Title 27, INSURANCE

Sec. 3. As used in this chapter, "covered individual" means an individual who is entitled to coverage under a health plan. As added by P.L.170-2022, SEC.36.

Sec. 4. (a) As used in this chapter, "health plan" means either of the following: (1) A policy of accident and sickness insurance as defined in IC 27-8-5-1, but not including any insurance, plan, or policy set forth in IC 27-8-5-2.5(a). (2) An individual contract (as defined in I…

Sec. 5. As used in this chapter, "health plan operator" means the following: (1) In the case of a health plan described in section 4(a)(1) of this chapter, the insurer that issued the policy. (2) In the case of a health plan described in section 4(a)(2) of this chapter, the healt…

Sec. 6. For purposes of this chapter: (1) an ambulance service provider that provides ambulance service to an individual covered by a health plan is "nonparticipating" with respect to the health plan if the ambulance service provider has not, by contract, affiliation, agreement, …

Sec. 7. As used in this chapter, "person" means an individual, a corporation, a limited liability company, a partnership, or another legal entity. As added by P.L.170-2022, SEC.36.

Sec. 7.5. As used in this chapter, "state employee health plan" means either of the following: (1) A self-insurance program established under IC 5-10-8-7(b) to provide group coverage. (2) A prepaid health care delivery plan through which health services are provided under IC 5-10…

Sec. 8. (a) The state shall fairly negotiate rates and terms with any ambulance service provider willing to become a participating provider with respect to the state employee health plan. (b) In negotiations under subsection (a), the state employee health plan must consider all o…

Sec. 8.1. A health plan operator shall provide payment to a nonparticipating ambulance service provider for ambulance service provided to a covered individual: (1) at a rate set or approved, by contract or ordinance, by the county or municipality in which the ambulance service or…

Sec. 8.2. (a) If a health plan operator makes payment to a nonparticipating ambulance service provider according to section 8.1 of this chapter for ambulance service provided to a covered individual: (1) the payment shall be considered payment in full for the ambulance service pr…

Sec. 8.3. (a) A health plan operator that receives a clean claim for ambulance service provided to a covered individual by a nonparticipating ambulance service provider: (1) shall remit payment for the ambulance service directly to the nonparticipating ambulance service provider …