Chapter 176A

Section 1. Any corporation organized under the laws of the commonwealth for the purpose of establishing, maintaining and operating a non-profit hospital service plan whereby hospital care and reimbursement for other health services may be provided by such corporation, or by a hos…

Section 10. Any plan whereby such a corporation agrees with a group of two or more persons or with the employer, employers or representatives of a group of two or more persons to furnish hospital benefits and reimbursement for other health services to said persons alone or to the…

Section 10A. Other provisions of this chapter and chapter one hundred and seventy-six G notwithstanding, any nonprofit hospital service corporation, either individually or by contract with a corporation formed under chapter one hundred and seventy-six B, one or more hospitals lic…

Section 11. The president, vice-president, if any, the secretary, assistant secretary, if any, the treasurer, and assistant treasurer, if any, shall be annually sworn and their oaths entered of record in the books of the non-profit hospital service corporation. Each director shal…

Section 12. When any such non-profit hospital service corporation publishes its assets it shall in the same connection and with equal conspicuousness publish its liabilities, both computed on the basis allowed for its annual statements.

Section 13. Any non-profit hospital service corporation may provide for the issuance to its employees of hospital service coverage, medical service coverage, and reimbursement for other health coverage. The term ''employee'' as used in this section shall include an officer.

Section 14. No non-profit hospital service corporation, or any officer or agent thereof, shall make, issue, circulate or use, or cause or permit to be made, issued, circulated or used, any written or oral statement misrepresenting the terms of any subscriber's contract issued or …

[There is no 176A:14A.]

Section 14B. No nonprofit hospital service corporation may, without the express and informed written consent of its subscriber or a covered family member of its subscriber, disclose any information it may have acquired from or about any such subscriber or covered family member pe…

Section 15. Acquisition costs in connection with the solicitation of subscribers, and the cost of administration shall at all times be limited to such amounts as the commissioner of insurance shall approve as adequate and reasonable, but in any event, such acquisition costs shall…

Section 16. With the approval of the commissioner of insurance, a corporation subject to this chapter, alone or with one or more nonprofit corporations, the real estate of which is exempt from taxation, may acquire real estate it reasonably expects to use in whole or in part for …

Section 17. Any dispute arising between a corporation subject to this chapter, and any hospital with which such corporation has a contract for hospital service as authorized by this chapter, may with the consent of both parties be submitted to the center for health information an…

Section 18. Every such corporation subject to this chapter shall annually, on or before the first day of March, file in the office of the commissioner of insurance a statement, verified by at least two of the principal officers of said corporation, showing its condition as of the…

Section 18A. In an account of its financial condition, a non-profit hospital service corporation may include as an asset available for the payment of losses electronic data processing equipment, provided that the cost of such equipment at the time of acquisition is at least one h…

Section 19. Every corporation subject to this chapter is hereby declared to be a charitable and benevolent corporation and its property shall be exempt from state, city, county, district and municipal taxes.

Section 1A. Any person residing in the commonwealth shall have the right to become a subscriber of a nonprofit hospital service corporation if the qualifications of such person meet those specified in the by-laws of such corporation; provided, however, that such corporation may, …

Section 1B. A nonprofit hospital service corporation governed by this chapter shall offer medicare supplemental group coverage to that group of medical assistance recipients designated from time to time by the department of public welfare. Such coverage shall be provided at a rat…

Section 1C. For purposes of this section, retroactive premium rate increase shall mean any premium rate increase based upon an actual approved rate which is assessed to a subscriber after any payment has been made by said subscriber based upon an estimated premium rate for such p…

Section 1D. Any corporation subject to this chapter may make contracts of reinsurance relating to the providing of medical or other health services or reimbursement thereof, but the costs of such reinsurance shall not inure to or otherwise affect the premiums charged for any poli…

Section 2. Persons desiring to form such a non-profit hospital service corporation shall incorporate as provided in section three of chapter one hundred and eighty. The board of directors of each such corporation shall consist of thirty-one members, three of whom shall be officer…

Section 20. Every non-profit hospital service corporation shall, within thirty days after the adoption of any amendment to its by-laws, file with the commissioner of insurance for his approval a copy of such amendment certified under its corporate seal by its secretary.

Section 21. The commissioner of insurance may require any non-profit hospital service corporation to submit for his inspection copies of any circular or other advertising matter issued by it in the commonwealth.

Section 22. All provisions of this chapter relative to the filing of subscriber contract forms with, and the approval of such forms by, the commissioner of insurance shall also apply to all forms of riders, endorsements and applications designed to be attached to such forms, and …

Section 23. If the commissioner of insurance, in this section called the commissioner, is satisfied, as to any corporation subject to this chapter that (1) it has failed to comply with the provisions of its charter, or (2) it is being operated for profit, or (3) it is fraudulentl…

Section 24. Every such corporation shall set aside at the end of each calendar year out of its surplus funds, if any, but not otherwise, a special contingent reserve fund in an amount equal to, for the first year, the sum of one half of its then surplus funds, over and above its …

Section 25. Upon written notice by a non-profit hospital service corporation of its appointment of a person to act as its agent whose compensation in whole or in part is computed on a commission basis, the commissioner of insurance, in this section called the commissioner shall, …

Section 26. No corporation subject to this chapter shall pay any salary, compensation or emolument to any officer, trustee or director thereof, nor any salary, compensation or emolument amounting in any year to more than twenty thousand dollars to any person, unless such payment …

Section 27. The pertinent provisions of section one hundred and thirty-eight A of chapter one hundred and seventy-five shall apply to deductions on payroll schedules from the salary of any state, county or municipal employee for the payment of the amount payable by such an employ…

Section 28. Whoever violates any provision of this chapter for which no other penalty is provided by law, shall be punished by a fine of not more than five hundred dollars.

Section 29. The provisions of this chapter shall be applicable on or after January first, nineteen hundred and fifty-one to all non-profit hospital service corporations heretofore or hereafter formed, except as otherwise herein provided and except that as to existing corporations…

Section 3. No non-profit hospital service corporation shall make or issue any contract to provide hospital care and reimbursement for other health services until it has obtained from the commissioner of insurance, in this section called the commissioner, a certificate, in such fo…

Section 30. The invalidity of any section or provision of this chapter shall not invalidate any other section or provision thereof.

Section 31. Any corporation subject to this chapter may contract with any person for the purpose of providing administrative or other services relating to the providing of hospital or other health services or reimbursement therefor. In addition, with the approval of the commissio…

Section 32. A nonprofit hospital service corporation which, upon the death of a subscriber, owes the subscriber's estate an aggregate sum not exceeding two thousand dollars under any contract for hospital care or reimbursement for other health services, may, at any time not less …

Section 33. (a) For purposes of this section, the following words shall, unless the context clearly requires otherwise, have the following meanings:— ''Carrier'', a health maintenance organization authorized under chapter 176G, an insurance company authorized to provide accident …

Section 34. Pursuant to section 8B of chapter 62C, any corporation subject to this chapter shall provide written statements to residents of the commonwealth for whom creditable coverage is provided and shall provide a separate report verifying those statements to the commissioner…

[There is no 176A:35.]

Section 36. To the maximum extent possible, every non-profit hospital service corporation shall attribute every member to a primary care provider. Members may change their primary care provider, provided that the member gives notice to the carrier.

Section 37. To the extent permissible under applicable state and federal privacy laws, every non-profit hospital service corporation shall disclose patient-level data to providers in their network solely for the purpose of carrying out treatment, coordinating care among providers…

Section 38. (a) For the purposes of this section, the following words shall, unless the context clearly requires otherwise, have the following meanings: ''Behavioral health services'', care and services for the evaluation, diagnosis, treatment or management of patients with menta…

Section 3A. No corporation subject to this chapter, and no officer or agent thereof, shall cancel, refuse to issue or renew, or in any way make or permit any distinction or discrimination in the amount or payment of premiums or rates charged, in the length of coverage, or in any …

Section 3B. For the purposes of this section the following words shall have the following meanings:— ''Genetic information'', a written recorded individually identifiable result of a genetic test as defined by this section or explanation of such a result. ''Genetic test'', a test…

Section 4. Every non-profit hospital service corporation shall use a proper system of accounting, and employ either full time, or on a consulting basis, a competent accountant, a competent claim manager, a competent and experienced underwriter, and a competent and experienced act…

Section 5. Any corporation subject to this chapter may contract with corporations formed under chapter one hundred and seventy-six B for the joint administration of their business and for joint and co-operative writing and issuing of certificates and may enter into reciprocal arr…

Section 6. Nongroup contracts, except contracts providing supplemental coverage to medicare subject to the provisions of chapter one hundred and seventy-six K, issued and rates charged by nonprofit hospital service corporations to its subscribers for hospital care and reimburseme…

Section 7. The commissioner of insurance, or any person authorized by him to make examinations or investigations or to conduct hearings provided for by this chapter, shall have free access to all the assets of non-profit hospital service corporations for the purpose of verificati…

Section 8. No contract between the subscriber and the corporation shall be issued or delivered in the commonwealth which provides full room and board benefits in an extended care facility for other than the period of hospitalization coverage provided, or which provides benefits f…

Section 8A. (a) A contract between a subscriber and the corporation under an individual or group hospital service plan which is issued or renewed within or without the commonwealth shall provide mental health benefits on a nondiscriminatory basis to residents of the commonwealth …