Title 33 — Title 33
0 chapters · 1,218 sections in this title.
O.C.G.A. § 33-30-13 Managed care
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Guaranteed issue coverage. Discontinuance of state assignment system benefit plans upon availability of guaranteed issue coverage, §33-29A-9. HEALTH CARE SERVICES. Accurate provider directories, §§33-20C-1 to 33-20C-7. 1166 INDEX HEALTH CARE SERVICES —Cont’d Assignment and availab…
O.C.G.A. § 33-30-13.1 Furnishing claims experience to policyholders
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(a) As used in this Code section, the term ‘‘insurer’’ means an accident and sickness insurer, fraternal benefit society, health care corporation, provider sponsored health care corporation, health maintenance organization, or any similar entity. (b)(1) All insurers shall furnish,…
O.C.G.A. § 33-30-14 MEDICAID
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Accident and sickness insurance. Group or blanket policies. Exclusion or reduction of benefits. Persons eligible for or receiving medicaid, §33-24-25. Care management organizations, §§33-21A-1 to 33-21A-12. Administrative review process. Provider complaints and appeals, §33-21A-7.…
O.C.G.A. § 33-30-15 Agencies
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Insurance companies, §33-23-1. Agency captive insurance companies, §33-41-2. Agent. Health maintenance organizations, §33-21-19. Health plan purchasing cooperatives, §33-30A-1. Insurance companies, §33-23-1.
O.C.G.A. § 33-30-2 Effect of chapter upon other provisions
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Nothing in this chapter validates any charge or practice illegal under any rule of law or regulation governing usury, small loans, retail installment sales, or the like or extends the application of any statute, rule, or regulation to any transaction not otherwise subject thereto…
O.C.G.A. § 33-30-20 Short title
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This article shall be known and may be cited as the ‘‘Preferred Provider Arrangements Act.’’ History. — Code 1981, § 33-30-20, enacted by Ga. L. 1988, p. 1483, § 1.
O.C.G.A. § 33-30-21 Legislative intent
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It is the intent of the General Assembly to encourage health care cost containment while preserving quality of care by allowing health care insurers to enter into preferred provider arrangements and by establishing minimum standards for preferred provider arrangements and the hea…
O.C.G.A. § 33-30-22 Definitions
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As used in this article, the term: (1) ‘‘Emergency services’’ or ‘‘emergency care’’ means those health care services that are provided for a condition of recent onset and sufficient severity, including, but not limited to, severe pain, that would lead a prudent layperson, possess…
O.C.G.A. § 33-30-26 Public policy, §33-30-21
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Short title, §33-30-20. Standards, §33-30-23. Title of act, §33-30-20. Unlicensed entities. Filing requirements, §33-30-23. Premiums. Notice of premium increase, §33-29-22. Prepaid air ambulance services. Subscription agreements not considered insurance contracts, §33-1-21. Presc…
O.C.G.A. § 33-30-27 Promulgation of rules and regulations
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The Commissioner shall promulgate all rules and regulations necessary or appropriate to the administration and enforcement of this article. History. — Code 1981, § 33-30-27, enacted by Ga. L. 1988, p. 1483, § 1. 33-30-28 and 33-30-29. Redesignated as Code Sections 33-30-12 and 33…
O.C.G.A. § 33-30-4 Required provisions generally
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Each group accident and sickness policy shall contain in substance the following provisions: (1) A provision that, in the absence of fraud or intentional misrepresentation of material fact in applying for or procuring coverage under the terms of the group policy or contract, all …
O.C.G.A. § 33-30-4.2 Mammograms and pap smears
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Coverage, §33-30-4.2. Marriage. Termination of coverage as result of break in marital relationship, §33-24-21. Medical assistance recipients. Excluding or reducing coverage for eligible persons. Provisions in policies, §33-24-25. 1202 INDEX INSURANCE —Cont’d Policies —Cont’d Grou…
O.C.G.A. § 33-30-4.3 Health insurance plans
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Preferred provider agreements. Reasonable in relation to covered benefits, §33-24-59.59. Reasonable in relation to covered benefits, §33-24-59.59. COPAYMENTS —Cont’d Health maintenance organizations. Conditions for issuance of certificate of authority, §33-21-3. Evidence of coverage…
O.C.G.A. § 33-30-4.4 Bone marrow transplants
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Insurance, §33-29-3.3. HOSPITALS —Cont’d Medicaid care management organizations, §§33-21A-1 to 33-21A-12. HOSPITAL STAY FOR MOTHER AND BABY, §§33-24-58 to 33-24-58.2. HOUSING PROJECTS.
O.C.G.A. § 33-30-4.5 Coverage for child wellness services
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(a) As used in this Code section, the term: (1) ‘‘Child wellness services’’ means the periodic review of a child’s physical and emotional status conducted by a physician or conducted pursuant to a physician’s supervision, but shall not include periodic dental examinations or othe…
O.C.G.A. § 33-30-5 Direct payment for hospital or medical services
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Any group accident and sickness policy may provide that all or any portion of any indemnities provided by any policy on account of hospital, nursing, or medical or surgical services may, at the insurer’s option, be paid directly to the hospital or person rendering such services; …
O.C.G.A. § 33-30-6 Forms
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Filing of form of policy, §33-30-6. 1200 INDEX INSURANCE —Cont’d Policies —Cont’d Blanket accident and sickness insurance —Cont’d Medical assistance recipients. Exclusion or reduction of coverage of eligible persons. Provisions in policies, §33-24-25. Mental disorders, coverage o…
O.C.G.A. § 33-30-8 Restriction of benefits
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Preexisting illnesses or conditions, §33-24-26. Scope of provisions, §33-30-1.1. Standards and requirements for rating of small groups, §33-30-12. Temporomandibular joint dysfunction coverage, §33-30-14. HEALTH INSURANCE —Cont’d Group or blanket insurance —Cont’d Termination of c…
O.C.G.A. § 33-30-9 Payment of benefits under blanket accident and sickness policies
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(a) All benefits under any group or blanket accident and sickness policy shall be payable to the person insured, to his designated beneficiary or beneficiaries, or to his estate, provided that if the person 557 33-30-11 insured is a minor or mental incompetent, the benefits may be ma…
O.C.G.A. § 33-30A-1 Definitions
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As used in this chapter, the term: (1) ‘‘Agent’’ shall be defined as provided in Code Section 33-23-1. (2) ‘‘Carrier’’ means any entity that provides health insurance to employers in this state. For the purposes of this chapter, carrier includes an insurance company, hospital or m…
O.C.G.A. § 33-30A-10 Membership fees, §33-30A-4
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Insurance premium finance companies. Licenses, §33-22-3. Insurance private review agents. Certification, §§33-46-5, 33-46-6. Insurance rating organizations. Licensees. Annual fee, §33-9-15. Application fee, §33-9-12. Insurance title. Fees collected under title. Allowance of refunds…
O.C.G.A. § 33-30A-11 Individual insurance
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Generally, §§33-29-1 to 33-29-22. Policies approved in other states, insurers offering, §§33-29A-30 to 33-29A-35. Long-term care insurance, §§33-42-1 to 33-42-6. Medicare supplement insurance, §§33-43-1 to 33-43-9. Preferred provider arrangements, §§33-30-20 to 33-30-27. Accurate…
O.C.G.A. § 33-30A-2 Certificates of authority authorized and required
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(a) On and after July 1, 1997, the Commissioner is authorized to issue certificates of authority to nonprofit corporations to operate as health plan purchasing cooperatives to provide services to members located within particular geographic areas of the state in accordance with the…
O.C.G.A. § 33-30A-3 Areas of service
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(a) Each health plan purchasing cooperative shall serve a particular geographic area of the state that consists of either one entire county or more than one contiguous entire county. The Commissioner shall not authorize any purchasing cooperative to serve a geographic area which …
O.C.G.A. § 33-30A-5 Responsibilities of department
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The department shall assist health plan purchasing cooperatives. To this end, the department is responsible for: (1) Initially and thereafter annually certifying that each cooperative complies with the provisions of this chapter and regulations 581 33-30A-6 adopted pursuant to Co…
O.C.G.A. § 33-30A-6 Notification to members; marketing materials
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(a) Each cooperative shall use appropriate, efficient, and standardized means to notify members of the availability of health benefit plan coverage offered through the cooperative. (b)(1) Each cooperative shall make available to its members marketing materials prepared by or for t…
O.C.G.A. § 33-30A-7 Nonprofit corporation status; certificate of existence
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(a)(1) Each purchasing cooperative shall be a nonprofit corporation, and the provisions of Chapter 3 of Title 14 shall apply to each purchasing cooperative; provided, however, that the provisions of this chapter shall control to the extent of any conflict with the provisions of Cha…
O.C.G.A. § 33-30A-8 Surety bond required; guaranty of uninterrupted coverage
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(a) Prior to authorization by the Commissioner to operate as a health plan purchasing cooperative, a nonprofit corporation shall, directly or through a contractor which provides administrative services to the corporation, file with the Commissioner a corporate surety bond in an amo…
O.C.G.A. § 33-30A-9 Regulations
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The Commissioner shall issue regulations in accordance with Code Section 33-2-9 for the administration of this chapter. History. — Code 1981, § 33-30A-9, enacted by Ga. L. 1997, p. 1072, § 1. 33-30A-10. Fees.
O.C.G.A. § 33-30B-1 Short title
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This chapter shall be known and may be cited as the ‘‘Spending Account and Consumer Driven Health Plan Advancement Act.’’ History. — Code 1981, § 33-30B-1, enacted by Ga. L. 2003, p. 912, § 1. 33-30B-2. Purpose.
O.C.G.A. § 33-30B-2 Purpose
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The purposes of this chapter are to provide enabling provisions for spending accounts and consumer driven health plans, provide statutory authorization for the establishment of such plans, and facilitate the advancement of such plans as a response to escalating costs of health ca…
O.C.G.A. § 33-30B-3 Definitions
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As used in this chapter, the term: (1) ‘‘Consumer driven health plan’’ means a plan for the provision or reimbursement of health care services that makes available to enrolled individuals information on health, health care, the pricing of health care, and the pricing of health ca…
O.C.G.A. § 33-30B-4 Legislative purpose, §33-30B-2
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HEALTH CARE SPENDING ACCOUNTS AND CONSUMER DRIVEN HEALTH PLANS —Cont’d Notice. Insurance reimbursement attachment point. Relationship between plan amount and attachment point, §33-30B-5. Reimbursements.
O.C.G.A. § 33-30B-5 Health insurance
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Accident and sickness insurance. Cancellation or nonrenewal, §33-24-47.1. Small business employee choice of benefits. Notice and acknowledgment with alternative plan, §33-60-5. Surprise billing. Denying or restricting benefits based on balance billing, notice to insured, §33-20E-6.…
O.C.G.A. § 33-30B-6 Requirements for insurance contract
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The insurance contract providing reimbursements for expenditures for health care services incurred by the plan may be a stop-loss, specific excess and aggregate, or other similar contract. It may be written by an insurer licensed for life, accident, and sickness insurance under Co…
O.C.G.A. § 33-30B-7 Insurance
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Georgia Insurance Code. Provisions of title relating to particular matters to prevail over general provisions, §33-1-5. Kinds of insurance. Mutual exclusivity, §33-7-1. Life and health insurance guaranty association. General chapter governing, §33-38-3. Insurance companies. Capti…
O.C.G.A. § 33-31-1 Definitions
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As used in this chapter, the term: (1) ‘‘Credit accident and sickness insurance’’ means insurance on a debtor to provide indemnity for payments becoming due on a specific loan or other credit transaction while the debtor is disabled as defined in the policy. (2) ‘‘Credit life insur…
O.C.G.A. § 33-31-10 Termination, §33-31-5
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CREDIT LIFE AND ACCIDENT AND SICKNESS INSURANCE, §§33-31-1 to 33-31-12. CREDIT REPORTS. Consumer reporting agencies. Insurance information disclosures, §33-24-97. Health insurance.
O.C.G.A. § 33-31-11 Right of debtor to furnish insurance
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When credit life insurance or credit accident and sickness insurance is required as additional security for any indebtedness, the debtor, upon written request to the creditor, shall have the option of furnishing the required amount of insurance through existing policies of insura…
O.C.G.A. § 33-31-12 Health insurance
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Health care plans. Imposition of administrative fine for certain acts, §33-20-27. Motor vehicle insurance. Affidavit that insured’s motor vehicle is stolen. False statements, §33-1-15. Insurance companies. Administrative fines for certain acts of officers, employees, agents, etc., …
O.C.G.A. § 33-31-2 Applicability of chapter
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(a) Except as provided otherwise in subsection (c) of this Code section, all life insurance and all accident and sickness insurance sold in connection with loans or other credit transactions pursuant to a plan covering all debtors of a creditor or a class or classes of debtors sh…
O.C.G.A. § 33-31-3 Issuance of policies generally
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Credit life insurance and credit accident and sickness insurance shall be issued only in the following forms: (1) Individual policies of life insurance issued to debtors on the term plan; 591 33-31-4 (2) Individual policies of accident and sickness insurance issued to debtors on …
O.C.G.A. § 33-31-4 Amount of insurance
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(a) The amount of credit life insurance shall not exceed the indebtedness. Where indebtedness repayable in substantially equal installments is secured by an individual policy of credit life insurance, the amount of insurance shall not exceed the approximate unpaid indebtedness on…
O.C.G.A. § 33-31-5 Date insurance becomes effective; duration and termination of insurance
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The term of any credit life insurance or credit accident and sickness insurance shall commence, subject to acceptance by the insurer, on the date when the debtor becomes obligated to the creditor, except that, where a group policy provides coverage with respect to existing obliga…
O.C.G.A. § 33-31-7 Definitions
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Applicability of chapter. Issuance of policies generally. Amount of insurance. Date insurance becomes effective; duration and termination of insurance. Requirements as to issuance or delivery of policies generally. Issuance of policy or certificate of insurance; contents; delivery…
O.C.G.A. § 33-31-8 Filing of forms with Commissioner; approval or disapproval
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All forms, including policies, certificates of insurance, notices of proposed insurance, applications for insurance, binders, endorsements, and riders, together with the schedule of premiums therefor and the applicable maximum identifiable charges to debtors shall be filed with the …
O.C.G.A. § 33-31-9 Premiums; refunds and credits
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(a) Any insurer, subject to the power of the Commissioner to disapprove the form as provided in Code Section 33-31-8, may revise its schedules of premium rates from time to time and shall file such revised schedules with the Commissioner. Premiums charged by an insurer shall be de…
O.C.G.A. § 33-32-1 Standard fire policy
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(a) No policy of fire insurance covering property located in this state shall be made, issued, or delivered unless it conforms as to all provisions and the sequence of the standard or uniform form prescribed by the Commissioner, except that, with regard to multiple line coverage p…
O.C.G.A. § 33-32-2 Coverage of personal property changing in specifics
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A policy of insurance may be made to cover personal property changing in its specifics. History. — Ga. L. 1895, p. 51, § 1; Civil Code 1895, § 2110; Civil Code 1910, § 2545; Code 1933, § 56-701; Code 1933, § 56-3202, enacted by Ga. L. 1960, p. 289, § 1.
O.C.G.A. § 33-32-3 Privilege of rebuilding or reinstating property sustaining loss or damage
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The privilege of rebuilding or reinstating property sustaining loss or damage shall not exist unless it is reserved in the policy. History. — Orig. Code 1863, § 2766; Code 1868, § 2774; Code 1873, § 2816; Code 1882, § 2816; Civil Code 1895, § 2112; Civil Code 1910, § 2547; Code 1…