Title 41 — INSURANCE

41-5817. Record retention. (1) A public adjuster shall maintain a complete record of each transaction as a public adjuster. The records required by this section shall include the following: (a) Name of the insured; (b) Date, location and amount of the loss; (c) Copy of the contra…

41-5818. Standards of conduct of public adjuster. (1) A public adjuster is obligated, under his or her license, to serve with objectivity and complete loyalty the interest of his or her client alone; and to render to the insured such information, counsel and service, as within th…

41-5819. Reporting of actions. (1) The public adjuster shall report to the department any administrative action taken against the public adjuster in another jurisdiction or by another governmental agency in this state within thirty (30) days of the final disposition of the matter…

41-5820. Rules. The department may, in accordance with section 41-211, Idaho Code, promulgate reasonable rules as are necessary or proper to carry out the purposes of this chapter.

41-5821. Severability. If any provisions of this chapter, or the application of a provision to any persons or circumstances, shall be held invalid, the remainder of the chapter, and the application of the provision to persons or circumstances other than those to which it is held …

41-5901. short title. This chapter shall be known and may be cited as the "Idaho Health Carrier External Review Act."

41-5902. purpose and intent. The purpose of this chapter is to provide uniform standards for the establishment and maintenance of external review procedures to assure that covered persons have the opportunity for an independent review of a final adverse benefit determination, as …

41-5903. definitions. For purposes of this chapter: (1) "Administrative record" means all nonprivileged documents, records or other health information which was submitted, considered, generated or relied upon by the health carrier in the course of making the adverse benefit deter…

41-5904. applicability and scope. (1) Except as provided in subsection (2) of this section, this chapter shall apply to all health carriers. (2) The provisions of this chapter shall not apply to a plan, policy or certificate that provides coverage only for a specified disease, sp…

41-5905. notice of right to external review. (1) When a final adverse benefit determination is made, the health carrier shall notify the covered person in writing of the covered person’s right to request an external review to be conducted pursuant to section 41-5908, 41-5909 or 4…

41-5906. request for external review. A covered person may make a request for an external review of a final adverse benefit determination. Except for a request for an expedited external review as set forth in section 41-5909, Idaho Code, all requests for external review shall be …

41-5907. Exhaustion of internal grievance process. (1) Except as provided in subsection (2) of this section, a request for an external review pursuant to section 41-5908, 41-5909 or 41-5910, Idaho Code, shall not be made until the covered person has exhausted the health carrier’s…

41-5908. standard external review. (1) Within four (4) months after the date of issuance of a notice of a final adverse benefit determination pursuant to section 41-5905, Idaho Code, a covered person may file a request for an external review with the director. The request shall b…

41-5909. expedited external review. (1) A covered person may make a request for an expedited external review of a pre-service or concurrent service adverse benefit determination where the requested service meets the definition of an urgent care request and the covered person has …

41-5910. binding nature of external review decision. (1) For a health care benefit plan not subject to the employee retirement income security act of 1974 (ERISA), the external review decision is final and binding on the health carrier and on the covered person. No judicial actio…

41-5911. approval of independent review organizations. (1) The director shall approve independent review organizations eligible to be assigned on a random basis to conduct external reviews under this chapter. (2) In order to be eligible for approval by the director under this sec…

41-5912. minimum qualifications for independent review organizations. (1) To be approved to conduct external reviews, an independent review organization shall have and maintain written policies and procedures that govern all aspects of both the standard external review process an…

41-5913. hold harmless for independent review organizations. No independent review organization or clinical reviewer working on behalf of an independent review organization or an employee, agent or contractor of an independent review organization shall be liable in damages or oth…

41-5914. external review reporting requirements. (1) An independent review organization assigned pursuant to this chapter to conduct an external review shall maintain written records in the aggregate for Idaho by health carrier on all requests for external review for which it con…

41-5915. funding of external review. The health carrier against which a request for a standard external review or an expedited external review is filed shall pay the reasonable cost of the independent review organization for conducting the external review.

41-5916. disclosure requirements. (1) Each health carrier shall include a summary description of the external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage or other evidence of coverage it provides to covered persons. The dis…

41-5917. SEVERABILITY. The provisions of this act are hereby declared to be severable and if any provision of this act or the application of such provision to any person or circumstance is declared invalid for any reason, such declaration shall not affect the validity of the rema…

41-6001. legislative intent. [EFFECTIVE UNTIL JULY 1, 2029] The intent of the legislature is to provide a supplemental funding mechanism for the Idaho immunization program administered by the Idaho department of health and welfare, by creating a dedicated vaccine fund and an inde…

41-6002. definitions. [effective until july 1, 2029] As used in this chapter: (1) "Board" means the Idaho immunization assessment board created by section 41-6003, Idaho Code. (2) "Carrier" means: any entity subject to regulation by the department that provides or is authorized t…

41-6003. Idaho immunization assessment board. [EFFECTIVE UNTIL JULY 1, 2029] (1) There is hereby created in the Idaho department of insurance the Idaho immunization assessment board. The board will perform an essential governmental function in the exercise of powers conferred upo…

41-6004. plan of operation. [EFFECTIVE UNTIL JULY 1, 2029] (1) The board shall submit to the director a plan of operation and thereafter any amendments thereto. The plan of operation, and any amendments thereto, shall become effective upon written approval by the director. If the…

41-6005. Power and liability of the board. [effective until july 1, 2029] (1) The board shall have the power to: (a) Enter into contracts as are necessary or proper to carry out the provisions and purposes of this chapter, including contracts for administrative services; (b) Dete…

41-6006. Assessments. [EFFECTIVE UNTIL JULY 1, 2029] (1) The department of health and welfare shall report to the board on or before January 1 the total number of program-eligible children in the Idaho immunization reminder information system registry who received vaccines, the d…

41-6007. Idaho immunization dedicated vaccine fund. [effective until july 1, 2029] There is hereby created in the state treasury the Idaho immunization dedicated vaccine fund. Moneys in the fund shall be appropriated solely for purposes established by this chapter. All funds in e…

41-6008. rulemaking authority. [EFFECTIVE UNTIL JULY 1, 2029] Upon consultation with the board, the director shall have the authority to promulgate rules necessary to implement this chapter.

41-6101. short title. This chapter shall be known and may be cited as the "Idaho Health Insurance Exchange Act."

41-6102. purpose and intent. It is the public policy of the state of Idaho to actively resist federal actions that would limit or override state sovereignty under the 10th amendment of the United States constitution. Through this legislation, the state of Idaho asserts its sovere…

41-6103. definitions. For the purposes of this chapter: (1) "Board" means those individuals who, acting as a board of directors of the exchange, govern and act for the exchange pursuant to section 41-6104, Idaho Code. (2) "Conflict of interest" means that by taking any action or …

41-6104. establishment of the exchange and the board. (1) There is hereby created an independent body corporate and politic to be known as the "Idaho Health Insurance Exchange." Said exchange may exercise the authority and powers conferred by this chapter and such exercise shall …

41-6105. powers and authority of the exchange. (1) Unless otherwise required by this chapter, in the discretion of the board, the exchange shall have the powers and authority to: (a) Perform all duties that are necessary and appropriate to implement a health insurance exchange an…

41-6106. report. (1) The exchange shall submit a written report of its activities and the condition of the exchange to the director, the governor and the director of the legislative services office for distribution to all legislators on or before January 31, 2014, and annually on…

41-6107. relation to other laws. The board and the exchange are entitled to rely upon work performed by the director and the director of the Idaho department of health and welfare in furtherance of the purpose of this chapter that are not otherwise inconsistent with their respect…

41-6108. IDAHO CONTRACTORS IN A HEALTH INSURANCE EXCHANGE. Pursuant to sections 41-6104 and 41-6105, Idaho Code, the board shall, to the fullest extent practicable, enter into contracts with businesses conducting business in Idaho and employing citizens of this state to staff and…

41-6109. severability. The provisions of this act are hereby declared to be severable, and if any provision of this act or the application of such provision to any person or circumstance is declared invalid for any reason, such declaration shall not affect the validity of the rem…

41-6201. SHORT TITLE. The provisions of this chapter shall be known and may be cited as the "Idaho Motor Vehicle Service Contract Act."

41-6202. LEGISLATIVE INTENT. (1) The legislature finds and declares that a considerable number of Idaho citizens use contracts to provide necessary services for the repair and servicing of motor vehicles purchased and used within the state. (2) It is the intent of the legislature…

41-6203. definitions. As used in this chapter: (1) "Administrator" means the person responsible for the administration of the motor vehicle service contract; (2) "Director" means the director of the Idaho department of insurance; (3) "Incidental costs" means expenses specified in…

41-6204. Service contract reimbursement policy requirements. (1) The following are mandatory insurance provisions: (a) No motor vehicle service contract shall be issued, sold or offered for sale in this state unless the motor vehicle service contract provider is insured under a s…

41-6205. Motor vehicle service contract provisions. The following provisions shall apply to the sale of motor vehicle service contracts in the state: (1) A motor vehicle service contract may not be issued, sold or offered for sale in this state unless the contract contains a stat…

41-6206. Motor vehicle service contract requirements. Before the sale of any motor vehicle service contract, the motor vehicle service contract provider shall give written notice to the customer clearly disclosing that the purchase of the contract is not required either to purcha…

41-6207. Prohibited acts. (1) A motor vehicle service contract provider may not use in its name, contracts or literature: (a) Any of the words "insurance," "casualty," "surety," "mutual" or any other words descriptive of the insurance, casualty or surety business; or (b) A name d…

41-6208. Recordkeeping requirements. (1) All motor vehicle service contract providers shall keep accurate accounts, books and records concerning transactions regulated under the provisions of this act. A motor vehicle service contract provider’s accounts, books and records shall …

41-6209. licensing. Motor vehicle service contract providers, and persons marketing, administering, selling or offering to sell motor vehicle service contracts for motor vehicle service contract providers, are not required to obtain a license under title 41, Idaho Code. A motor v…

41-6210. guaranty. The provisions of the Idaho insurance guaranty association act, chapter 36, title 41, Idaho Code, shall not apply to any motor vehicle service contract, mechanical breakdown insurance or motor vehicle service contract liability insurance policy, as defined in t…

41-6211. Enforcement and Penalties. (1) The director may conduct examinations of motor vehicle service contract providers, administrators, insurers or other persons to enforce the provisions of this chapter and to protect motor vehicle service contract holders in this state. Upon…