Chapter 17 - HEALTH INSURANCE POLICIES

Section 58-17-1 - Requirements for all health insurance policies delivered in state
Section 58-17-1.1 - Grandfathered plans required to cover low-dose mammography-Extent of coverage
Section 58-17-1.2 - Policies to provide coverage for diabetes supplies, equipment and education-Exceptions-Conditions and limitations
Section 58-17-1.3 - Diabetes coverage not required of certain plans and policies
Section 58-17-1.4 - Policies required to cover occult breast cancer screening
Section 58-17-2 - Persons covered by policy
Section 58-17-2.1 - Health insurance on a franchise plan
Section 58-17-2.2 - Conversion privileges of insured's spouse upon divorce
Section 58-17-2.3 - Dependent coverage termination-Age-Full-time students
Section 58-17-3 - Time of commencement and termination to be set out in policy
Section 58-17-4 - Consideration for policy to be stated
Section 58-17-4.1 - Filing and approval of individual policy premium rates
Section 58-17-4.2 - Premium rates required to be reasonable-Rules to establish minimum standards promulgated by director
Section 58-17-4.3 - Transferred
Section 58-17-5 - Identification of forms, riders and endorsements-Form number, location
Section 58-17-6 - Style and arrangement of policy provisions-Printing, size of type
Section 58-17-7 - Documents forming part of policy-Setting forth in full, rates and classifications excepted
Section 58-17-8 - Exceptions and reductions of coverage to be clearly set out
Section 58-17-9 - Renewal of policy at option of insurer-Statement in policy so informing the policyholder
Section 58-17-10 - [Repealed]
Section 58-17-10.1 - Reduction of benefits because of increase in statutory disability benefits prohibited
Section 58-17-10.2 - Individual policy for insured's spouse required in policies covering spouse-Eligibility-Coverage-Waiting periods
Section 58-17-11 - Return of policy by purchaser-Refund of premium paid-Dissatisfaction with terms after examination
Section 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
Section 58-17-12 - Required provisions-Captions-Substitutes, approval by director
Section 58-17-13 - Omission from policy of inapplicable provision-Approval of director-Modification of inconsistent provision
Section 58-17-14 - Entire contract and change clauses required-Signed acceptance required for endorsements
Section 58-17-15 - Time limit on certain defenses-Application of section
Section 58-17-16 - [Repealed]
Section 58-17-17 - Grace period on premiums required in policy
Section 58-17-18 - Renewal of policy-Restriction on company's right to refuse
Section 58-17-19 - Reinstatement when premium not paid within grace period
Section 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
Section 58-17-21 - Notice of claim-Provision required in policy
Section 58-17-22 - Notice of claim-Loss of time benefit-Optional provision, insertion by insurer
Section 58-17-23 - Claim forms-Furnishing by insurer
Section 58-17-24 - Proofs of loss-Provision required in policy
Section 58-17-25 - Time of payment of claims-Provision required in policy
Section 58-17-26 - Payment of claims-Persons to whom benefits payable-Provision required in policy
Section 58-17-27 - Payment of claims-Optional provisions, insertion by insurer
Section 58-17-28 - Physical examination of insured-Autopsy in death claims-Provision required in policy
Section 58-17-29 - Action to recover under policy-Time for beginning
Section 58-17-30 - Beneficiary-Changes reserved to insured
Section 58-17-30.1 - Continuation of coverage for child with intellectual or physical disability-Proof of dependency
Section 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
Section 58-17-30.3 - Premature birth and congenital defects covered-Applicability
Section 58-17-30.4 - Notice of birth or adoption required for continued coverage
Section 58-17-30.5 - Coverage for inpatient alcoholism treatment required
Section 58-17-30.6 - Alcoholism benefits provided-Days of care
Section 58-17-30.7 - Policies excluded from alcoholism coverage requirements
Section 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
Section 58-17-30.9 - Notice that dependent is no longer eligible for coverage-Premium adjustment
Section 58-17-31 - Optional policy provisions
Section 58-17-32 - Occupational change-Policy provision for adjustment of premium or benefits
Section 58-17-33 - Misstatement of age-Policy provision for adjustment of benefits
Section 58-17-34 - Earnings of insured-Policy provision for adjustment of benefits
Section 58-17-35 - Earnings adjustment clause to be coupled with insured's right to continue policy in force
Section 58-17-36 - Option of insurer to define "valid loss of time coverage"
Section 58-17-37 - Unpaid premiums-Deduction from benefits
Section 58-17-38 - Conformity with state statutes of insured
Section 58-17-39 - Illegal occupation of insured
Section 58-17-40 - Renewal of policy at option of insurer
Section 58-17-41 - Order of policy provisions
Section 58-17-42 - Age limit in policy-Effect of acceptance of premiums or misstatement of age
Section 58-17-43 - Third parties taking policy covering insured
Section 58-17-44 - Foreign or alien insurer-Policy provision required by home state
Section 58-17-45 - Policy of domestic insurer delivered in other state-Compliance with laws of other state
Section 58-17-46 - Policy provisions not subject to chapter-Conforming to statute required
Section 58-17-47 - Nonconforming and conflicting provisions construed in conformity with statute
Section 58-17-48 - Liability and workers' compensation insurance-Inapplicability of health insurance provisions
Section 58-17-49 - Health insurance provisions inapplicable to group or blanket policy
Section 58-17-50 - Life insurance, endowment or annuity contracts not subject to health insurance provisions
Section 58-17-51 - Health insurance provisions inapplicable to reinsurance
Section 58-17-52 - Prior contracts or policies excepted
Section 58-17-53 - Optometric services-Reimbursement, exceptions
Section 58-17-54 - Reimbursement provisions applicable to all healing arts licensees-Self-insurance plans for public employees-Restrictions on policy limitations
Section 58-17-54.1 - Copayment or coinsurance amounts for chiropractic, physical therapy, or occupational therapy services
Section 58-17-55 - Reimbursement provisions applicable to licensed hospitals
Section 58-17-56 - Reimbursement for service rendered or supervised by qualified mental health professional
Section 58-17-57 - Abuse of health insurance as misdemeanor
Section 58-17-58 - Waiver of required deductible or co-payment for charitable purposes permitted
Section 58-17-59 - When waiver presumed
Section 58-17-60 - Certain payments exempt
Section 58-17-61 - Assignment of health insurance proceeds to certain hospitals authorized
Section 58-17-62 - Coverage for phenylketonuria
Section 58-17-63 - Health benefit plan defined
Section 58-17-64 - Minimum loss ratio for individual health benefit plans
Section 58-17-65 - Individual health insurance plan used in conjunction with managed care plan or utilization review organization
Section 58-17-66 - Definitions for 58-17-66 through 58-17-87
Section 58-17-67 - Professional association defined
Section 58-17-68 - Professional association plan defined
Section 58-17-69 - Creditable coverage defined
Section 58-17-70 - Application of 58-17-66 to 58-17-87, inclusive
Section 58-17-71 - Separate classes of individual business-Reasons-Number
Section 58-17-72 - Transitional period when additional class of business acquired
Section 58-17-73 - Director approval required to establish additional classes of business-Rates or rating methodologies
Section 58-17-74 - Provisions for premium rates for individual health benefit plans
Section 58-17-74.1 - Premium rate limitations
Section 58-17-75 - Promulgation of rules for rates charged for individual health benefit plans
Section 58-17-76 - Transfer into or out of class of business
Section 58-17-77 - Temporary suspension of premium rates for individual health insurance-Reasons
Section 58-17-78 - Required disclosure when offering individual health benefit plan
Section 58-17-79 - Documentation of rating methods and practices
Section 58-17-80 - [Repealed]
Section 58-17-81 - Availability of information on rating methods and practices of carriers offering individual health benefit plans
Section 58-17-82 - Renewal of individual health benefit plans-Exceptions
Section 58-17-83 - Election not to renew individual health benefit plan-Future business restricted
Section 58-17-84 - Provisions for carriers providing individual coverage other than excepted benefits
Section 58-17-84.1 - Anesthesia and hospital or ambulatory surgery center charges for dental care to be covered for certain persons
Section 58-17-85, 58-17-85.1 - [Repealed]
Section 58-17-86 - [Repealed]
Section 58-17-87 - Director to promulgate rules for individual health insurance-Scope of rules
Section 58-17-88 - Minimum inpatient care coverage following delivery
Section 58-17-89 - Shorter hospital stay permitted-Follow-up visit within forty-eight hours required
Section 58-17-90 - Notice to policyholders-Disclosures
Section 58-17-91 to 58-17-96 - [Repealed]
Section 58-17-97 - Provisions covering preexisting conditions
Section 58-17-98 - Health insurance policies to provide coverage for biologically-based mental illnesses
Section 58-17-99 - Application of section 58-17-98-Exemptions
Section 58-17-100 - Definitions
Section 58-17-101 - Insurer may not exclude certain off-label uses of prescription drugs
Section 58-17-102 - Exceptions
Section 58-17-103 - Provisions limited to cancer or life threatening diseases
Section 58-17-104 - Deductibles, copayments, and managed care review not affected
Section 58-17-105 - Drugs used in research trials not covered
Section 58-17-106 - No reduction or limitation of coverage otherwise required by law
Section 58-17-107 - Health insurance policies to provide coverage for prostate cancer screening
Section 58-17-108 - Disability income insurance defined
Section 58-17-109 - Exclusion or reduction of benefits
Section 58-17-110 - Commencement of loss
Section 58-17-111 - Minimum standards-Exceptions
Section 58-17-112 - Promulgation of rules regarding disability income policies-Content
Section 58-17-113, 58-17-114 - [Repealed]
Section 58-17-115 - [Repealed]
Section 58-17-116 - [Repealed]
Section 58-17-117, 58-17-118 - [Repealed]
Section 58-17-119 to 58-17-124 - [Repealed]
Section 58-17-125 - [Repealed]
Section 58-17-126 - [Repealed]
Section 58-17-127 to 58-17-137 - [Repealed]
Section 58-17-138 - [Repealed]
Section 58-17-139 to 58-17-141 - [Repealed]
Section 58-17-142 - Maximum premium rates for plans issued prior to August 1, 2003-Rate provisions of section 58-17-75 to apply upon carrier's discontinuance of active marketing
Section 58-17-143 - [Repealed]
Section 58-17-144, 58-17-145 - [Repealed]
Section 58-17-145.1 - Deadline for submission of health claim under risk pool
Section 58-17-146 - Dental insurers prohibited from setting fees for noncovered service
Section 58-17-146.1 - Certain contract terms voidable by dentist
Section 58-17-147 - Elective abortion coverage prohibited in qualified health plan offered through health insurance exchange
Section 58-17-148 - Qualified health plan sold through exchange to provide for placement through licensed insurance producer-Commissions
Section 58-17-149 - Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period
Section 58-17-150 - Retrospective payment of clean claims for covered services provided by health care professional during credentialing period-Requirements
Section 58-17-151 - Applications to be credentialed
Section 58-17-152 - Application of sections 58-17-149 to 58-17-151
Section 58-17-153 - Coverage for treatment of hearing impairment for persons under age nineteen
Section 58-17-154 - Definitions for sections 58-17-155 to 58-17-162
Section 58-17-155 - Exceptions to application of sections 58-17-154 to 58-17-162
Section 58-17-156 - Policies, contracts, certificates, and plans subject to sections 58-17-154 to 58-17-162
Section 58-17-157 - Coverage for applied behavior analysis for treatment of autism spectrum disorders
Section 58-17-158 - Authorization, prior approval, and other care management requirements-Annual maximum benefit
Section 58-17-159 - Qualifications of person performing or supervising applied behavior analysis
Section 58-17-160 - Review of treatment
Section 58-17-161 - Services under individualized service plan, family service plan, or education program
Section 58-17-162 - Effective date of sections 58-17-154 to 58-17-161
Section 58-17-163 - Dental care insurers to honor assignment of benefits
Section 58-17-164 - Revocation of assignment of dental insurance benefits
Section 58-17-165 - Reimbursement of payment from insured following receipt of payment from insurer
Section 58-17-166 - Scope of benefits not affected-Medical benefits not included
Section 58-17-167 - Definitions pertaining to telehealth coverage
Section 58-17-168 - Coverage for health care services provided through telehealth
Section 58-17-169 - Discrimination between coverage for services provided in person and through telehealth prohibited
Section 58-17-170 - Application of telehealth coverage requirements
Section 58-17-171 - Payment for dental services-Credit card requirement prohibited