Title XXV, Business and Financial Institutions

prohibited. No corporation subject to the provisions of this subtitle shall use an itemized statement furnished pursuant to KRS 216B.250 for insurance payment purposes where benefits have been assigned.

(1) All individual or group service or indemnity type contracts and all certificates thereunder issued by a nonprofit corporation shall provide coverage for health care treatment or services rendered by ambulatory surgical centers approved by the Kentucky Health Facilities and He…

podiatrists, physicians or chiropractors. (1) When any contract, plan or policy issued in this state by any corporation subject to the provisions of this subtitle provides for reimbursement for any service which is within the lawful scope of practice of an optometrist duly licens…

Any group policy, group plan or group contract issued in this state by a nonprofit hospital, medical-surgical, or health service corporation shall offer the master policyholder the option to purchase in new contracts the minimum benefits for treatment of alcoholism as specified i…

craniomandibular jaw disorders. (1) All policies, contracts, or plans issued in this state, including subscription or membership certificates thereunder, which provide for surgical or nonsurgical treatment of skeletal disorders shall provide coverage for medically necessary proce…

services performed by physician. Any policy, contract or plan issued in this state by a nonprofit hospital, medical-surgical, dental and health service corporation which provides coverage for services which can be lawfully performed within the scope of the license of a duly licen…

requirements for covered diagnostic breast examinations or supplemental breast examinations. Nonprofit hospital, medical-surgical, dental, and health service corporation contracts in this Commonwealth shall comply with KRS 304.17-316.

mastectomy, diagnosis and treatment of endometrioses and endometritis, and bone density testing -- Duties of insurer. (1) All nonprofit hospital, medical-surgical, dental, and health service corporations issuing contracts in this Commonwealth providing hospital, medical, or surgi…

(1) All nonprofit hospital, medical-surgical, dental, and health service corporations issuing contracts in this Commonwealth which provide hospital, medical, or surgical expense benefits for treatment of breast cancer by chemotherapy shall also provide coverage for treatment of b…

(1) On or after June 18, 1970, no corporation subject to the provisions of this subtitle shall deliver or issue for delivery in this state any subscription certificate or membership certificate describing health benefits available, or any indorsement, rider, or application which …

(1) For purposes of this section, "mental illness" means psychosis, neurosis or an emotional disorder. (2) Any offer to sell a policy or contract of general health insurance to be issued, delivered, issued for delivery, amended or renewed by a nonprofit hospital, medical- surgica…

worker. Every policy, contract, or plan issued, delivered, or renewed in this state by a nonprofit hospital, medical-surgical, dental, or health service corporation which provides coverage for services performed by a licensed psychologist pursuant to KRS Chapter 319, or a license…

Any corporation subject to the provisions of this subtitle may contract with any agency, instrumentality, or political subdivision of the United States, or of this state for making available hospital, medical-surgical, dental and other health care services, and in aid or furthera…

Appointment. (1) An agent of the corporation shall be licensed as an agent with a health line of authority in accordance with the provisions of Subtitle 9 of this chapter regulating all aspects of agent licenses. (2) Subsection (1) of this section includes the requirement that th…

and health service corporations. (1) Nonprofit hospital, medical-surgical, dental, and health service corporations shall be subject to the provisions of KRS 304.2-210, 304.2-220, 304.2-230, 304.2-240, 304.2-250, 304.2-260, 304.2-270, 304.2-280, 304.2-290, 304.2-300, and Subtitle …

(1) If the certificate of authority of a corporation is suspended, the corporation shall not, during the period of suspension, enroll any additional subscribers or members except newborn children or other newly acquired dependents of existing subscribers or members, and shall not…

Any individual subscriber or member of a corporation subject to the provisions of this subtitle who believes himself or herself to be aggrieved by any act or omission of a corporation or its officers, trustees, directors, agents, or representatives, may file a statement in writin…

The commissioner may promulgate reasonable rules and regulations not inconsistent with the provisions of this subtitle that the commissioner deems necessary for the proper administration of this subtitle.

Nothing contained in this subtitle shall be construed to affect or apply to hospitals, or other licensed health care institutions, nor to any individuals, partnerships, associations, or corporations which are the direct purveyors of health services; nor shall it be construed to l…

Nonprofit hospital, medical-surgical, dental, and health service corporations shall be subject to the provisions of this subtitle, and to the following provisions of this code, to the extent applicable and not in conflict with the express provisions of this subtitle: (1) Subtitle…

reason of age. Nonprofit hospital, medical-surgical, dental, and health service corporations delivering or issuing for delivery Medicare supplement contracts as defined in KRS 304.14-500 to 304.14-550, or renewing such contracts, shall make available upon request Medicare supplem…

corporations as insurers to offer home health care coverage -- Conditions. (1) All nonprofit hospital, medical-surgical, dental and health service corporations issuing policies in the Commonwealth which provide hospital, medical, or surgical expense benefits shall make available …

All nonprofit, medical-surgical, dental, and health service corporations issuing long-term care coverage shall comply with KRS 304.14-600 to 304.14-625.

spouse. (1) Any private employer doing business in this state who provides for his employees on a self-insured basis, hospital or surgical benefits, other than for specific diseases or accidental injury only, shall purchase a conversion health insurance policy. Upon the terminati…

(1) A converted policy issued pursuant to the conversion privilege provided in KRS 304.32-300 providing hospital or surgical expense insurance shall provide on an expense incurred basis, the following minimum benefits: (a) Hospital room and board benefits of twenty-five dollars (…

Any private employer doing business in this state who provides for his employees, on a self-insured basis, hospital or surgical benefits shall be subject to KRS 304.14-135. Failure to accept forms prescribed by the commissioner shall be punishable pursuant to KRS 304.99-010.

Any private employer doing business in this state who provides for his or her employees on a self-insured basis hospital or surgical benefits shall notify the Department of Insurance of the existence of the program within sixty (60) days of June 17, 1978. Any employer doing busin…

and requires utilization review of benefits. (1) Every employer in this state which provides coverage of hospital benefits on a self- insured basis and requires the utilization review of such benefits by an insurer, its designee, or a private review agent shall: (a) Be a register…

(1) Short title. This subtitle may be cited as the "Insurers Rehabilitation and Liquidation Law." (2) Construction. No limitation of powers. This subtitle shall not be interpreted to limit the powers granted the commissioner by other provisions of the law. (3) Liberal constructio…

The proceedings authorized by this subtitle may be applied to: (1) All domestic insurers, whether or not they purport to do business in this state; (2) All insurers who are doing, or have done, an insurance business in this state, and against whom claims arising from that busines…

For the purposes of this subtitle: (1) "Agent" means all persons who have collected or are holding premiums or other assets of the insurer, including but not limited to brokers, intermediaries, managing general agents, underwriting managers, and reinsurance managers, and any othe…

(1) Actions by commissioner. Except as provided in subsection (2) of this section, and subsection (1) of KRS 304.33-230, no delinquency proceeding shall be commenced under this subtitle by anyone other than the commissioner and no court shall have jurisdiction to entertain, hear …

(1) Except as provided in KRS 304.33-052 and 304.33-055, any receiver appointed in a proceeding under this subtitle may at any time apply for and any court of general jurisdiction may grant such restraining orders, temporary and permanent injunctions, and other orders as are deem…

(1) (a) A federal home loan bank shall not be stayed or otherwise prohibited by a court from exercising its rights regarding collateral pledged by an insurer- member for more than ten (10) days following the date a temporary restraining order, preliminary injunction, or permanent…

contracts. Notwithstanding any other provision of this subtitle or statute to the contrary: (1) As used in this section: (a) 1. "Netting agreement": a. Means an agreement, including a master agreement or bridge agreement for one (1) or more master agreements, that: i. Documents o…

In any proceeding under this subtitle in which the receiver is the prevailing party, the court shall award the receiver, in addition to such other relief as may be appropriate, all costs and expenses, including, but not limited to, attorneys' fees incurred in pursuing that litiga…

(1) Duty to cooperate. Any officer, manager, trustee, or agent of any insurer, and any other person with executive authority over or in charge of any segment of the insurer's affairs or in possession of property to which the commissioner has a claim shall cooperate with the commi…

An insurer that is subject to any delinquency proceedings, whether formal or informal or administrative or judicial, shall not: (1) Be released from such proceeding, unless such proceeding is converted into a judicial rehabilitation or liquidation proceeding; (2) Be permitted to …

In any proceeding under this subtitle the commissioner and his or her deputies shall be responsible on their official bonds for the faithful performance of their duties. If the court deems it desirable for the protection of the assets, it may at any time require an additional bon…

Every proceeding commenced before June 18, 1970, is deemed to have commenced under this subtitle for the purpose of conducting the proceeding thereafter, except that in the discretion of the commissioner the proceeding may be continued, in whole or in part, as it would have been …

Every proceeding heretofore commenced under the laws in effect before July 13, 1990, shall be deemed to have commenced under this subtitle for the purpose of conducting the proceeding henceforth, except that in the discretion of the commissioner the proceeding may be continued, i…

(1) Whenever the commissioner has reasonable cause to believe, and determines that any insurer has committed or engaged in, or is committing or engaging in or is about to commit or engage in any act, practice, or transaction that would subject it to formal delinquency proceedings…

The commissioner, the commissioner's special deputies, and all others appointed to act on the commissioner's behalf in connection with any delinquency proceedings under this subtitle shall not be liable for any acts or omissions done in good faith and within the scope of their au…

(1) Issuance. Upon the filing by the commissioner in any Circuit Court in this state of a verified petition alleging any ground that would justify a court order for a formal delinquency proceeding against an insurer under this subtitle and that the interests of policyholders or c…

(1) Confidentiality of commissioner's hearings. The commissioner shall hold all hearings in summary proceedings privately unless the insurer requests a public hearing, in which case the hearing shall be public. (2) Confidentiality of court hearings. The court may hold all hearing…

(1) The commissioner may apply by verified petition to the court for an order directing the commissioner to rehabilitate a domestic insurer or an alien insurer domiciled in this state on any one (1) or more of the following grounds: (a) Any ground on which the commissioner may ap…

(1) Appointment of rehabilitator. An order to rehabilitate the business of a domestic insurer, or an alien insurer domiciled in this state, shall appoint the commissioner and his or her successors in office rehabilitator and shall direct the rehabilitator forthwith to take posses…

(1) Special deputy. The commissioner as rehabilitator shall appoint one (1) or more special deputies, who are active or retired senior executives from a successful insurer, and who shall have all the powers and responsibilities of the rehabilitator granted under this section, and…

(1) The rehabilitator shall appear before the committee no more than two (2) weeks after he has disclosed his final recommendation, unless the chairman has designated a date beyond the two (2) week period, to disclose his recommendation to the committee and to hear the comments o…

(1) Stays in pending litigation. Except as provided in KRS 304.33-052 and 304.33-055, any court in this state before which any action or proceeding by or against an insurer is pending when a rehabilitation order against the insurer is entered shall, upon request of the rehabilita…