Title 20 — Insurance
29 chapters · 1,539 sections in this title.
A.R.S. § 20-2301 Definitions; late enrollee coverage
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A. In this chapter, unless the context otherwise requires: 1. "Accountable health plan" means an entity that offers, issues or otherwise provides a health benefits plan and that is approved by the director as an accountable health plan pursuant to section 20-2303. 2. "Affiliation…
A.R.S. § 20-2302 Scope of article
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A. This article applies to any health benefits plan that provides coverage to eligible employees or dependents in this state and that is issued by an accountable health plan if: 1. Any portion of the premium or benefits is paid by or on behalf of the employer. 2. The eligible emp…
A.R.S. § 20-2303 Approval as accountable health plan; definition
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An entity may offer, issue or otherwise provide a health benefits plan only if the entity is authorized to transact insurance in this state and is approved as an accountable health plan by the director based on a determination that the entity meets the applicable requirements of …
A.R.S. § 20-2304 Availability of insurance; premium tax exemption
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A. As a condition of doing business in this state, each accountable health plan shall offer at least one health benefits plan on a guaranteed issuance basis to small employers as required by this section. All small employers qualify for this guaranteed offer of coverage. The acco…
A.R.S. § 20-2306 Use of uniform employee health status questionnaire
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B. An accountable health plan may add to the questionnaire additional questions that pertain to eligibility for coverage and for underwriting purposes and may ask the producer or the employees and dependents follow-up questions about their responses to the uniform employee health…
A.R.S. § 20-2307 Eligibility; annual open enrollment period
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A. Except as otherwise provided in this section or section 20-2308 or 20-2309, an accountable health plan may not exclude from coverage any employee or a spouse or a dependent child of the employee if the person meets the eligibility requirements established by the employer. B. S…
A.R.S. § 20-2308 Portability
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A newborn child, adopted child or child placed for adoption is an eligible individual if the child was timely enrolled and otherwise would have met the definition of an eligible individual as prescribed in section 20-1379 other than the required period of creditable coverage and …
A.R.S. § 20-2309 Renewability
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A. At least sixty days before the date of expiration of a health benefits plan, an accountable health plan that provides a health benefits plan shall provide for written notice to the employer of the terms for renewal of the plan. The notice shall include an explanation of the ex…
A.R.S. § 20-2310 Discrimination prohibited; preexisting conditions; wellness programs
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A. Except as provided in subsection B of this section, a health benefits plan may not deny, limit or condition the coverage or benefits based on a person's health status-related factors or a lack of evidence of insurability. B. A health benefits plan shall not exclude coverage fo…
A.R.S. § 20-2311 Premium rates and rating practices
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A. The premium rate that an accountable health plan charges during a rating period for a health benefits plan issued to a small employer shall not vary by more than sixty percent from the index rate for health benefits plans involving the same or similar coverage, family size and…
A.R.S. § 20-2313 Marketing practices
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A. An accountable health plan or its insurance producer shall not: 1. Discourage an employer from filing an application for a health benefits plan because of the health status-related factors, industry, occupation or geographic location of the employer. 2. Encourage or direct an …
A.R.S. § 20-2321 Maternity benefits; adoption; coverage
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A. A contract that is issued to an enrollee pursuant to this article and that provides coverage for maternity benefits shall also provide that the maternity benefits apply to the costs of the birth of a child who is legally adopted by the enrollee if all of the following are true…
A.R.S. § 20-2322 Mental health services and benefits; definitions
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A. Beginning on January 1, 1998, any health benefits plan that is offered by an accountable health plan and that provides services or health benefits that include mental health services or mental health benefits shall comply with this section. B. If the health benefits plan does …
A.R.S. § 20-2324 Bona fide associations; definitions
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A. An association qualifies as a path 1 bona fide association if the association meets the following requirements: 1. Has been formed and maintained in good faith for purposes other than obtaining insurance and does not condition membership in the association on the purchase of i…
A.R.S. § 20-2325 Diabetes; equipment; supplies
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A. Any health benefits plan that is offered by an accountable health plan and that provides coverage for diabetes shall also provide coverage for equipment and supplies that are medically necessary and that are prescribed by a health care provider, including: 1. Blood glucose mon…
A.R.S. § 20-2326 Drugs; cancer treatment; definitions
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1. Require coverage of any prescription drug used in the treatment of a type of cancer if the United States food and drug administration has determined that the prescription drug is contraindicated for that type of cancer. 2. Require coverage for any experimental prescription dru…
A.R.S. § 20-2327 Metabolic disorders; medical foods; definitions
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A. Any health benefits plan that is offered by an accountable health plan and that contains a prescription drug benefit shall provide coverage of medical foods to treat inherited metabolic disorders as provided by this section. B. The metabolic disorders triggering medical foods …
A.R.S. § 20-2328 Accountable health plans; clinical trials; cancer; definitions
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A. An accountable health plan is not obligated to pay any costs, other than covered patient costs, that are directly associated with a cancer clinical trial that is offered in this state and in which the enrollee participates voluntarily. A cancer clinical trial is a course of tr…
A.R.S. § 20-2329 Prescription contraceptive drugs and devices; definition
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A. An accountable health plan that provides a health benefits plan that provides coverage for: 1. Prescription drugs shall also provide coverage for any prescribed drug or device that is approved by the United States food and drug administration for use as a contraceptive. An acc…
A.R.S. § 20-2330 Continuation of small group coverage; notice; duration; definitions
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A. For health benefit plans issued or renewed after December 31, 2018, a health benefits plan shall provide that an enrollee and any qualified dependent may continue coverage under the plan as provided in this section. B. A small employer shall notify the enrollee in writing of t…
A.R.S. § 20-2331 Accountable health plans; varying copayments and deductibles allowed
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A. Except as provided in sections 20-1379 and 20-2304, an accountable health plan may offer one or more health benefits plans that contain a choice of deductibles, coinsurance, copayments, out-of-pocket and any other cost sharing levels. Plans offered under this section shall cle…
A.R.S. § 20-2332 Eosinophilic gastrointestinal disorder; formula
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A. Any health benefit plan that is offered by an accountable health plan and that contains a prescription drug benefit shall cover amino acid-based formula that is ordered by a physician or by a registered nurse practitioner if: 1. The insured has been diagnosed with an eosinophi…
A.R.S. § 20-2341 Uninsured small business health insurance plans; mandatory coverage exemption; definitions
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A. A policy, subscription contract, contract, plan or evidence of coverage issued to an uninsured small business by a health care insurer is not subject to the requirements of any of the following: 1. Section 20-461, subsection A, paragraph 17 and subsection B. 2. Section 20-826,…