to chapter--Conforming to statute required. 58-17-47
Nonconforming and conflicting provisions construed in conformity with statute. 58-17-48
Liability and workers' compensation insurance--Inapplicability of health insurance provisions. 58-17-49
Health insurance provisions inapplicable to group or blanket policy. 58-17-50
Life insurance, endowment or annuity contracts not subject to health insurance provisions. 58-17-51
Health insurance provisions inapplicable to reinsurance. 58-17-52
Prior contracts or policies excepted. 58-17-53
Optometric services--Reimbursement, exceptions. 58-17-54
Reimbursement provisions applicable to all healing arts licensees--Self-insurance plans for public employees--Restrictions on policy limitations. 58-17-54.1
Copayment or coinsurance amounts for chiropractic, physical therapy, or occupational therapy services. 58-17-55
Reimbursement provisions applicable to licensed hospitals. 58-17-56
Reimbursement for service rendered or supervised by qualified mental health professional. 58-17-57
"Abuse of health insurance" defined--Violation as misdemeanor. 58-17-58
Waiver of required deductible or co-payment for charitable purposes permitted. 58-17-59
When waiver presumed. 58-17-60
Certain payments exempt. 58-17-61
Assignment of health insurance proceeds to certain hospitals authorized. 58-17-62
Coverage for phenylketonuria. 58-17-63
"Health benefit plan" defined. 58-17-64
Minimum loss ratio for individual health benefit plans. 58-17-65
Individual health insurance plan used in conjunction with managed care plan or utilization review organization. 58-17-66
Definitions for 58-17-66 to 58-17-87. 58-17-67
"Professional association" defined. 58-17-68
"Professional association plan" defined. 58-17-69
"Creditable coverage" defined. 58-17-70
Application of 58-17-66 to 58-17-87, inclusive. 58-17-71
Separate classes of individual business--Reasons--Number. 58-17-72
Transitional period when additional class of business acquired. 58-17-73
Director approval required to establish additional classes of business--Rates or rating methodologies. 58-17-74
Provisions for premium rates for individual health benefit plans. 58-17-74.1
Premium rate limitations. 58-17-75
Promulgation of rules for rates charged for individual health benefit plans. 58-17-76
Transfer into or out of class of business. 58-17-77
Temporary suspension of premium rates for individual health insurance--Reasons. 58-17-78
Required disclosure when offering individual health benefit plan. 58-17-79
Documentation of rating methods and practices. 58-17-80
Availability of information on rating methods and practices of carriers offering individual health benefit plans. 58-17-82
Renewal of individual health benefit plans--Exceptions. 58-17-83
Election not to renew individual health benefit plan--Future business restricted. 58-17-84
Provisions for carriers providing individual coverage other than excepted benefits. 58-17-84.1
Anesthesia and hospitalization for dental care to be provided certain covered persons. 58-17-85
, 58-17-85.1. Repealed. 58-17-86
Director to promulgate rules for individual health insurance--Scope of rules. 58-17-88
Minimum inpatient care coverage following delivery. 58-17-89
Shorter hospital stay permitted--Follow-up visit within forty-eight hours required. 58-17-90
Notice to policyholders--Disclosures. 58-17-91
to 58-17-96. Repealed. 58-17-97
Provisions covering preexisting conditions. 58-17-98
Health insurance policies to provide coverage for biologically-based mental illnesses. 58-17-99
Application of § 58-17-98--Exemptions. 58-17-100
Insurer may not exclude certain off-label uses of prescription drugs. 58-17-102
Provisions limited to cancer or life threatening diseases. 58-17-104
Deductibles, copayments, and managed care review not affected. 58-17-105
Drugs used in research trials not covered. 58-17-106
No reduction or limitation of coverage otherwise required by law. 58-17-107
Health insurance policies to provide coverage for prostate cancer screening. 58-17-108
"Disability income insurance" defined. 58-17-109
Exclusion or reduction of benefits. 58-17-110
Commencement of loss. 58-17-111
Minimum standards--Exceptions. 58-17-112
Promulgation of rules regarding disability income policies--Content. 58-17-113
, 58-17-114. Repealed . 58-17-115
, 58-17-118. Repealed. 58-17-119
to 58-17-124. Repealed . 58-17-125
to 58-17-137. Repealed. 58-17-138
to 58-17-141. Repealed. 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. 58-17-143
, 58-17-145. Repealed. 58-17-145.1
Deadline for submission of health claim under risk pool. 58-17-146
Dental insurers prohibited from setting fees for noncovered service. 58-17-147
Elective abortion coverage prohibited in qualified health plan offered through health insurance exchange. 58-17-148
Qualified health plan sold through exchange to provide for placement through licensed insurance producer--Commissions. 58-17-149
Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period. 58-17-150
Retrospective payment of clean claims for covered services provided by health care professional during credentialing period--Requirements. 58-17-151
Applications to be credentialed. 58-17-152
Application of §§ 58-17-149 to 58-17-151. 58-17-153
Coverage for treatment of hearing impairment for persons under age nineteen. 58-17-154
Definitions for §§ 58-17-155 to 58-17-162. 58-17-155
Exceptions to application of §§ 58-17-154 to 58-17-162. 58-17-156
Policies, contracts, certificates, and plans subject to §§ 58-17-154 to 58-17-162. 58-17-157
Coverage for applied behavior analysis for treatment of autism spectrum disorders. 58-17-158
Authorization, prior approval, and other care management requirements--Annual maximum benefit. 58-17-159
Qualifications of person performing applied behavior analysis (Effective until January 1, 2018). 58-17-159
Qualifications of person performing or supervising applied behavior analysis (Effective January 1, 2018). 58-17-160
Review of treatment. 58-17-161
Services under individualized service plan, family service plan, or education program.
Effective date of §§ 58-17-154 to 58-17-161.58-17-163
Dental care insurers to honor assignment of benefits.58-17-164
Revocation of assignment of dental insurance benefits.58-17-165
Reimbursement of payment from insured following receipt of payment from insurer.58-17-166
Scope of benefits not affected--Medical benefits not included.