Title 20 — Insurance

Amendments to the plan of operation may be made by the directors of the association, subject to the approval of the director, or shall be made at the direction of the director consistent with the provisions of section 20-2206.

Except as otherwise provided in this chapter, a liability insurance policy issued by the association shall be on a claims-made basis. The policy form shall be filed with and approved by the director.

A policy issued pursuant to this chapter may provide that the association may cancel any of its policies for the reasons specified in section 20-1673 or in the event of nonpayment of any premium assessment or other charge by sending to the insured written notice at least ten days…

A. All policies written by the association shall contain a provision that guarantees the insured that the association shall issue, on the written demand of any insured to whom it has issued a claims-made policy, an occurrence rider comparable to that provided in the voluntary mar…

A. The rates, rating plans, rating rules, rating classifications and territories applicable to insurance written by the association, and the statistics relating thereto, are subject to the provisions of chapter 2, article 4.1 of this title, giving consideration to the past and pr…

A. On a determination that within the next one hundred eighty days thereafter the association will be unable to pay its outstanding lawful obligations as they mature in the regular course of business as shown by an excess of such lawful obligations over admitted assets, the assoc…

A. An initial assessment of up to five hundred dollars may be imposed by the director on every participating insurer of the association to defray the initial operating expenses of the plan. The initial assessment may be refunded by the association. B. If sufficient monies are not…

All members of the association shall participate in its writings, expenses, servicing allowance, management fees and losses in the proportion that the net direct premium of each member, excluding that portion of a premium attributable to the operation of the association, written …

Any applicant to the association or any person insured pursuant to this chapter, or their representatives, or any affected member may appeal to the director within thirty days after any ruling, action or decision by or on behalf of the association, with respect to those items def…

Annually on or before January 1, the association shall file in the office of the director a statement which contains information with respect to its transactions, condition, operations and affairs during the preceding year. Such statement shall contain such matters and informatio…

The director shall make an examination into the affairs of the association at least annually. The examination shall be conducted and the report filed in the manner prescribed in section 20-156.

All reasonable and necessary costs incurred by the director pursuant to this chapter shall be charged to and immediately reimbursed by the association.

There is no liability on the part of nor does any cause of action accrue against the association or its members, the director or his authorized representatives or any other person or organization for any acts or omissions made in good faith by them during any proceeding or concer…

The association shall not be a member of the Arizona guaranty fund nor shall that fund or this state or any of its political subdivisions be otherwise responsible for losses sustained by the joint underwriting association.

Dissolution of the association, including its assets and liabilities, shall be accomplished under the supervision of the director.

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. 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…

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. 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…

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. 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 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. 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. 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. 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. 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. 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. 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. 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. 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…

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. 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. 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. 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. 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. 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. 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. 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,…

In this chapter, unless the context otherwise requires: 1. "Completed operations liability" means liability arising out of the installation, maintenance or repair of any product at a site which is not owned or controlled by either: (a) A person who performs that work. (b) A perso…

A. A risk retention group, pursuant to this title, shall be chartered and licensed to write only liability insurance pursuant to this chapter and, except as provided in this chapter, must comply with this title with respect to insurers that are chartered and licensed in this stat…

A. Before offering insurance in this state, a risk retention group shall submit to the director all of the following: 1. Evidence that the group meets the criteria of a risk retention group. 2. A statement identifying the state or states in which the risk retention group is chart…

A. No risk retention group is required or permitted to join or contribute financially to any insurance insolvency guaranty fund, or similar mechanism, in this state, and no risk retention group, or its insureds or claimants against its insureds, may receive any benefit from any f…

A. A purchasing group which meets the criteria established under the federal liability risk retention act of 1986 is exempt from any law of this state relating to the creation of groups for the purchase of insurance, prohibition of group purchasing or any law that would discrimin…

A. A purchasing group which intends to do business in this state, before doing business, shall furnish notice to the director which: 1. Identifies the state in which the group is domiciled. 2. Specifies the lines and classifications of liability insurance which the purchasing gro…

A. A purchasing group may not purchase insurance from a risk retention group that is not chartered in a state or from an insurer which is not admitted in the state in which the purchasing group is located, unless the purchase is effected through a licensed insurance producer. B. …

The director may make use of any of the powers established under this title to enforce the laws of this state so long as those powers are not specifically preempted by the product liability risk retention act of 1981, as amended by the risk retention amendments of 1986. This incl…

A risk retention group which violates any provision of this chapter is subject to civil penalties set forth in section 20-220 and section 20-456 and to revocation or suspension of its license and the right to do business in this state.

A. No person, firm, association or corporation may act or aid in any manner in soliciting, negotiating or procuring liability insurance in this state from a risk retention group unless the person, firm, association or corporation is licensed as an insurance producer in accordance…

An order issued by any district court of the United States enjoining a risk retention group from soliciting or selling insurance or operating in any state on a finding that such a group is in a hazardous financial condition is enforceable in the courts of this state.

The director may adopt rules relating to risk retention groups as may be necessary or desirable to carry out the provisions of this chapter.