Title 21 — Insurance
53 chapters · 1,244 sections in this title.
AS 21.51.300 Requirement of other jurisdictions.
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(a) A policy of a foreign or alien insurer, when delivered or issued for delivery to a person in this state, may contain any provision that is not less favorable to the insured or the beneficiary than the provisions of this chapter and that is prescribed or required by the law of…
AS 21.51.310 Conforming to statute.
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(a) A policy provision that is not subject to this chapter may not make a policy, or any portion of a policy, less favorable to the insured or the beneficiary than the provisions of the policy that are subject to this chapter. (b) A policy delivered or issued for delivery to a pe…
AS 21.51.320 Age limit.
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If the policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if the date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium afte…
AS 21.51.330 Franchise health insurance.
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(a) Health insurance on a franchise plan is that form of health insurance issued to (1) five or more employees of a corporation, copartnership, or individual employer or a governmental corporation, agency, or department of them; or (2) 10 or more members, employees, or employees …
AS 21.51.340 Violations. [Repealed, § 22 ch 149 SLA 1984.]
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[Repealed or reserved.]
AS 21.51.400 Renewability and certification.
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A health care insurer that offers a health care insurance plan in the individual market shall comply with the guaranteed renewability requirements established under 42 U.S.C. 300gg-42 and shall comply with the certification of coverage requirements established under 42 U.S.C. 300…
AS 21.51.405 Rate requirements; filings; regulations.
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(a) Rates charged for a health insurance policy may not be excessive, inadequate, or unfairly discriminatory. (b) An insurer shall file with the director the premium rates charged for an individual health care insurance plan before using them. A premium rate or premium rate chang…
AS 21.51.500 Definitions.
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In this chapter, (1) “health care exchange” means an American Health Benefit Exchange established under 42 U.S.C. 18031. (2) “health care insurance plan” has the meaning given in AS 21.54.500; (3) “health care insurer” has the meaning given in AS 21.54.500; (4) “individual market…
AS 21.53.010 Prohibited sale or advertising.
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An insurer, hospital or medical service corporation, or fraternal benefit society may not advertise, market, sell, deliver, or offer for delivery a long-term care insurance policy unless the policy complies with this chapter, AS 21.18, AS 21.45, the health insurance requirements …
AS 21.53.020 Disclosure and performance standards.
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An insurer, hospital or medical service corporation, or fraternal benefit society that delivers or issues for delivery a long-term care insurance policy may not (1) cancel, fail to renew, or otherwise terminate the policy on the grounds of age or deterioration of the mental or ph…
AS 21.53.030 Preexisting conditions.
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(a) An insurer, hospital or medical service corporation, or fraternal benefit society may not include, in a long-term care insurance policy or certificate, a definition of “preexisting condition” that is more restrictive than the following: preexisting condition means a condition…
AS 21.53.040 Prior hospital or institutional care conditions prohibited.
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(a) A long-term care insurance policy may not be delivered or issued for delivery in this state if the policy conditions eligibility (1) on a prior hospitalization requirement; (2) on the receipt of a higher level of institutional care, when care is provided in an institutional s…
AS 21.53.050 Right of return; outline of coverage; delivery.
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(a) A long-term care insurance applicant may return a policy within 30 days after delivery and have the premium refunded if, after examination of the policy, the applicant is not satisfied with the policy. A long-term care insurance policy must have a notice prominently printed o…
AS 21.53.060 Long-term care benefits under life insurance policies; denial of claims.
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(a) In addition to the requirements of AS 21.45, at the time of policy delivery, a policy summary shall be included with an individual life insurance policy if the policy or policy rider provides long-term care benefits. In the case of direct response solicitations, the insurer s…
AS 21.53.062 Incontestability period.
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(a) If a long-term care insurance policy has been in force for less than six months, an insurer may rescind the policy or deny an otherwise valid long-term care claim under the policy on a showing of misrepresentation that is material to the acceptance for coverage. (b) If a long…
AS 21.53.064 Nonforfeiture benefits.
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(a) Except as provided in (b) of this section, a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder has been offered the option of purchasing a policy including a nonforfeiture benefit. The insurer may offer a nonforf…
AS 21.53.066 Producer training requirements.
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(a) A person may not sell, solicit, or negotiate long-term care insurance unless the person is licensed as an insurance producer for health or life insurance lines of authority and has completed a one-time training course that meets the requirements in (d) of this section. (b) A …
AS 21.53.068 Limitations related to producers and third-party administrators.
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An insurer that authorizes issuance of a long-term care insurance policy by a producer or a third-party administrator under the underwriting authority of the insurer granted to the producer or third-party administrator using the insurer's underwriting guidelines may issue a long-…
AS 21.53.070 Group long-term care insurance.
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Group long-term care insurance coverage may not be offered to a resident of this state under a group policy issued in another state, unless the state in which the policy is issued has statutory or regulatory provisions applicable to group long-term care insurance that are substan…
AS 21.53.080 Organizational requirements of associations.
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An insurer, hospital or medical service corporation, or a fraternal benefit society may not issue group long-term care insurance to an association or a trust or the trustee of a fund established, created, or maintained for the benefit of members of one or more associations, unles…
AS 21.53.090 Required regulations.
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The director shall adopt regulations regarding (1) the sale of long-term care insurance that provide minimum standards for (A) terms of renewability; (B) initial and subsequent conditions of eligibility; (C) nonduplication of coverage provisions; (D) coverage of dependents; (E) b…
AS 21.53.200 Definitions.
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In this chapter, (1) “applicant” means in the case of an individual long-term care insurance policy, the person who seeks to contract for benefits, and in the case of a group long-term care insurance policy, the proposed certificate holder; (2) “certificate” means a certificate i…
AS 21.54.010 Required provisions of group policies.
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Each group health insurance policy must contain in substance the following provisions: (1) a provision that, in the absence of fraud, all statements made by applicants or the policyholder or by an insured person shall be considered representations and not warranties, and that a s…
AS 21.54.015 Rate requirements; filings; regulations; health care insurance restrictions.
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(a) Rates charged for a group health insurance policy may not be excessive, inadequate, or unfairly discriminatory. (b) A health care insurer may decline to cover or may restrict the coverage offered to a self-employed individual under an association plan authorized under AS 21.5…
AS 21.54.020 Direct payment to providers.
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(a) On the written request of a covered person, a health care insurer shall pay amounts due under a health insurance policy directly to the provider of medical care services. A health insurance policy may not contain a provision that requires services be provided by a particular …
AS 21.54.030 Required provisions of blanket policies.
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An insurer authorized to write health insurance in this state shall have the power to issue blanket health insurance. A blanket policy may not be issued or delivered in this state unless a copy of the form of the policy has been filed in accordance with AS 21.42.120. Each blanket…
AS 21.54.040 Application and certificates not required.
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An individual application may not be required from a person covered under a blanket health insurance policy or contract, nor is it necessary for the insurer to furnish each person a certificate.
AS 21.54.050 Payment of blanket health policy benefits.
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(a) All benefits under a blanket health insurance policy shall be paid to (1) the person insured; (2) the designated beneficiary or beneficiaries of the person insured; (3) the estate of the person insured; (4) the parent, guardian, or other person actually supporting the person …
AS 21.54.060 Group health insurance defined.
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(a) Group health insurance is that form of health insurance covering groups of persons as defined below, with or without one or more members of their families or one or more of their dependents, or covering one or more members of the families or one or more dependents of the grou…
AS 21.54.070 Blanket health insurance defined.
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Article 2. Health Care Insurance Provisions, Requirements, and Restrictions. Blanket health insurance is declared to be that form of health insurance covering groups of persons as enumerated in one of the following subdivisions: (1) under a policy or contract issued to a common c…
AS 21.54.100 Unfair discrimination.
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(a) A health care insurer that offers, issues for delivery, delivers, or renews a health care insurance plan in the group market may not establish rules for eligibility, including continued eligibility and waiting periods under the plan, for an individual or dependent of an indiv…
AS 21.54.105 Special enrollment requirements related to Medicaid and state child health plan coverage.
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A health care insurer that offers, issues, delivers, or renews a health care insurance plan in the group market shall allow an eligible employee or dependent of an employee to enroll for coverage under the terms of the plan if the employee or dependent (1) is covered by Medicaid …
AS 21.54.110 Preexisting condition exclusion.
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(a) A health care insurance plan offered, issued for delivery, delivered, or renewed in the group market may not contain a preexisting condition exclusion that (1) relates to a condition, regardless of cause, for which medical advice, diagnosis, care, or treatment was recommended…
AS 21.54.120 Creditable coverage.
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(a) A health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall count a period of creditable coverage based on (1) the standard method authorized by 42 U.S.C. 300gg (Health Insurance Portability …
AS 21.54.130 Renewability, termination, and modification of coverage.
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(a) Except for a multiple employer welfare arrangement, a health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall renew or continue in force the coverage under the plan at the option of the pla…
AS 21.54.140 Renewability of coverage for a multiple employer welfare arrangement.
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A health benefit plan that is a multiple employer welfare arrangement subject to this title may not deny an employer whose employees are covered under the plan continued access to the same or a different plan according to the terms of the plan, except (1) for nonpayment of contri…
AS 21.54.150 Mental health benefits. [Repealed, § 116 ch 81 SLA 1997.]
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[Repealed or reserved.]
AS 21.54.151 Mental health or substance use disorder benefits.
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A health care insurer that offers a health care insurance plan in the group market shall comply with the mental health or substance use disorder benefit requirements established under 42 U.S.C. 300gg-26.
AS 21.54.160 “Excepted benefits” defined.
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“Excepted benefits” means benefits under one or more or any combination of the following: (1) benefits under (A) coverage only for accident, disability income insurance, or both; (B) coverage issued as a supplement to liability insurance; (C) liability insurance, including genera…
AS 21.54.170 Determination of size of employer.
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The determination of whether an employer is a large or small employer is subject to the following: (1) the size of an employer that was not in existence throughout the preceding calendar year must be based on the average number of employees that the employer is reasonably expecte…
AS 21.54.180 Individual health care insurance policies offered in the group market. [Repealed, § 94(b) ch 23 SLA 2011.]
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Article 3. General Provisions.
AS 21.54.500 Definitions.
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In this chapter, (1) “aggregate lifetime limit” means a dollar limit on the total amount that may be paid for benefits under a health care insurance plan offered in the group market with respect to an individual or unit of coverage; (2) “annual limit” means a dollar limit on the …
AS 21.55.010 Creation; membership; information from members.
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(a) There is established a nonprofit incorporated legal entity to be known as the Comprehensive Health Insurance Association. Membership consists of all licensed hospital or medical service corporations in the state that offer subscriber contracts for major medical coverage, all …
AS 21.55.020 Board of directors; organization.
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(a) The board of directors of the association consists of seven individuals. Five board members shall be selected by association members, subject to approval by the director of the division of insurance, and two board members shall be consumers selected by the director of the div…
AS 21.55.030 General powers.
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The association may (1) exercise the powers granted to insurers under the laws of the state; (2) sue or be sued; (3) enter into contracts with insurers, similar associations in other states, or with other persons for the performance of administrative functions; (4) establish admi…
AS 21.55.040 Plan of operation.
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(a) The association shall submit to the director a plan of operation and amendments necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and amendments become effective upon approval in writing by the directo…
AS 21.55.050 Administrative Procedure Act.
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The association is exempt from AS 44.62 (Administrative Procedure Act).
AS 21.55.060 Tax exemption.
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Article 2. State Health Insurance Plans. The association is exempt from the payment of fees and taxes levied by the state or any of its political subdivisions except taxes levied on real or personal property.
AS 21.55.100 Types of insurance plans.
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(a) The association shall make available to a person who is eligible for coverage under this chapter at least one individual state plan of health insurance. The association shall offer a plan with the deductible, copayment, and calendar year maximum limits as described in AS 21.5…
AS 21.55.110 Minimum benefits of state health insurance plan.
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Except as provided in AS 21.55.120 — 21.55.140, the minimum standard benefits of a health insurance plan offered under AS 21.55.100(a) shall be benefits with a lifetime maximum of $1,000,000 for each individual for usual, customary, reasonable, or prevailing charges or, when appl…