CHAPTER 22. DISABILITY INSURANCE
- Part 1. General Provisions
- 33-22-101. Exceptions to scope.
- 33-22-102. Third-party ownership.
- 33-22-103. Violations.
- 33-22-104. through reserved.
- 33-22-107. Premium increase restriction -- exception -- notice of rate increase and policy changes.
- 33-22-108. reserved.
- 33-22-109. Riders.
- 33-22-110. Preexisting conditions.
- 33-22-111. Policies and certificates to provide for freedom of choice of practitioners -- professional practice not enlarged.
- 33-22-112. Disability insurance coverage of services of state institutions -- provision void -- rate of payment.
- 33-22-113. Disability insurance coverage of persons eligible for public medical assistance.
- 33-22-114. Coverage required for services provided by physician assistants.
- 33-22-115. through reserved.
- 33-22-121. Notice required for cancellation or refusal to renew.
- 33-22-122. Contents of notice -- proof -- limitation on recovery -- exemptions.
- 33-22-123. Return of unearned premium.
- 33-22-124. reserved.
- 33-22-125. Independent chiropractic physical examination or review of records.
- 33-22-126. through reserved.
- 33-22-129. Coverage for outpatient self-management training and education for treatment of diabetes -- limited benefit for medically necessary equipment and supplies.
- 33-22-130. Coverage for adopted children from time of placement -- preexisting conditions.
- 33-22-131. Coverage for treatment of inborn errors of metabolism.
- 33-22-132. Coverage for mammography examinations.
- 33-22-133. Coverage for minimum hospital stay following childbirth.
- 33-22-134. Postmastectomy care.
- 33-22-135. Coverage for reconstructive breast surgery after mastectomy -- benefits and conditions.
- 33-22-136. Insurance for spouse and dependents of deceased peace officer, game warden, or firefighter.
- 33-22-137. Cost-sharing requirements -- applicability.
- 33-22-138. and reserved.
- 33-22-140. Definitions.
- 33-22-141. Crediting previous coverage.
- 33-22-142. Certification of creditable coverage.
- 33-22-143. Rules.
- 33-22-144. through reserved.
- 33-22-150. Reciprocal limitations on claim filing and claim audits -- time limit for reimbursements or offsets -- exceptions.
- 33-22-151. Offset agreement.
- 33-22-152. Continuation of dependent coverage.
- Part 10. Home Health Care Coverage
- Part 11. Long-Term Care Insurance Act
- 33-22-1101. Short title.
- 33-22-1102. Purpose.
- 33-22-1103. Compliance required.
- 33-22-1104. Scope.
- 33-22-1105. and reserved.
- 33-22-1107. Definitions.
- 33-22-1108. Preexisting condition -- definition.
- 33-22-1109. and reserved.
- 33-22-1111. Outline of coverage.
- 33-22-1112. Required content for certificate.
- 33-22-1113. Disclosure and performance standards for long-term care insurance.
- 33-22-1114. Prohibited practices and policy provisions.
- 33-22-1115. Prior hospitalization or institutionalization.
- 33-22-1116. Nonforfeiture benefits -- offer requirement.
- 33-22-1117. Appropriate sale criteria.
- 33-22-1118. reserved.
- 33-22-1119. Right to return policy -- free look -- refunds upon denial of application.
- 33-22-1120. Extraterritorial jurisdiction.
- 33-22-1121. Rules.
- 33-22-1122. Policy waiting periods not cumulative.
- 33-22-1123. Delivery of policy -- policy summary -- monthly reports.
- 33-22-1124. Denial of claims.
- 33-22-1125. Benefit triggers.
- 33-22-1126. Additional standards for qualified long-term care contracts -- definitions.
- 33-22-1127. Incontestability period.
- 33-22-1128. Insurance producer training requirements.
- 33-22-1129. Penalties.
- Part 12. Limited Benefit Disability Insurance (Repealed)
- Part 16. Subrogation -- Notice
- Part 17. Preferred Provider Agreements
- 33-22-1701. Short title.
- 33-22-1702. Purpose.
- 33-22-1703. Definitions.
- 33-22-1704. Preferred provider agreements authorized.
- 33-22-1705. Incentives in health benefit plans.
- 33-22-1706. Permissible and mandatory provisions in provider agreements, insurance policies, and subscriber contracts.
- 33-22-1707. Rules.
- Part 18. Small Employer Health Insurance Availability Act
- 33-22-1801. Short title.
- 33-22-1802. Purpose.
- 33-22-1803. Definitions.
- 33-22-1804. Applicability and scope.
- 33-22-1805. through reserved.
- 33-22-1808. Establishment of classes of business.
- 33-22-1809. Restrictions relating to premium rates.
- 33-22-1810. Renewability of coverage.
- 33-22-1811. Availability of coverage -- required plans.
- 33-22-1812. Repealed.
- 33-22-1813. Standards to ensure fair marketing.
- 33-22-1814. Restoration of terminated coverage.
- 33-22-1815. Qualifications for voluntary purchasing pool.
- 33-22-1816. Commissioner powers and duties -- application for registration -- reporting insolvency.
- 33-22-1817. Collection of charges and premiums.
- 33-22-1818. Repealed.
- 33-22-1819. Repealed.
- 33-22-1820. Periodic market evaluation -- report.
- 33-22-1821. Waiver of certain laws.
- 33-22-1822. Administrative procedure.
- 33-22-1823. through reserved.
- 33-22-1827. Benefits required in basic health benefit plan.
- 33-22-1828. Benefits required in standard benefit plan.
- Part 19. Obstetricians and Gynecologists -- Primary Care Physicians
- 33-22-1901. Scope -- purpose.
- 33-22-1902. Definitions.
- 33-22-1903. Obstetricians or gynecologists as primary care physicians.
- 33-22-1904. Self-referral for obstetrical or gynecological care permitted.
- 33-22-1905. Surcharges not allowed.
- 33-22-1906. Payment of covered services provided by certified advanced practice registered nurses.
- 33-22-1907. Disclosure.
- 33-22-1908. Enforcement.
- Part 2. Individual Policy Requirements
- 33-22-201. Format and content.
- 33-22-202. Required provisions -- captions -- omissions -- substitutions -- order.
- 33-22-203. Requirement of other jurisdictions -- statutes -- violation.
- 33-22-204. Entire contract -- changes.
- 33-22-205. Time limit on certain defenses.
- 33-22-206. Grace period.
- 33-22-207. Reinstatement.
- 33-22-208. Notice of claim.
- 33-22-209. Claim forms.
- 33-22-210. Proofs of loss.
- 33-22-211. Time of payment of claims.
- 33-22-212. Payment of claims.
- 33-22-213. Physical examination and autopsy.
- 33-22-214. Legal actions.
- 33-22-215. Change of beneficiary.
- 33-22-216. Repealed.
- 33-22-217. through reserved.
- 33-22-221. Optional policy provisions -- substitutes.
- 33-22-222. Change of occupation.
- 33-22-223. Misstatement of age.
- 33-22-224. Other insurance in this insurer.
- 33-22-225. Insurance with other insurers -- provision of service or expense incurred basis.
- 33-22-226. Insurance with other insurers -- other benefits.
- 33-22-227. Relation of earnings to insurance.
- 33-22-228. Unpaid premiums.
- 33-22-229. Conformity with state statutes.
- 33-22-230. Illegal occupation.
- 33-22-231. Intoxicants and narcotics.
- 33-22-232. Renewal at option of insurer.
- 33-22-233. through reserved.
- 33-22-241. Definitions.
- 33-22-242. Waiver of preexisting condition exclusion -- exclusion prohibited.
- 33-22-243. Premium increases to be distributed proportionately.
- 33-22-244. Disclosure standards -- individual policy.
- 33-22-245. Uniform health benefit plan -- individual.
- 33-22-246. Preexisting conditions relating to individual market.
- 33-22-247. Guaranteed renewability of individual health insurance coverage.
- 33-22-248. through reserved.
- 33-22-261. Terminated.
- 33-22-262. Terminated.
- 33-22-263. Terminated.
- Part 20. Small Business Health Insurance Purchasing Pool
- 33-22-2001. Establishment of small business health insurance pool -- intent.
- 33-22-2002. Small business health insurance pool -- definitions.
- 33-22-2003. Board of directors -- composition -- appointment -- compensation.
- 33-22-2004. Powers and duties of board.
- 33-22-2005. Duties of commissioner -- rulemaking authority.
- 33-22-2006. Premium incentive payments, premium assistance payments, and tax credits for small employer health insurance premiums paid -- eligibility for small group coverage -- amounts.
- 33-22-2007. Filing for tax credit -- filing for premium incentive payments and premium assistance payments.
- 33-22-2008. Registration -- funding limitations -- transfers -- maximum number -- waiting list -- information transfer for tax credits.
- 33-22-2009. Penalties.
- Part 3. Requirements for Certain Individual Coverages
- 33-22-301. Coverage of newborn under disability policy.
- 33-22-302. Age limits -- effect on coverage.
- 33-22-303. Coverage for well-child care.
- 33-22-304. Continuation of coverage for individuals with disabilities -- individual contracts.
- 33-22-305. Short title.
- 33-22-306. Purpose.
- 33-22-307. Continuity of coverage.
- 33-22-308. Form of coverage -- requirements -- evidence of insurability -- preexisting conditions.
- 33-22-309. Notice.
- 33-22-310. Nonduplication.
- 33-22-311. Overinsurance.
- Part 4. Franchise Disability Insurance (Repealed)
- Part 5. Group Disability Insurance
- 33-22-501. Group disability insurance defined -- eligible groups.
- 33-22-502. Required provisions of group policies.
- 33-22-503. Continuation of benefits to dependents.
- 33-22-504. Newborn infant coverage.
- 33-22-505. Direct payment of hospital and medical services.
- 33-22-506. Continuation of coverage for persons with disabilities -- group contracts.
- 33-22-507. Continuing group coverage after reduction of work schedule.
- 33-22-508. Conversion on termination of eligibility.
- 33-22-509. Preexisting conditions.
- 33-22-510. Insured's family -- conversion entitlement.
- 33-22-511. Applicability.
- 33-22-512. Coverage for well-child care.
- 33-22-513. Limitation of eligibility on conversion.
- 33-22-514. Preexisting conditions relating to group market.
- 33-22-515. Coverage of autism spectrum disorders.
- 33-22-516. through reserved.
- 33-22-521. Disclosure standards -- group policy.
- 33-22-522. Uniform health benefit plan -- group.
- 33-22-523. Special enrollment periods.
- 33-22-524. Guaranteed renewability of coverage for employers in group market.
- 33-22-525. Guaranteed renewability in multiple employer welfare arrangements.
- 33-22-526. Group health discrimination prohibited.
- 33-22-527. through reserved.
- 33-22-530. Notice required for cancellation for nonpayment of group health insurance.
- Part 6. Blanket Disability Insurance
- Part 7. Coverage for Mental Illness, Alcoholism, and Drug Addiction
- Part 8. Extended Health Insurance (Repealed)
- Part 9. Medicare Supplement Insurance Minimum Standards
- 33-22-901. Short title.
- 33-22-902. Purpose.
- 33-22-903. Definitions.
- 33-22-904. Standards for policy provisions -- rules.
- 33-22-905. Minimum standards for benefits and payment of claims -- rules.
- 33-22-906. Loss ratio standards and filing requirements -- limits on compensation.
- 33-22-907. Disclosure standards -- informational brochure -- rules.
- 33-22-908. Notice of free examination.
- 33-22-909. Administrative procedures.
- 33-22-910. Filing requirements for advertising.
- 33-22-911. Penalties.
- 33-22-912. through reserved.
- 33-22-921. Discontinuance or nonrenewal -- alternate policy or certificate -- same insurer.
- 33-22-922. Discontinuance or nonrenewal -- alternate policy -- unauthorized bulk reinsurance.
- 33-22-923. Replacement policy or certificate -- different insurer.
- 33-22-924. Renewal requirement.