Title 83, Insurance

(a) As used in Sections 83-9-201 through 83-9-222, the following words shall have the meaning ascribed herein unless the context clearly requires otherwise:(a) “Association” means the Comprehensive Health Insurance Risk Pool Association.(b) “Board” means the board of directors of…

(1) Every insurer shall participate in the association. (2) The requirements of this plan shall become effective April 15, 1991. The policies shall be available for sale January 1, 1992.

(1) Any individual who is and continues to be a resident shall be eligible for coverage under this plan if evidence is provided of:(a) A notice of rejection or refusal to issue health insurance coverage for health reasons by one (1) insurer;(b) A refusal by an insurer to issue he…

Any order or decision of the commissioner under Sections 83-9-1 through 83-9-21 shall be subject to review by appeal (writ of certiorari) to the circuit court at the instance of any party in interest. The filing of the appeal (petition for such writ) shall operate as a stay of an…

(1) There is created a nonprofit legal entity to be known as the “Comprehensive Health Insurance Risk Pool Association.” All insurers, as a condition of doing business, shall be members of the association. (2) (a) The association shall operate subject to the supervision and appro…

The Comprehensive Health Insurance Risk Pool Association shall have the authority to develop and fund an online portal that shall be available to all Mississippians to assist consumers in selection of a health plan. This program shall have the capacity to aggregate information re…

Neither the board nor its employees shall be liable for any obligations of the association. There shall be no liability on the part of and no cause of action shall arise against any member insurer or its agents or employees, the association or its agents or employees, members of …

(1) The association shall:(a) Establish administrative and accounting procedures for the operation of the association.(b) Establish procedures under which applicants and participants in the plan may have grievances reviewed by an impartial body and reported to the board.(c) Selec…

Upon the cessation of operations by the Comprehensive Health Insurance Risk Pool Association, the distribution of any funds held by the association, including the refund of assessments, shall require the prior approval of the Commissioner of Insurance.

(1) The board shall select an insurer, through a competitive bidding process, to administer the plan. The board shall evaluate bids submitted under this subsection based on criteria established by the board, which criteria shall include:(a) The insurer’s proven ability to handle …

(1) For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors shall assess the member insurers at such time and for such amounts as the board finds necessary. Assessments shall be due not less than thirty (30) d…

The coverage provided by the plan shall be directly insured by the association, and the policies shall be issued through the administering insurer. Subject to the approval of the commissioner, the association may close enrollment in, and/or cease to offer the coverage provided by…

(1) (a) Notwithstanding any other provision of the law to the contrary, except as otherwise provided in subsections (3) and (4) of this section, no health coverage plan shall restrict coverage for medically appropriate treatment prescribed by a physician and agreed to by a fully …

(1) Coverage offered. (a) The plan shall offer the coverage specified in this section for each eligible person subject to the association’s discretion to close enrollment and/or cease offering coverage as authorized in Section 83-9-219.(b) If an eligible person is also eligible f…

Neither the participation in the association as member insurers, the establishment of rates, forms or procedures nor any other joint or collective action required by Sections 83-9-201 through 83-9-222 shall be the basis of any legal action, criminal or civil liability or penalty …

(1) Any insurance company authorized to do business of health insurance in this state may join with one or more other such insurance companies to offer to any resident of this state who is sixty-five (65) years of age or older, and to the spouse of such resident, insurance agains…

(1) (a) As used in this section, the following terms shall be defined as provided in this subsection:(b) “Anti-cancer medication” means drugs and biologics that are used to kill, slow, or prevent the growth of cancerous cells.(c) “Health plan or policy” means any hospital, health…

Every individual accident and health policy or service contract, except travel or nonrenewable accident policies, issued for delivery in the State of Mississippi on or after July 1, 1971, by an insurance company, nonprofit hospital service plan, or medical service corporation sha…

(a) For the purposes of Sections 83-9-251 through 83-9-257, the following words and phrases shall have the meanings as defined in this section unless the context clearly indicates otherwise:(a) “Exchange” means a state, federal, or partnership exchange or marketplace operating in…

(a) The Commissioner of Insurance shall have the authority to:(a) Establish any program, promulgate any rule, policy, guideline, or plan; or change any program, rule, policy or guideline to implement, establish, create, administer, or otherwise operate an exchange;(b) Apply for, …

There is created in the State Treasury a special fund to be designated as the “Mississippi Health Insurance State Exchange Trust Fund.” The Commissioner of Insurance is authorized to expend monies from this fund for the payment of the expenses incurred in the creation, implementa…

The Comprehensive Health Insurance Risk Pool Association shall have the authority to develop and fund an online portal that shall be available to all Mississippians to assist consumers in selection of a health plan. This program shall have the capacity to aggregate information re…

(1) Except as otherwise provided herein, a health insurance policy shall provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. To the extent that the screening, diagnosis, and treatment of autism spectrum disorder are not already covered by a h…

Notwithstanding any provision of any policy of accident or sickness insurance as defined by Section 83-9-1, issued on or after January 1, 1975, whenever such policy provides for the reimbursement for loss resulting from sickness, or from bodily injury by accidental means, or both…

The provisions of Sections 83-9-27 through 83-9-31 shall apply only to group policies or group plans of health affording coverage from sickness, or bodily injury by accidental means, or both, or nonprofit health plans corporations regulated by the Mississippi Insurance Commission…

(1) No policy of accident and sickness insurance shall be delivered or issued for delivery to any person in this state unless:(a) The entire money and other considerations therefor are expressed therein; and(b) The time at which the insurance takes effect and terminates is expres…

(1) A basic group health insurance policy shall be offered to employers of fewer than twenty-five (25) employees. Such a basic group health policy shall provide coverage for hospital expenses and services rendered by a physician licensed by this state, but is not subject to the r…

The coverage required under Section 83-9-27 shall not exceed One Thousand Dollars ($1,000.00) during any calendar year, and shall extend only to treatment and services rendered by a physician and hospitals licensed by the state wherein the service or hospitalization is rendered.

Every hospital, health or medical expenses insurance policy, hospital or medical service contract, health maintenance organization and preferred provider organization that is delivered or issued for delivery in this state and otherwise provides anesthesia benefits shall offer ben…

(1) All individual and group health insurance policies providing coverage on an expense incurred basis and individual and group service or indemnity type contracts issued after January 1, 1980, by an insurer or nonprofit corporation which provides coverage for a family member of …

(1) In this section, “health benefit plan” means a plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident or sickness and that is offered by any insurance company, group hospital service corporation or health maintenance …

(1) This section shall apply to any health benefit plan that provides coverage to two (2) or more employees of an employer in this state if any of the following conditions are satisfied:(a) Any portion of the premium or benefits is paid by or on behalf of the employer;(b) An elig…

(1) As used in this section:(a) “Employee benefit plan” means any plan, fund or program established or maintained by an employer or by an employee organization, or both, to the extent that such plan, fund or program was established or is maintained for the purpose of providing fo…

(1) As used in this section:(a) “Employee benefit plan” means any plan, fund or program established or maintained by an employer or by an employee organization, or both, to the extent that such plan, fund or program was established or is maintained for the purpose of providing fo…

(1) When medications for the treatment of any medical condition are restricted for use by an insurer by a step therapy or fail-first protocol, the prescribing practitioner shall have access to a clear and convenient process to expeditiously request an override of that restriction…

(1) As used in this section, the term “gender transition procedures” means the same as defined in Section 41-141-3. (2) A health benefit plan under an insurance policy or other plan providing health care coverage in this state shall not include reimbursement for gender transition…

(1) For the purposes of this section, the following words and phrases shall have the meanings as defined herein unless the context clearly indicates otherwise:(a) “Health benefit plan” means a policy, contract, certificate or agreement entered into, offered by or issued by an ins…

(a) As used in Sections 83-9-37 through 83-9-43, Mississippi Code of 1972:(a) “Alternative delivery system” means a health maintenance organization (HMO), preferred provider organization (PPO), exclusive provider organization (EPO), individual practice association (IPA), medical …

(1) This section shall be known and may be cited as the “Mississippi Triage, Treat and Transport to Alternative Destination Act.” (2) As used in this section, the following terms shall be defined as provided in this subsection:(a) “911 call” means a communication made on behalf o…

(1) (a) The minimum allowable reimbursement rate under any policy of accident and sickness insurance as defined by Section 83-9-1 to an out-of-network ambulance service provider for all covered services shall be the rates contracted between an ambulance service provider and a cou…

(1) (a) Except as otherwise provided herein, all alternative delivery systems and all group health insurance policies, plans or programs regulated by the State of Mississippi shall provide covered benefits for the treatment of mental illness, except for policies which only provid…

(1) The Commissioner of Insurance may disapprove a policy form, amendatory rider or endorsement currently in effect if the commissioner finds that a portion or all of the policy form, amendatory rider or endorsement:(a) Is in any respect in violation of any state or federal laws;…

Any insurer, subcontractor, third-party administrator or other payor that administers a health benefit policy issued in another state that covers a person in this state, shall reimburse providers at the reimbursement rate as provided in the state of issuance, if that reimbursemen…

(1) As used in this section, the following terms shall be defined as provided in this subsection:(a) “Cost-sharing requirements” means a deductible, coinsurance, copayment or similar out-of-pocket expense.(b) “Diagnostic breast examinations” means a medically necessary and approp…

(1) Covered benefits for services in this section shall be limited to coverage of treatment of clinically significant mental illness. (2) Treatment under this section shall be covered for a minimum of thirty (30) days per year for inpatient services, a minimum of sixty (60) days …

Methods of determining levels of payment or reimbursement for services or for the type of facility charges eligible for payment or reimbursement pursuant to Sections 83-9-37 through 83-9-43 shall be consistent with those for medical illnesses in general and shall take into consid…