CONTRACTS
- Coverage
- 695B.1901 - Required provision concerning coverage for continued medical treatment.
- 695B.1903 - Required provision concerning coverage for treatment as part of clinical trial or study.
- 695B.1905 - Required provision concerning coverage for prescription drug previously approved for medical condition of insured.
- 695B.1907 - Required provision concerning coverage for screening for colorectal cancer.
- 695B.1908 - Required provision concerning coverage for certain drugs for treatment of cancer.
- 695B.191 - Required provision concerning coverage relating to mastectomy.
- 695B.1912 - Required provision concerning coverage for cytologic screening tests and mammograms for certain women.
- 695B.1914 - Required provision concerning coverage of certain gynecological and obstetrical services without authorization or referral from primary care physician.
- 695B.1916 - Required provision concerning coverage of drug or device for contraception and of hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions.
- 695B.1918 - Required provision concerning coverage of health care services related to contraceptives and hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions
- 695B.192 - Required provision concerning coverage relating to complications of pregnancy.
- 695B.1923 - Required provision concerning coverage for treatment of certain inherited metabolic diseases.
- 695B.1925 - Required provision concerning coverage for human papillomavirus vaccine.
- 695B.1927 - Required provision concerning coverage for management and treatment of diabetes.
- 695B.193 - Required provision concerning coverage for newly born and adopted children and children placed for adoption.
- 695B.1931 - Required provision concerning coverage relating to treatment of temporomandibular joint.
- 695B.1938 - Required provision concerning coverage for treatment of conditions relating to severe mental illness.
- 695B.194 - Required provision concerning benefits for treatment of abuse of alcohol or drugs.
- 695B.1942 - Required provision concerning coverage for prostate cancer screening.
- 695B.1944 - Required provision concerning coverage for employee or member on leave without pay as result of total disability.
- General Provisions
- 695B.180 - Required provisions.
- 695B.181 - Provision in contract requiring binding arbitration authorized; procedures for arbitration; declaratory relief.
- 695B.182 - Required procedure for arbitration of disputes concerning independent medical evaluations.
- 695B.185 - Limitations on deductibles and copayments charged under group contract which offers difference of payment between preferred providers of health care and providers who are not preferred.
- 695B.187 - Group contract issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer.
- 695B.189 - Continuation of coverage under group contract: Required provision.
- Miscellaneous Provisions
- 695B.200 - Group contracts written under master contract: Conditions required for issuance.
- 695B.210 - Group master service contract: Required provisions.
- 695B.220 - Blanket service contracts: Issuance to college, school or school personnel; pupils not to be compelled to accept service.
- 695B.225 - Policies of group insurance: Order of benefits.
- 695B.230 - Filing and approval of forms and schedules of premium rates.
- 695B.240 - Provision of group service coverage before approval of forms.
- 695B.250 - Extensions of time; automatic approval.
- 695B.2505 - Approval or denial of claims; payment of claims and interest; requests for additional information; award of costs and attorney’s fees; compliance with requirements.
- Reimbursement
- 695B.1951 - Reimbursement for treatment by podiatrist.
- 695B.1955 - Reimbursement for treatment by licensed clinical alcohol and drug abuse counselor.
- 695B.196 - Reimbursement for acupuncture.
- 695B.197 - Reimbursement for treatment by licensed psychologist.
- 695B.1973 - Reimbursement for treatment by licensed marriage and family therapist or licensed clinical professional counselor.
- 695B.1975 - Reimbursement for treatment by licensed associate in social work, social worker, independent social worker or clinical social worker.
- 695B.198 - Reimbursement for treatment by chiropractor.
- 695B.199 - Reimbursement for services provided by certain nurses; prohibited limitations; exception.
- 695B.1995 - Reimbursement to provider of medical transportation.