Title 27, INSURANCE

Sec. 9.2. As used in this chapter, "fraternal benefit society" refers to a society (as defined in IC 27-11-1-11) that holds a certificate of authority issued under IC 27-11-4 or IC 27-11-8-5. As added by P.L.276-2013, SEC.19.

Sec. 9.3. As used in this chapter, "health insurer" means the following: (1) A health maintenance organization. (2) A limited service health maintenance organization. (3) An insurer that makes one (1) or more of the types of insurance described in Class 1(b) or Class 2(a) of IC 2…

Sec. 9.4. As used in this chapter, "health maintenance organization" has the meaning set forth in IC 27-13-1-19. As added by P.L.51-2002, SEC.4.

Sec. 9.6. As used in this chapter, "insurer" includes: (1) a health maintenance organization; (2) a limited service health maintenance organization; and (3) a fraternal benefit society. As added by P.L.51-2002, SEC.5. Amended by P.L.276-2013, SEC.21.

Sec. 9.8. As used in this chapter, "limited service health maintenance organization" has the meaning set forth in IC 27-13-34-4. As added by P.L.51-2002, SEC.6.

Sec. 1. The title insurance enforcement fund is established for the following purposes: (1) To provide supplemental funding for department operations that are related to title insurance, including any of the following: (A) The investigation of any matter concerning title insuranc…

Sec. 2. The title insurance enforcement fund shall be administered by the commissioner. The expenses of administering the title insurance enforcement fund shall be paid from money in the fund. As added by P.L.171-2006, SEC.5.

Sec. 3. The treasurer of state shall invest the money in the fund not currently needed to meet the obligations of the fund in the same manner as other public money may be invested. As added by P.L.171-2006, SEC.5.

Sec. 4. Money in the fund at the end of a state fiscal year does not revert to the state general fund. As added by P.L.171-2006, SEC.5.

Sec. 5. The budget agency may augment the appropriation for the department of insurance from balances in the fund. As added by P.L.171-2006, SEC.5.

Sec. 6. The following shall be deposited in the title insurance enforcement fund: (1) Policy reporting fees remitted by title insurers to the commissioner under section 7 of this chapter. (2) Other amounts remitted to the commissioner or the department that are required by law to…

Sec. 7. (a) A person that purchases a title insurance policy shall pay to the title insurer that issues the title insurance policy a fee of five dollars ($5) as a fee for the title insurance enforcement fund at the time of payment for the title insurance policy. (b) A title insur…

Sec. 1. (a) Each health maintenance organization shall appoint a medical director who has an unlimited license to practice medicine under IC 25-22.5 or an equivalent license issued by another state. (b) The medical director is responsible for oversight of treatment policies, prot…

Sec. 10. Each health maintenance organization shall demonstrate to the commissioner that the health maintenance organization has developed an access plan to meet the needs of the health maintenance organization's enrollees, including vulnerable and underserved enrollees and enrol…

Sec. 11. The health maintenance organization shall develop standards for continuity of care following enrollment, including sufficient information on how to access care within the health maintenance organization. As added by P.L.69-1998, SEC.14.

Sec. 12. (a) As used in this section, "nonparticipating provider" means a provider that has not entered into an agreement with a health maintenance organization to serve as a participating provider. (b) After September 30, 2009, if a health maintenance organization makes a paymen…

Sec. 2. Beginning July 1, 1999, each health maintenance organization shall include a sufficient number and type of primary care providers and other appropriate providers throughout the health maintenance organization's service area to: (1) meet the needs of; and (2) provide a cho…

Sec. 2.5. (a) A health maintenance organization may not discriminate against a provider acting within the scope of the provider's license or certification with respect to: (1) participation; (2) reimbursement; (3) indemnification; or (4) scope of care; solely on the basis of the …

Sec. 3. (a) The provisions of this section do not apply until July 1, 1999. (b) Each health maintenance organization shall demonstrate to the department that the health maintenance organization offers an adequate number of: (1) acute care hospital services; (2) primary care provi…

Sec. 4. Beginning July 1, 1999, primary care providers shall include licensed physicians who practice in one (1) or more of the following areas: (1) Family practice. (2) General practice. (3) Internal medicine. (4) As a woman's health care provider, in compliance with IC 27-8-24.…

Sec. 5. (a) The provisions of the section do not apply until July 1, 1999. (b) When an enrollee's primary care provider determines that the enrollee needs a particular health care service and the health maintenance organization determines that the type of health care service need…

Sec. 6. (a) A health maintenance organization shall include provisions in the health maintenance organization's contracts with providers to provide for continuation of care in the event that a provider's contract with the health maintenance organization is terminated, provided th…

Sec. 7. Each health maintenance organization shall provide the following: (1) Telephone access to the health maintenance organization during business hours to ensure enrollee access for routine care. (2) Twenty-four (24) hour telephone access to either: (A) a representative of th…

Sec. 8. (a) Each health maintenance organization shall establish guidelines for establishing reasonable periods of time within which an enrollee must be given an appointment with a participating provider, except as provided in section 9 of this chapter regarding emergency service…

Sec. 9. (a) As used in this section, "care obtained in an emergency" means, with respect to an enrollee, covered services that are: (1) furnished by a provider within the scope of the provider's license and as otherwise authorized under law; and (2) needed to evaluate or stabiliz…

Sec. 0.1. As used in this chapter, "administrative denial" means the denial by a health carrier for nonmedical reasons of a health provider facility's or provider's claim for reimbursement. As added by P.L.215-2025, SEC.48.

Sec. 0.2. As used in this chapter, "affiliate" means any person who, directly or indirectly through one (1) or more intermediaries, controls, is controlled by, or is under common control with, the person to whom affiliation is attributed. As added by P.L.198-2021, SEC.16.

Sec. 1. As used in this chapter, "emergency" means a medical condition that arises suddenly and unexpectedly and manifests itself by acute symptoms of such severity, including severe pain, that the absence of immediate medical attention could reasonably be expected by a prudent l…

Sec. 1.5. (a) As used in this chapter, "health carrier" means an entity: (1) that is subject to IC 27 and the administrative rules adopted under IC 27; and (2) that enters into a contract to: (A) provide health care services; (B) deliver health care services; (C) arrange for heal…

Sec. 10. (a) This section applies to a health provider contract in which at least one (1) of the parties is a health provider facility. (b) A health provider contract that: (1) requires the parties to commence negotiations to amend the terms of the contract if there is a change i…

Sec. 11. The department shall do the following: (1) Require health carriers to meet network adequacy standards that are no less stringent than the network adequacy standards established by the Centers for Medicare and Medicaid Services. (2) When assessing whether a health carrier…

Sec. 2. As used in this chapter, "health maintenance organization" means a person that undertakes to provide or arrange for the delivery of health care services to individuals on a prepaid basis, except for the individual's responsibility for copayments or deductibles. The term i…

Sec. 3. As used in this chapter, "health provider contract" means an agreement with a provider or a health provider facility relating to terms and conditions of reimbursement for health care services provided to an individual under: (1) an employee welfare benefit plan (as define…

Sec. 3.2. As used in this chapter, "health provider facility" means any of the following: (1) A hospital, as defined in IC 16-18-2-179(a). (2) A hospital system. (3) An affiliate of a hospital or hospital system. As added by P.L.198-2021, SEC.19.

Sec. 3.5. As used in this chapter, "hospital system" means: (1) a parent corporation of at least one (1) hospital and any entity affiliated with the parent corporation through ownership, governance, or membership; or (2) a hospital and any entity affiliated with the hospital thro…

Sec. 4. (a) As used in this chapter, "person" means an individual, an agency, a political subdivision, a partnership, a corporation, an association, or any other entity. (b) The term does not include a health care provider described in IC 16-18-2-163(a)(1), IC 16-18-2-163(a)(2), …

Sec. 5. As used in this chapter, "provider" means an individual or entity licensed or legally authorized to provide health care services. As added by P.L.197-2001, SEC.1.

Sec. 6. (a) Except as provided in subsection (b), a person may not require a provider, as a condition of entering into a health provider contract for the provision of health care services other than health care services to enrollees of a health maintenance organization, to provid…

Sec. 6.5. (a) As used in this section, "health plan" means any of the following that provides coverage for health care services: (1) A policy of accident and sickness insurance (as defined in IC 27-8-5-1). However, the term does not include the coverages described in IC 27-8-5-2.…

Sec. 7. (a) This section applies to health provider contracts entered into or renewed after June 30, 2020. (b) A health provider contract, including a contract with a pharmacy benefit manager or a health facility, may not contain a provision that prohibits the disclosure of healt…

Sec. 7.5. (a) This section applies to a health provider contract entered into, amended, or renewed after June 30, 2025. (b) When a health carrier is in the process of negotiating a health provider contract with a health provider facility or provider, the health carrier must provi…

Sec. 8. (a) This section applies to a health provider contract entered into, amended, or renewed after June 30, 2025. (b) A health provider contract, including a contract with a pharmacy benefit manager, may not contain a provision that does any of the following: (1) Limits the a…

Sec. 9. (a) This section applies to health provider contracts entered into or renewed after June 30, 2024. (b) If a party to a health provider contract intends to terminate the contractual relationship with another party to the health provider contract, the terminating party must…

Sec. 1. (a) As used in this chapter, "closing agent" means a person that: (1) closes an escrow transaction in connection with the purchase, sale, or financing of an interest in real estate; and (2) is required to be licensed as an insurance producer under IC 27-1-15.6. (b) The te…

Sec. 10. A closing agent may advance an amount not to exceed five hundred dollars ($500) from an escrow account on behalf of a party to an escrow transaction for the purpose of paying incidental fees, including conveyance and recording fees. Incidental fees may be paid in order t…

Sec. 2. As used in this chapter, "escrow account" means a checking account established by a closing agent with a: (1) bank; (2) savings and loan association; (3) credit union; or (4) savings bank; that is chartered under the laws of a state or the United States and used exclusive…