Title 41 — INSURANCE

41-2201. Scope of chapter — Short title. (1) This chapter applies only to group disability insurance contracts and to blanket disability insurance contracts as herein provided for. (2) This chapter may be cited as the "group or blanket disability insurance law".

41-2202. "Group disability insurance" defined — Eligible groups. "Group disability insurance" is hereby declared to be that form of disability insurance covering groups of persons as defined below, with or without one or more members of their families or one or more of their depe…

41-2203. Required provisions in group policies. Each such group disability insurance policy shall contain in substance the following provisions: (1) A provision that, in the absence of fraud, all statements made by applicants or the policyholders or by an insured person shall be …

41-2204. Direct payment of hospital and medical services. Any group disability policy may provide that all or any portion of any indemnities provided by any such policy on account of hospital, nursing, medical or surgical services may, at the insurer’s option, be paid directly to…

41-2205. Readjustment of premiums — Dividends. Any contract of group disability insurance may provide for the readjustment of the rate of premium based upon the experience thereunder. If a policy dividend is hereafter declared or a reduction in rate is hereafter made or continued…

41-2206. "Blanket disability insurance" defined. "Blanket disability insurance" is hereby declared to be that form of disability insurance covering groups of persons as enumerated in one of the following subdivisions. (1) Under a policy or contract issued to any common carrier or…

41-2207. Required provisions in blanket policies. Any insurer authorized to write disability insurance in this state shall have the power to issue blanket disability insurance. No such blanket policy may be issued or delivered in this state unless a copy of the form thereof shall…

41-2208. Application and certificates not required. An individual application shall not be required from a person covered under a blanket disability policy or contract, nor shall it be necessary for the insurer to furnish each such person a certificate of the insurance.

41-2209. Payment of benefits under blanket policy. All benefits under any blanket disability policy shall be payable to the person insured, or to his designated beneficiary or beneficiaries, or to his estate; except, that if the person insured be a minor or mental incompetent, su…

41-2210. Required provision in group and blanket policies. (1) Any group disability insurance contract or blanket disability insurance contract, delivered or issued for delivery in this state which provides coverage for injury or sickness for newborn dependent children of subscri…

41-2210A. Limitation of benefits for elective abortions. All policies, contracts, plans or certificates of group or blanket disability insurance delivered, issued for delivery or renewed in this state after the effective date of this section shall exclude coverage for elective ab…

41-2211. Scope of act — Replacement of group disability insurance, group nonprofit hospital and medical service contracts and health care service plans. The provisions of this act shall apply to all policies of group disability insurance issued in this state pursuant to the provi…

41-2212. Definitions. In this act, unless the context otherwise requires: (1) "Carrier" shall mean the insurance company, nonprofit hospital and medical service corporation, or other entity responsible for the payment of benefits or provision of services under a policy. (2) "Depe…

41-2213. Policy standards — Disabled individuals. Every policy containing the benefits described in subsections (1), (2) and (3) of this section must contain a provision which provides for a reasonable extension of benefits with respect to employees or dependents who become total…

41-2214. Policy standards — Maternity benefits. If a policy provides any benefits for pregnancy, childbirth or miscarriage and if an employee or dependent covered for such benefit is pregnant at the time of discontinuance and is not eligible for any replacement group coverage wit…

41-2215. Policy standards — Replacement contracts. (1) Any carrier providing replacement coverage with respect to hospital, medical or surgical expense benefits within a period of sixty (60) days from the date of discontinuance of a prior policy providing such hospital, medical o…

41-2216. Coordination of benefits — Coordination with social security benefits. (1) Under the authority of this section and section 41-2141, Idaho Code, the director shall promulgate rules that are in accordance with the model regulations of the national association of insurance …

41-2217. Services provided by governmental entities. (1) From and after July 1, 1990, no group or blanket disability insurance policy shall be issued in Idaho which excludes from coverage services rendered the insured while a resident in an Idaho state institution, provided the s…

41-2218. Mammography coverage. (1) From and after July 1, 1992, all group or blanket disability insurance policies which provide coverage for the surgical procedure known as a mastectomy which are delivered, issued for delivery, continued or renewed in this state shall provide mi…

41-2220. Coverage provided to persons having insurance. An insurer providing group disability insurance coverage in this state shall make available to citizens of this state current major medical disability benefit policies under the terms set forth in this section. An insurer pr…

41-2221. Crediting of preexisting condition waiting period. (1) Health benefit plans covering large employers shall comply with the following provisions: (a) A health benefit plan shall not deny, exclude or limit benefits for a covered individual for covered expenses incurred mor…

41-2223. Renewability of coverage. (1) A health benefit plan subject to the provisions of this chapter shall be renewable with respect to all eligible employees or dependents, at the option of the employer, except in any of the following cases: (a) Nonpayment of the required prem…