P.R. Laws tit. 3, § 729f
The benefits to be provided by the health plans described in § 729e of this title may be of the following types:
(1) Service benefit plan.—
(A) Hospital benefits.
(B) Surgical benefits.
(C) In-hospital medical benefits.
(D) Ambulatory patient benefits.
(E) Supplemental benefits, including dental services.
(F) Obstetrical benefits.
(2) Indemnity benefit plan.—
(A) Hospital care.
(B) Surgical care and treatment.
(C) Medical care and treatment.
(D) Obstetrical benefits.
(E) Prescribed drugs, medicines, and prosthetic devices.
(F) Other medical supplies and services.
(G) Supplemental benefits, including dental services.
(3) Employee organization plans.— Benefits of the types specified in this section under subsections (1) or (2) or both. Benefits contracted for under subsections (1) and (2) of this section shall include normal costs as well as costs of an abnormal or catastrophic nature within the normal limits of the policy; such benefits may include benefits for disability, death or dismemberment, without evidence of insurability; Provided, however, That said benefits shall be included in the coverage only at the employee’s option. No insurer or employee organization will condition the sale of the benefits specified in subsections (1) and (2) to the sale of the benefits for disability, death and dismemberment.
The benefits described in this section shall include services for mental conditions, tuberculosis, mastectomy, and any other post-mastectomy reconstructive surgery necessary for the physical and emotional recovery of the patient.
History —June 29, 1963, No. 95, p. 280, § 6; June 19, 1969, No. 38, p. 72; July 2, 1985, No. 54, p. 193; Jan. 4, 2003, No. 50, § 1.