Chapter 689A - Individual Health Insurance
- ELIGIBILITY FOR COVERAGE
- 689A.420 - Definitions.
- 689A.430 - Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency.
- 689A.440 - Insurer prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order.
- 689A.450 - Certain accommodations to be made when child is covered under policy of noncustodial parent.
- 689A.460 - Insurer to authorize enrollment of child of parent who is required by order to provide medical coverage under certain circumstances; termination of coverage of child.
- GENERAL PROVISIONS
- MISCELLANEOUS PROVISIONS
- 689A.050 - Entire contract; changes.
- 689A.060 - Time limit on certain defenses.
- 689A.070 - Grace period.
- 689A.080 - Reinstatement.
- 689A.090 - Notice of claim.
- 689A.100 - Claim forms: Required provision.
- 689A.105 - Claim forms: Uniform billing, claims forms.
- 689A.110 - Claim forms: Acceptance of uniform forms.
- 689A.120 - Time of payment of claims.
- 689A.130 - Payment of claims.
- 689A.135 - Assignment of benefits to provider of health care.
- 689A.140 - Physical examination and autopsy.
- 689A.150 - Legal actions.
- 689A.160 - Change of beneficiary.
- 689A.170 - Right to examine and return policy.
- 689A.180 - Optional provisions.
- 689A.190 - Extended disability benefit.
- 689A.200 - Change of occupation.
- 689A.210 - Misstatement of age.
- 689A.220 - Coordination of benefits: Same insurer.
- 689A.230 - Coordination of benefits: All coverages.
- 689A.240 - Relation of earnings to insurance.
- 689A.250 - Unpaid premiums.
- 689A.260 - Conformity with state statutes.
- 689A.270 - Illegal occupation.
- 689A.290 - Renewability.
- 689A.300 - Order of certain provisions.
- 689A.310 - Ownership of policy by person other than insured.
- 689A.320 - Requirements of other jurisdictions.
- 689A.330 - Policies issued for delivery in another state.
- 689A.340 - Limitation on provisions not subject to chapter; effect of violation.
- 689A.350 - Age limit.
- 689A.360 - Filing of rates.
- 689A.370 - Health insurance on franchise plan.
- 689A.380 - Definitions of terms used in policies.
- 689A.390 - Summary of coverage: Contents of disclosure; approval by Commissioner.
- 689A.400 - Summary of coverage: Copy to be provided before policy issued; policy may not be offered unless summary approved by Commissioner.
- 689A.405 - Coverage for prescription drugs: Provision of notice and information regarding use of formulary.
- 689A.410 - Approval or denial of claims; payment of claims and interest; requests for additional information; award of costs and attorney’s fees; compliance with requirements.
- 689A.413 - Insurer prohibited from denying coverage solely because person was victim of domestic violence.
- 689A.415 - Insurer prohibited from denying coverage solely because insured was intoxicated or under influence of controlled substance; exceptions.
- 689A.417 - Insurer prohibited from requiring or using information concerning genetic testing; exceptions.
- PORTABILITY AND ACCOUNTABILITY
- REIMBURSEMENT FOR CERTAIN MEDICALLY RELATED TREATMENT ANDSERVICES
- 689A.0475 - Acupuncture.
- 689A.048 - Treatment by licensed psychologist.
- 689A.0483 - Treatment by licensed marriage and family therapist or licensed clinical professional counselor.
- 689A.0485 - Treatment by licensed associate in social work, social worker, independent social worker or clinical social worker.
- 689A.0487 - Treatment by licensed podiatrist.
- 689A.049 - Treatment by licensed chiropractor; restriction on policy limitations.
- 689A.0493 - Treatment by licensed clinical alcohol and drug abuse counselor. Â
- 689A.0495 - Services provided by certain registered nurses; restriction on policy limitations; exception.
- 689A.0497 - Provider of medical transportation.
- REQUIRED PROVISIONS
- 689A.040 - Contents of policy; substitution of provisions; captions; omission or modification of provisions.
- 689A.0403 - Procedure for arbitration of disputes concerning independent medical evaluations.
- 689A.04033 - Coverage for treatment received as part of clinical trial or study.
- 689A.04036 - Coverage for continued medical treatment.
- 689A.0404 - Coverage for use of certain drugs for treatment of cancer.
- 689A.04042 - Coverage for screening for colorectal cancer.
- 689A.04045 - Coverage for prescription drug previously approved for medical condition of insured.
- 689A.0405 - Coverage for cytologic screening test and mammograms for certain women.
- 689A.041 - Coverage relating to mastectomy.
- 689A.0413 - Coverage for certain gynecological or obstetrical services without authorization or referral from primary care physician.
- 689A.0415 - Coverage for drug or device for contraception and for hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions.
- 689A.0417 - Coverage for health care services related to contraceptives and hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions.
- 689A.042 - Coverage relating to complications of pregnancy.
- 689A.0423 - Coverage for treatment of certain inherited metabolic diseases.
- 689A.0425 - Individual health benefit plan that includes coverage for maternity care and pediatric care: Requirement to allow minimum stay in hospital in connection with childbirth; prohibited acts.
- 689A.0427 - Coverage for management and treatment of diabetes.
- 689A.043 - Coverage of newly born and adopted children and children placed for adoption.
- 689A.0435 - Coverage for autism spectrum disorders. [Effective January 1, 2011.]
- 689A.044 - Coverage for human papillomavirus vaccine.
- 689A.0445 - Coverage for prostate cancer screening.
- 689A.045 - Termination of coverage on dependent child.
- 689A.0455 - Coverage for treatment of conditions relating to severe mental illness.
- 689A.046 - Benefits for treatment of abuse of alcohol or drugs.
- 689A.0465 - Coverage of treatment of temporomandibular joint.
- SYSTEM FOR RESOLVING COMPLAINTS OF INSUREDS
- 689A.745 - Approval; requirements; examination.
- 689A.750 - Annual report; insurer to maintain records of complaints concerning something other than health care services.
- 689A.755 - Written notice to insured explaining right to file complaint; notice to insured required when insurer denies coverage of health care service.