Title 27, INSURANCE

Sec. 9. A trust created under section 7 of this chapter is subject to regulation by the department as follows: (1) The trust must be registered with the department. (2) The trust shall: (A) retain a total risk for the self-insurance fund of not more than one hundred twenty-five p…

Sec. 1. As used in this chapter, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1. The term does not include a policy, plan, or coverage set forth in IC 27-8-5-2.5(a). As added by P.L.190-2023, SEC.31.

Sec. 2. As used in this chapter, "wearable cardioverter defibrillator" means a device that: (1) is worn externally on an individual's body; (2) continually monitors and analyzes the individual's heart rhythm; and (3) delivers a shock to the heart when an abnormal heart rhythm is …

Sec. 3. (a) A policy of accident and sickness insurance must provide coverage for wearable cardioverter defibrillators, including the cost of the wearable cardioverter defibrillator, any necessary accessory, and ongoing monitoring services. (b) The coverage required under subsect…

Sec. 4. The coverage required by this chapter may not be subject to an annual or lifetime limitation. As added by P.L.190-2023, SEC.31.

Sec. 1. (a) A health maintenance organization shall develop and implement a procedure to evaluate whether to provide coverage for new medical technologies and new applications of existing medical technologies, including medical treatments, procedures, drugs, and devices. (b) A he…

Sec. 2. (a) A health maintenance organization that limits coverage for experimental treatments, procedures, drugs, or devices must clearly state the limitations in any contract, policy, agreement, or certificate of coverage. (b) The disclosure required under subsection (a) must i…

Sec. 3. (a) If a health maintenance organization denies coverage for a treatment, procedure, drug, or device on the grounds that the treatment, procedure, drug, or device is experimental, the health maintenance organization shall provide the enrollee with a written explanation th…

Sec. 1. As used in this chapter, "trusteed surplus" means the aggregate value of a United States branch's: (1) surplus and reserve funds required under IC 27-1-6; and (2) trust assets described in section 4 of this chapter; plus investment income accrued on the items described in…

Sec. 2. As used in this chapter, "United States branch" means: (1) an entity that is considered, for purposes of this chapter, to be a domestic company through which insurance business is transacted in the United States by an alien company; and (2) the alien company's assets and …

Sec. 3. Indiana may serve as a state of entry to enable an alien company to transact insurance business in the United States through a United States branch if the United States branch: (1) qualifies under this title for a certificate of authority as if the United States branch we…

Sec. 4. (a) A trust account established under section 3(2) of this chapter must contain, at all times, an amount equal to the United States branch's reserves and other liabilities, plus the: (1) minimum capital and surplus requirement; or (2) authorized control level risk based c…

Sec. 5. (a) The commissioner shall require a United States branch to do the following before granting the United States branch a certificate of authority to transact insurance business as described in section 3(1) of this chapter: (1) Comply with this chapter and any other requir…

Sec. 6. (a) A United States branch shall file with the commissioner, not later than March 1, May 15, August 15, and November 15 of each year, all of the following: (1) Statements of the insurance business transacted in the United States, the assets held by or for the United State…

Sec. 7. (a) Before issuing a new or renewal certificate of authority to a United States branch, the commissioner may require satisfactory proof: (1) in the charter of the alien company transacting business through the United States branch; (2) by an agreement evidenced by a certi…

Sec. 8. If the commissioner determines from a quarterly or annual statement, a trusteed surplus statement, or another report that a United States branch's trusteed surplus is less than: (1) the minimum capital and surplus requirements; or (2) the authorized control level risk bas…

Sec. 1. Beginning January 1, 2000, each health maintenance organization shall make available a health maintenance organization comparison sheet for each policy or contract that either covers or is marketed to an Indiana resident or the resident's employer. As added by P.L.69-1998…

Sec. 2. (a) The comparison sheet required under section 1 of this chapter must include information of general interest to: (1) purchasers of group contracts and individual contracts; and (2) individuals covered by each group contract or individual contract. (b) The comparison she…

Sec. 3. A health maintenance organization shall provide a completed health maintenance organization comparison sheet to the following: (1) Upon request, to an enrollee or subscriber or to the enrollee's or subscriber's employer. (2) As part of the health maintenance organization'…

Sec. 1. (a) This chapter applies beginning January 1, 2016. (b) This chapter does not do the following: (1) Impose corporate governance standards or internal procedures that are not otherwise required under IC 27. (2) Limit the commissioner's authority, or the rights and obligati…

Sec. 10. (a) If a CGAD contains the material information necessary to allow the reviewing commissioner to understand the insurer's or insurance group's corporate governance structure, policies, and procedures, the insurer or insurance group may determine whether to respond to a r…

Sec. 11. (a) Documents, materials, and other information related to a CGAD, including the CGAD, that are in the possession or control of the department and obtained by, created by, or disclosed to the commissioner or another person under this chapter, are: (1) considered to be pr…

Sec. 12. (a) The commissioner may, at the insurer's expense, retain third party consultants, including attorneys, actuaries, accountants, and others who are not part of the commissioner's staff, that: (1) the commissioner considers necessary to review a CGAD, related information,…

Sec. 13. (a) An insurer that fails, without just cause (as determined by the commissioner), to timely file a CGAD as required by this chapter shall, after notice and hearing under IC 4-21.5, pay a civil penalty of one hundred dollars ($100) for each day of noncompliance, not to e…

Sec. 14. Notwithstanding IC 1-1-1-8, section 11 of this chapter is not severable. As added by P.L.146-2015, SEC.19.

Sec. 15. The commissioner may adopt rules under IC 4-22-2 to implement this chapter. As added by P.L.146-2015, SEC.19.

Sec. 2. As used in this chapter, "corporate governance annual disclosure" or "CGAD" means a confidential report filed by an insurer or insurance group under this chapter. As added by P.L.146-2015, SEC.19.

Sec. 3. As used in this chapter, "insurance group" means insurers and affiliates of an insurance holding company system (as defined in IC 27-1-23-1). As added by P.L.146-2015, SEC.19.

Sec. 4. As used in this chapter, "insurer" has the same meaning as set forth in IC 27-1-2-3, except that the term: (1) refers only to domestic insurers (as defined in IC 27-1-36-8); and (2) does not include agencies, authorities, or instrumentalities of the United States, possess…

Sec. 5. As used in this chapter, "NAIC" refers to the National Association of Insurance Commissioners. As added by P.L.146-2015, SEC.19.

Sec. 6. (a) An insurer or insurance group of which the insurer is a member shall, not later than June 1 of each calendar year, submit: (1) to the commissioner; or (2) if the insurer is a member of an insurance group, to the lead state commissioner of the insurance group (as deter…

Sec. 7. (a) Subject to subsection (b), an insurer or insurance group may complete a CGAD using corporate governance information at the level of disclosure at which the insurer's or insurance group's system of corporate governance is structured, as follows: (1) The ultimate contro…

Sec. 8. If a CGAD is submitted by an insurer as a member of an insurance group, the lead state commissioner of the insurance group (as determined by the procedures in the Financial Analysis Handbook) shall: (1) review a CGAD submitted under section 6 of this chapter; and (2) make…

Sec. 9. If an insurer or insurance group: (1) submits, in other: (A) documents submitted to the commissioner, including proxy statements filed with registration statements required by IC 27-1-23-3; or (B) state or federal filings provided to the department; information that is su…

Sec. 1. As used in this chapter, "certificate" means a document issued to an individual group member as evidence of the group member's coverage under a master group insurance policy. As added by P.L.32-2012, SEC.2.

Sec. 10. (a) An insurer may cancel or refuse to renew an individual certificate while maintaining in force the master policy and other individual certificates issued under the master policy. (b) An insurer that cancels or refuses to renew a master policy shall, within a period de…

Sec. 11. The department may adopt rules under IC 4-22-2 to implement this chapter. As added by P.L.32-2012, SEC.2.

Sec. 2. As used in this chapter, "group" means the following: (1) The membership of any of the following: (A) A trade association. (B) A professional association. (C) A labor union. (D) An employee association. (E) A club. (F) A league. (G) A fraternity. (H) A guild. (I) Another …

Sec. 3. As used in this chapter, "group administrator" means the officers or directors of a group or any other person legally vested with the responsibility to manage the affairs of a group. In the case of a group that consists of employees of a single employer, the employer is c…

Sec. 4. As used in this chapter, "group insurance policy" means a policy of insurance that provides personal excess liability insurance or personal umbrella liability insurance to participating group members under one (1) master policy: (1) that is issued to the group administrat…

Sec. 5. An insurer that is: (1) authorized under IC 27-1-3-20 to engage in the business of insurance in Indiana; or (2) doing business with an insurance producer that is licensed under IC 27-1-15.8; may issue a group insurance policy in Indiana. As added by P.L.32-2012, SEC.2.…

Sec. 6. (a) A group described in section 2(1) of this chapter must meet the following requirements to be eligible to purchase coverage under a group insurance policy: (1) The group consists of at least ten (10) individuals who are members. (2) The group has been in existence for …

Sec. 7. An insurer may apply to a group insurance policy a lower rate than the rate shown in the insurer's manual for insurance policies that are: (1) of the same type as the group insurance policy; and (2) individually issued to insureds of the same class as the group members in…

Sec. 8. (a) A group administrator may, if authorized by the insurer, aggregate the group members' premiums and remit the premiums to the insurer or insurance producer. (b) If an insurer authorizes payment of premiums as described in subsection (a), payment of a premium by a group…

Sec. 9. (a) A certificate that is issued under a group insurance policy to an individual participating group member must include the following information: (1) The full name and address of the insurer. (2) The policy number of the master policy. (3) The full name, address, and te…

Sec. 1. Not more than ninety (90) days after the date of the version specified in IC 27-1-1.5 of a diagnostic or procedure code described in this section: (1) a health maintenance organization and a limited service health maintenance organization shall begin using the version spe…