Title 27, INSURANCE

Sec. 3.2. (a) As used in this chapter, "final settlement" means a determination: (1) of the amount owed to an insured: (A) under the building coverage part of an insurance policy issued by an insurer; and (B) for damage to or loss of a building or other structure caused by fire o…

Sec. 4. As used in this chapter, "insurer" means a fire and marine insurance company, as defined in IC 27-1-2-3(u). As added by P.L.247-1989, SEC.2.

Sec. 4.2. As used in this chapter, "municipality" has the meaning set forth in IC 36-1-2-11. As added by P.L.238-2013, SEC.4.

Sec. 4.3. (a) This chapter applies to damage to or loss of a building or structure caused by fire or explosion only if all of the following are true: (1) The municipality in which the building or structure is located is included on the list maintained by the department under sect…

Sec. 4.4. (a) A municipality may elect to be governed by this chapter by submitting to the department a written request. The request must: (1) be approved by adoption of an ordinance by the municipality's legislative body; and (2) contain contact information for the specific indi…

Sec. 4.5. (a) An insurer that: (1) issued an insurance policy that: (A) covers a building or other structure that is: (i) located in a municipality governed by this chapter; and (ii) damaged by a fire or explosion; and (B) is in effect at the time that the fire or explosion occur…

Sec. 5. (a) This section does not apply to damage or loss to a building or structure described in section 4.5 of this chapter if: (1) not more than fifteen (15) days after final settlement has occurred concerning the building or structure, the named insured files with the insurer…

Sec. 6. (a) Upon a judgment being rendered under IC 36-7-9-13(c) or IC 36-7-9-13(d), the municipality is entitled to the available insurance proceeds set aside only: (1) to the extent of the costs set forth in IC 36-7-9-12; and (2) for demolition and rehabilitation expenses certi…

Sec. 7. An insurer complying with this chapter or attempting in good faith to comply with this chapter is immune from civil and criminal liability in connection with actions taken under this chapter, and those actions, including withholding payment of any insurance proceeds under…

Sec. 8. Insurance proceeds set aside in an escrow account under section 5 of this chapter shall be considered as having been paid to the insured in satisfaction of any contractual liability under the policy. As added by P.L.247-1989, SEC.2.

Sec. 9. The department, the commissioner and employees of the department, the state fire marshal, a deputy fire marshal, an enforcement authority, or an officer of a municipality complying with this chapter or attempting in good faith to comply with this chapter is immune from ci…

Sec. 1. As used in this chapter, "casualty insurance company" has the meaning set forth in IC 27-1-2-3(t). As added by P.L.146-2015, SEC.32.

Sec. 2. As used in this chapter, "group" means a group of individuals who: (1) have similar professional attributes; (2) belong to the group for purposes other than that of obtaining insurance; and (3) are eligible to purchase motor vehicle insurance. As added by P.L.146-2015, SE…

Sec. 3. As used in this chapter, "group non-trucking liability insurance policy" means a policy of insurance that provides non-trucking liability insurance, and may provide optional physical damage insurance coverage, to participating group members under one (1) master policy: (1…

Sec. 4. As used in this chapter, "motor vehicle insurance" means the type of insurance described in IC 27-1-5-1, Class 2(f). As added by P.L.146-2015, SEC.32.

Sec. 5. As used in this chapter, "non-trucking liability insurance" means insurance that provides third party liability coverage for property damage or bodily injury caused by the operation of a for hire motor carrier truck for purposes other than for hire motor carrier truck pur…

Sec. 6. An insurer that is authorized under IC 27-1-3-20 to: (1) transact business as a casualty insurance company; and (2) offer motor vehicle insurance; may provide a group non-trucking liability insurance policy. As added by P.L.146-2015, SEC.32.

Sec. 0.1. The following amendments to this chapter apply as follows: (1) The addition of sections 8.5, 10.5, 27, 28, 29, 30, 31, 32, 33, and 34 (before its repeal) of this chapter by P.L.93-1995 applies to all small employer health insurance plans issued or renewed under this cha…

Sec. 1. This chapter applies to any group health insurance plan that is issued for delivery in Indiana to at least two (2) employees of a small employer located in Indiana if one (1) of the following conditions is met: (1) Any part of the premium or benefits is paid by a small em…

Sec. 10. As used in this chapter, "insurer" means any person who provides health insurance in Indiana. The term includes the following: (1) A licensed insurance company. (2) A prepaid hospital or medical service plan. (3) A health maintenance organization. (4) A multiple employer…

Sec. 10.5. (a) As used in this chapter, "late enrollee" means an eligible employee or a dependent of an eligible employee who did not request enrollment in a health insurance plan of a small employer during the initial enrollment period during which the individual was entitled to…

Sec. 11. As used in this chapter, "midpoint rate" means for small employers with similar case and benefit design characteristics the arithmetic average of the applicable base premium rate and the corresponding highest premium rate. As added by P.L.127-1992, SEC.1.

Sec. 12. As used in this chapter, "new business premium rate" means the premium rate charged or offered by the small employer insurer to small employers with similar case characteristics and benefit design characteristics for newly issued health insurance plans. As added by P.L.1…

Sec. 13. As used in this chapter, "rating period" means the calendar period for which premium rates established by a small employer insurer are assumed to be in effect, as determined by the small employer insurer. As added by P.L.127-1992, SEC.1.

Sec. 14. (a) This subsection applies only with respect to grandfathered health plan coverage described in 45 CFR 147.140. As used in this chapter, "small employer" means any person, firm, corporation, limited liability company, partnership, or association actively engaged in busi…

Sec. 15. As used in this chapter, "small employer insurer" means any insurer that offers a health insurance plan covering the employees of a small employer. As added by P.L.127-1992, SEC.1.

Sec. 16. Premium rates for a health insurance plan are subject to the following: (1) For all small employer business, the premium rates charged during a rating period to small employers with similar case characteristics for the same or similar benefit design characteristics, or t…

Sec. 17. (a) This chapter is not intended to affect the use by a small employer insurer of legitimate rating factors other than claim experience, health status, or duration of coverage in the determination of premium rates. (b) A small employer insurer shall apply rating factors,…

Sec. 18. A small employer insurer may not offer to transfer a small employer into or out of a plan with substantially the same benefit design unless the offer is made to transfer all small employers in that plan without regard to case characteristics, claim experience, health sta…

Sec. 19. Except as provided in section 20 of this chapter, a small employer insurer may only cancel or refuse to renew a health insurance plan for the following reasons: (1) Nonpayment of required premiums. (2) Fraud or misrepresentation of the small employer, or with respect to …

Sec. 20. (a) A small employer insurer may cease to renew all small employer plans. (b) The insurer shall provide notice to all affected health insurance plans and to the commissioner at least one (1) year before termination of coverage unless the coverage is placed with another i…

Sec. 21. (a) An insurer who ceases to renew all small employer plans may not do the following: (1) Accept any new small employer business for five (5) years after the notice of nonrenewal of the plans. (2) Transfer or otherwise provide coverage to any of the employers from the no…

Sec. 22. Each small employer insurer shall make reasonable disclosure in solicitation and sales materials provided to small employers of the provisions affecting premium rate changes. As added by P.L.127-1992, SEC.1.

Sec. 23. Each small employer insurer shall maintain for three (3) years at the insurer's principal place of business a complete and detailed description of the insurer's rating practices and renewal underwriting practices, including information and documentation that demonstrate …

Sec. 24. (a) Each small employer insurer shall maintain an actuarial certification verifying that the insurer is in compliance with this chapter and that the rating methods of the insurer are actuarially sound. A copy of the certification shall be retained by the insurer at the i…

Sec. 25. A small employer insurer shall make the information and documentation described in section 23 of this chapter available to the commissioner upon request. The information is proprietary and trade secret information and is not subject to disclosure by the commissioner to a…

Sec. 26. The commissioner may suspend all or any part of section 16 of this chapter as to the premium rates applicable to one (1) small employer for at least one (1) rating period upon a filing by the small employer insurer and a finding by the commissioner that either: (1) the s…

Sec. 27. (a) This section shall be applied in conformity with the requirements of the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), as in effect on September 23, 20…

Sec. 28. (a) As used in this section, "health insurance plan" means coverage provided under any of the following: (1) A hospital or medical expense incurred policy or certificate. (2) A hospital or medical service plan contract. (3) A health maintenance organization subscriber co…

Sec. 29. (a) This section shall be applied in conformity with the requirements of the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), as in effect on September 23, 20…

Sec. 3. As used in this chapter, "actuarial certification" means a written statement by a member of the American Academy of Actuaries that a small employer insurer is in compliance with section 16 of this chapter, based upon the person's examination, including a review of the app…

Sec. 30. Except as permitted under sections 27 and 29 of this chapter, a small employer insurer shall not modify a health insurance plan with respect to: (1) a small employer; or (2) an eligible employee or dependent; through riders, endorsements, or otherwise to restrict or excl…

Sec. 31. (a) If an eligible employee who has been continuously covered under a health insurance plan for at least ninety (90) days: (1) loses coverage under the plan as the result of: (A) termination of employment; (B) reduction of hours; (C) marriage dissolution; or (D) attainme…

Sec. 31.1. (a) This section becomes effective on the effective date of a mechanism enacted by the general assembly to offset the potential fiscal impact on small employers and small employer insurers that results from the establishment of a continuation policy under this section.…

Sec. 32. (a) If an individual: (1) becomes an eligible employee of a small employer after the date that a small employer insurer first insures an eligible employee of the small employer under a health insurance plan; and (2) is not a late enrollee; the individual and all dependen…

Sec. 33. (a) If a small employer insurer offers coverage under a health insurance plan to a small employer, the small employer insurer shall provide the employer coverage under the plan for: (1) all eligible employees of the small employer; and (2) the dependents of all eligible …