Title 20, Insurance

In determining the financial condition of a reciprocal insurer the director shall apply the following rules: 1. He shall charge as liabilities the same reserves as are required of incorporated insurers issuing nonassessable policies on a reserve basis. 2. The surplus deposits of …

Individuals, partnerships and corporations of this state may make application, enter into agreement for and hold policies or contracts in or with and be a subscriber of any domestic, foreign or alien reciprocal insurer. Any corporation organized under the laws of this state shall…

A. The advisory committee of a domestic reciprocal insurer exercising the subscribers' rights shall be selected under such rules as the subscribers adopt. B. Not less than two thirds of the committee shall be subscribers other than the attorney, or any person employed by, represe…

A. The liability of each subscriber, other than as to a nonassessable policy, for the obligations of the reciprocal insurer shall be an individual, several and proportionate liability, and not joint. B. Except as to a nonassessable policy each subscriber shall have a contingent a…

A. No action shall lie against any subscriber upon any obligation claimed against the insurer until a final judgment has been obtained against the insurer and remains unsatisfied for thirty days. B. Any such judgment shall be binding upon each subscriber only in such proportion a…

A. Assessments may from time to time be levied upon subscribers of a domestic reciprocal insurer liable therefor under the terms of their policies by the attorney upon approval in advance by the subscribers' advisory committee and the director, or by the director in liquidation o…

Every subscriber of a domestic reciprocal insurer having contingent liability shall be liable for, and shall pay his share of any assessment, as computed and limited in accordance with this article, if: 1. While his policy is in force or within one year after its termination, he …

No one policy or subscriber as to such policy, shall be assessed or charged with an aggregate of contingent liability as to obligations incurred by a domestic reciprocal insurer in any one calendar year, in excess of the amount provided for in the power of attorney or in the subs…

A. If a reciprocal insurer has a surplus of assets over all liabilities at least equal to the minimum capital stock generally required of a domestic stock insurer authorized to transact like kinds of insurance, upon application of the attorney and as approved by the subscribers' …

A reciprocal insurer may from time to time return to its subscribers any unused premiums, savings or credits accruing to their accounts. Any such distribution shall not unfairly discriminate between classes of risks, or policies, or between subscribers, but this shall not prevent…

Upon the liquidation of a domestic reciprocal insurer, its assets remaining after discharge of its indebtedness and policy obligations, the return of any contributions of the attorney or other persons to its surplus made as provided in section 20-778, and the return of any unused…

A. A domestic reciprocal insurer upon affirmative vote of not less than two thirds of its subscribers who vote on such merger pursuant to due notice and the approval of the director of the terms therefor, may merge with another reciprocal insurer or be converted to a stock or mut…

A. If the assets of a reciprocal insurer are at any time insufficient to discharge its liabilities, other than any liability on account of funds contributed by the attorney or others, and to maintain the required surplus, its attorney shall forthwith make up the deficiency or lev…

Legal title of real property acquired as an eligible investment in accordance with section 20-556 must be held in the name of the reciprocal insurer. Notwithstanding any other provision in this section, all deeds, notes, mortgages or other documents relating to the purchase, sale…

A. Hospital service corporations, medical service corporations, dental service corporations, optometric service corporations and hospital, medical, dental and optometric service corporations incorporated in this state are governed by this article and are exempt from all other pro…

In this article, unless the context otherwise requires, "hospital service corporations", "medical service corporations", "dental service corporations", "optometric service corporations" and "hospital, medical, dental and optometric service corporations" mean corporations organize…

The corporation as defined in section 20-822 shall be organized under the laws of this state relating to private corporations not for pecuniary profit, insofar as such laws are not inconsistent with any of the provisions of this article.

Such a corporation may issue contracts to its subscribers only when the director has, by certificate of authority, authorized it so to do. Application for a certificate of authority shall be made on forms supplied or approved by the director containing such information as the dir…

The director shall issue a certificate of authority authorizing the applicant to issue contracts to its subscribers when it is shown to the satisfaction of the director that: 1. The applicant is established as a bona fide, nonprofit hospital service corporation, medical service c…

A corporation that is exempt from the risk-based capital requirement prescribed in section 20-488.08 shall maintain unimpaired capital or surplus, or both, in the amount of at least twenty-five thousand dollars.

A. A contract between a corporation and its subscribers shall not be issued unless the form of such contract is approved in writing by the director. B. Each contract shall plainly state the services to which the subscriber is entitled and those to which the subscriber is not enti…

A. A hospital service corporation or medical service corporation 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 subscriber participates voluntarily. A ca…

A. Except as provided in sections 20-1379 and 20-2304, a corporation may offer one or more subscription contracts that contain a choice of deductibles, coinsurance, copayments, out-of-pocket and any other cost sharing levels. Plans offered under this section shall clearly disclos…

A. Any contract that is offered by a hospital service corporation or medical service corporation and that contains a prescription drug benefit shall cover amino acid-based formula that is ordered by a physician or a registered nurse practitioner if: 1. The subscriber has been dia…

A. A hospital service corporation or medical service corporation shall not: 1. Exclude or deny coverage for a treatment or impose dollar limits, deductibles and coinsurance provisions based solely on the diagnosis of autism spectrum disorder. For the purposes of this paragraph, "…

A. A subscription contract may limit coverage to a subscriber for a human organ transplant or posttransplant care if either of the following applies: 1. The transplant operation is performed in the People's Republic of China or the Hong Kong special administrative region. 2. The …

A. Corporations governed by this article shall at all times have on deposit with the state treasurer the following amounts: 1. If newly formed under this article, two hundred thousand dollars. 2. If formed under prior law, such amount as was so required under prior law. B. Every …

The directors of a corporation governed by this article shall at all times include representatives of: 1. Dentists licensed to practice in this state who have contracted with the corporation to render dental service to subscribers, if the corporation is a dental service corporati…

A. The operating and administrative expenses of any such corporation, including all costs in connection with solicitation of subscribers to the corporation and capital expenditures, shall not exceed thirty per cent of paid subscriptions during the first year of operation, twenty-…

A. Not later than March 31 of each year every corporation shall file with the director a statement of its financial condition, transactions and affairs as of the preceding December 31 as prescribed in sections 20-223 and 20-234 and shall pay the annual renewal fee prescribed in s…

A corporation shall not: 1. Pay to any officer of the corporation any salary, compensation or emolument amounting in any year to more than $5,000, unless the board of directors of the corporation first authorizes the salary, compensation or emolument. 2. Make any agreement with a…

A. Nothing in this article alters the relationship of physician and patient, registered nurse practitioner and patient, dentist and patient or optometrist and patient. B. The corporation shall not in any way influence the subscriber in the subscriber's free choice of hospital, ph…

Such a corporation shall be subject to the provisions of article 4 of chapter 3 of this title (rehabilitation and liquidation) and article 6 of chapter 2 of this title (unfair practices).

All orders of the director made pursuant to this article are subject to chapter 1, article 2 of this title, including the right of hearing, rehearing and appeal.

No liability shall attach to any corporation holding a certificate of authority under this article by reason of the failure on the part of any of its participating hospitals, physicians, dentists or optometrists to render service, except as provided by this article, to any of its…

A. Every corporation doing business pursuant to this article is declared to be a nonprofit and benevolent institution and to be exempt from state, county, district, municipal and school taxes, including the taxes prescribed by this title, and excepting only the fees prescribed by…

The private property of the subscribers, agents, officers, directors, members and employees of any corporation holding a certificate of authority under this article shall be wholly exempt from any of the debts, obligations and liabilities of the corporation.

A. This article shall not apply to any corporation operating or maintaining a hospital service plan, medical service plan, dental service plan or optometric service plan, participation in which is limited to its employees and the employees of other persons or corporations with wh…

This article shall not be construed in any manner to abrogate, amend or annul any certificate, license or right acquired prior to January 1, 1955 by any corporation, insurer, hospital, physician, dentist, optometrist, individual or subscriber under or pursuant to Laws 1945, 1st s…

A. Notwithstanding any provision of any subscription contract of a hospital and medical service corporation, benefits shall not be denied under the contract for any medical or surgical service performed by a holder of a license issued pursuant to title 32, chapter 7 or 11, if the…

If a subscription contract of a hospital and medical service corporation provides for or offers reimbursement for any service which is within the lawful scope of the practice of a chiropractor holding a certificate or license issued by the state in which the services are rendered…

If a subscription contract of a hospital and medical service corporation provides for or offers reimbursement for any service which is within the lawful scope of the practice of a psychologist holding a certificate or license issued by the state in which the services are rendered…

If a subscription contract of a hospital and medical service corporation provides or offers reimbursement for any service which is within the scope of the practice of a registered nurse practitioner or a certified registered nurse qualified under the rules adopted by the state bo…

A. Any corporation that offers a health benefits plan shall establish a procedure by which a subscriber may apply for a standing referral to a network health care professional. The corporation shall provide a subscriber with a standing referral if all of the following conditions …

A. A corporation with a prescription drug benefit that uses a drug formulary as a component of the subscription contract shall provide to its subscribers notice in the contract and any disclosure form regarding the applicable drug formulary. The corporation shall write the notice…

A. Any corporation that offers a health benefits plan shall allow any new subscriber whose health care provider is not a member of the provider network, on written request of the subscriber to the corporation, to continue an active course of treatment with that health care provid…