Title 20 — Insurance

Any corporation that provides coverage for medical supplies shall provide coverage for those medical supplies through one or more participating vendors who are reasonably accessible to subscribers as determined by the department in terms of hours of service and areas of coverage …

[Repealed or reserved.]

1. Except as otherwise provided in this subsection, a corporation may not limit or deny the coverage of health care services provided through telehealth, including ancillary services, and may apply only the same limits or exclusions on a health care service provided through teleh…

A. A contract that is issued, delivered or renewed by a corporation on or after January 1, 2016 and that provides coverage both for cancer treatment medications that are injected or intravenously administered by a health care provider and for patient-administered cancer treatment…

A. Beginning January 1, 2018, any contract that is issued, delivered or renewed by a corporation and that provides coverage for prescription eyedrops to treat glaucoma or ocular hypertension may not deny coverage for a refill of a prescription for eyedrops to treat glaucoma or oc…

All contracts issued, delivered or renewed on or after July 1, 2017 by a corporation in this state must provide coverage for lawful health care services that are provided by a health care provider to a subscriber regardless of the familial relationship of the health care provider…

B. A subscription contract shall cover biomarker testing for the purposes of diagnosis, treatment, appropriate management or ongoing monitoring of a subscriber's disease or condition to guide treatment decisions when the test provides clinical utility as demonstrated by medical a…

An insurance contract offered by a hospital, medical, dental or optometric service corporation shall not exclude coverage of a condition if the insured person has previously had tests for the condition and the condition was not found to exist. There must be evidence that a condit…

A. Except as specifically provided in sections 20-1379 and 20-1380, with respect to the determination of whether a person is an eligible individual, a hospital and medical service corporation shall not consider the availability of or a person's eligibility for medical assistance …

A. With respect to subscribers who are members of a group with more than one carrier, if there is an insolvency of a hospital service corporation, medical service corporation, dental service corporation, optometric service corporation or hospital, medical, dental and optometric s…

A. The director may suspend or revoke a certificate of authority issued to a corporation pursuant to this article if the director finds that any of the following conditions exist: 1. The corporation is operating significantly in contravention of its basic organizational documents…

A. A hospital service corporation, medical service corporation or hospital and medical service corporation may issue a subscription contract to an uninsured individual that is not subject to the requirements of any of the following: 1. Section 20-461, subsection A, paragraph 17 a…

A. A contract, entered into or renewed on or after January 1, 2011, between a dental service corporation and a dentist who is licensed to practice in this state shall not require the dentist to provide services to an individual covered under a subscription contract based on a fee…

A. A subscription contract that is issued or renewed on or after January 1, 2017 and that provides coverage for prescription drugs: 1. May not deny coverage and shall prorate the cost sharing rate for a prescription drug covered by the contract that is dispensed by a network phar…

1. Require the optometrist to provide a service to an individual covered under a subscription contract based on a fee set by the optometric service corporation unless the service for which the fee applies is a covered service under the individual's subscription contract. 2. Prohi…

In this article, unless the context otherwise requires: 1. "Association or order" means any association or order that is a nonprofit military mutual aid association, whose members are officers or enlisted, regular or reserve, active, retired or honorably discharged members of the…

A. A society operates on the lodge system if the society has a supreme governing body and subordinate lodges into which members are elected, initiated or admitted according to the society's laws, rules and ritual. The laws of the society shall require subordinate lodges to hold m…

A society has a representative form of government if: 1. It has a supreme governing body constituted in one of the following ways: (a) The supreme governing body is an assembly that is composed of delegates who are elected directly by the members or at intermediate assemblies or …

A. A society shall operate for the benefit of its members and their beneficiaries and shall: 1. Provide benefits pursuant to section 20-875. 2. Operate for social, intellectual, educational, charitable, benevolent, moral, fraternal, patriotic or religious purposes. This benefit m…

A. A society shall specify all of the following: 1. Eligibility standards for each membership class. If the society provides benefits on the lives of children, the minimum age for adult membership shall be not less than fifteen years of age or more than twenty-one years of age. 2…

A. The principal office of a domestic society shall be located in this state. The meetings of the society's supreme governing body may be held in any state, district, province or territory in which the society has at least one subordinate lodge or in any other place that is deter…

A. The officers and members of the supreme governing body or a subordinate body of a society are not personally liable for any benefits that are provided by the society. B. A society may indemnify and reimburse any person who is or was a director, officer, employee or agent of a …

The laws of the society may provide that a subordinate body or any subordinate officers or members shall not waive any provision of the laws of the society. A provision prohibiting waiver is binding on the society, its members and every member's beneficiaries.

Beginning on January 1, 1995, a domestic fraternal benefit society may be organized as follows: 1. Seven or more citizens of the United States, a majority of whom are citizens of this state, who desire to form a fraternal benefit society may make, sign and acknowledge articles of…

A. The supreme governing body of a domestic society may amend its laws in accordance with its laws at any regular or special meeting, or if the laws provide, by referendum. A referendum may be held in accordance with the society's laws by the vote of the voting members of the soc…

A. A society may create, maintain and operate or establish an organization to operate not for profit institutions to further the purposes of the society as prescribed by section 20-864. An institution established pursuant to this section may provide services for free or for a rea…

A. Pursuant to a reinsurance agreement, a domestic fraternal benefit society may cede any part or all of its risks to an insurer other than another fraternal benefit society that has the power to take the reinsurance and that is authorized to transact business in this state, or i…

A. A domestic fraternal benefit society may consolidate or merge with any other society if it complies with this section. The society shall file the following with the director: 1. A certified copy of the written contract that contains in full the terms and conditions of the cons…

A domestic fraternal benefit society may convert to and be licensed as a mutual life insurance company by complying with the requirements of this title relating to mutual insurers. The board of directors shall prepare a plan of conversion in writing. The plan of conversion shall …

A. A fraternal benefit society may provide the following contractual benefits in any form: 1. Death benefits. 2. Endowment benefits. 3. Annuity benefits. 4. Temporary or permanent disability benefits. 5. Hospital, medical or nursing benefits. 6. Monument or tombstone benefits to …

A. At all times the owner of a benefit contract may change the beneficiary or beneficiaries in accordance with the laws or rules of the society unless the owner waives this right and requests in writing that the beneficiary designation be irrevocable. A society may limit the scop…

Any money or other benefit, charity, relief or aid that a society pays, provides or renders is not subject to attachment, garnishment or other process and shall not be seized, taken, appropriated or applied to pay any debt or liability of any member, beneficiary or other person w…

A. A society shall issue to each owner of a benefit contract a certificate that specifies the amount of benefits provided under the certificate. The certificate shall state that it constitutes the benefit contract as of the date of issuance of the certificate, together with any r…

A. For certificates that are issued before January 1, 1996, the value of every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted shall comply with the applicable provisions of law that were in effect before January 1, 1995. B. …

A society shall invest its funds only in those investments that are authorized by this title. A foreign or alien society that is permitted or seeking to do business in this state and that invests its funds in accordance with the laws of the state, district, territory, country or …

A. Unless otherwise provided in the benefit contract, all assets shall be held, invested and disbursed for the use and benefit of the society, and no member or beneficiary has any individual rights in the assets and is not entitled to any apportionment on the surrender of any par…

Fraternal benefit societies are governed by this article and are subject to and governed by the following articles and sections of this title to the extent that the articles and sections apply to the societies and are not modified by the provisions of this article: 1. Chapter 1, …

Every authorized society and every society that is exempt under section 20-893 is deemed to be a charitable and benevolent institution and is exempt from all state, county, district, municipal and school taxes, including the taxes prescribed by this title, except that a society i…

A. The standards of valuation for certificates that are issued before January 1, 1996 are the standards of valuation that were in effect immediately before January 1, 1995. B. The minimum standards of valuation for certificates that are issued on or after January 1, 1996 shall be…

Each fraternal benefit society shall file reports as follows: 1. Unless the director extends the time for filing for good cause shown, on or before March 1, each society transacting business in this state shall annually file with the director a true statement of its financial con…

A certificate of authority issued to a society remains in effect on payment of the annual renewal fee prescribed by section 20-167 unless the society voluntarily terminates or the director suspends or revokes the certificate.

A. The director or the director's designee may examine any domestic, foreign or alien society that is authorized or applying for authorization to transact business in this state in the same manner as prescribed by section 20-156. B. The director shall not make public any financia…

A foreign or alien society shall not transact business in this state unless the director issues a certificate of authority to the foreign or alien society pursuant to sections 20-215 and 20-216. A foreign or alien society applying for a certificate of authority shall substantiall…

A court in this state shall not hear an application or petition for injunction against a domestic, foreign or alien society or lodge, any delinquency or other proceeding for dissolution of a society or the appointment of a conservator or receiver unless the application or petitio…

A. An insurance producer of a society or its subsidiary or affiliated organizations shall be licensed pursuant to chapter 2, article 3 of this title. The director may waive the examination for licensure if the applicant was licensed after January 1, 1955 and has been an active so…

Each society authorized to transact business in this state is subject to chapter 2, article 6 of this title, except that nothing in chapter 2, article 6 of this title applies to or affects the right of a society to determine its eligibility requirements for membership or to offer…

A. A person who knowingly or wilfully makes a false or fraudulent statement or representation in or relating to an application for membership or for the purpose of obtaining money from or a benefit in a society is guilty of a class 6 felony. B. A person who wilfully makes a false…

A. The following fraternal benefit societies and associations or orders are exempt from compliance with this article and all other insurance laws of this state: 1. Fraternal benefit societies that were doing business in this state on January 1, 1955 and that provide benefits excl…

In this article, unless the context otherwise requires: 1. "Member" means an individual who is enrolled in a group prepaid dental plan as a principal subscriber together with such person's dependents who are entitled to dental care services under the plan solely because of their …

A. No person, unless authorized pursuant to article 3 or article 9 of this chapter, may establish or operate a prepaid dental plan organization in this state, or sell or offer to sell, or solicit offers to purchase, or receive advance or periodic consideration in conjunction with…