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Montana Statutes, Title 33

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Montana/Statutes

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Title 33, Title 33

37 chapters · 1,713 sections in this title.

All chapters in Title 331,713 Ch 2, REGULATION OF INSURANCE COMPANIES311 Ch 22, DISABILITY INSURANCE227 Ch 20, LIFE INSURANCE154 Ch 1, ADMINISTRATION AND GENERAL PROVISIONS106 Ch 17, INSURANCE PRODUCERS, ADJUSTERS, CONS…80 Ch 15, THE INSURANCE CONTRACT72 Ch 18, UNFAIR TRADE PRACTICES67 Ch 3, DOMESTIC STOCK AND MUTUAL INSURERS65 Ch 16, RATES -- RATING AND ADVISORY ORGANIZ…62 Ch 4, FARM MUTUAL INSURERS51 Ch 32, HEALTH UTILIZATION REVIEW47 Ch 30, HEALTH SERVICE CORPORATIONS44 Ch 10, INSURANCE GUARANTY ASSOCIATIONS41 Ch 7, FRATERNAL BENEFIT SOCIETIES39

44 sections·Filtered byTitle 33✕Ch 30✕

Mont. Code Ann. § 33-30-1001 Newborn Infants Covered By Insurance By Health Service Corporation
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A disability insurance plan or group disability insurance plan issued by a health service corporation may not be issued or amended in this state if it contains any disclaimer, waiver, preexisting condition exclusion, or other limitation of coverage relative to the accident and si…
Mont. Code Ann. § 33-30-1002 Disability Coverage Of Services Received In State Institutions -- Coverage Of Persons Eligible For Public Medical Assistance
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(1) It is unlawful for any health service corporation issuing membership contracts in Montana to exclude from coverage in a membership contract services rendered the insured while a resident in a Montana state institution if the services to the insured would be covered by the mem…
Mont. Code Ann. § 33-30-1003 Continuation Of Coverage For Persons With Disabilities -- Individual Contracts
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(1) An individual hospital or medical service plan contract delivered or issued for delivery in this state that provides that coverage of a dependent child terminates upon attainment of the limiting age for dependent children specified in the contract must also provide in substan…
Mont. Code Ann. § 33-30-1004 Continuation Of Coverage For Persons With Disabilities -- Group Contracts

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(1) A group hospital or medical service plan contract delivered or issued for delivery in this state that provides that coverage of a dependent child of an employee or other member of the covered group terminates upon attainment of the limiting age for dependent children specifie…

Mont. Code Ann. § 33-30-1005 Right Of Rescission

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Each membership contract, other than a group contract, issued for delivery in this state on or after January 1, 1980, must contain a notice stating in substance that if the person to whom the contract is issued is not satisfied for any reason, the person is permitted to return th…

Mont. Code Ann. § 33-30-1006 Continuing Group Coverage After Termination

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A person covered by a group hospital or medical service plan contract, issued or renewed by a health service corporation after October 1, 1981, may, for a period of 1 year with the consent of the employer or the trustees, continue coverage under the group contract during the pers…

Mont. Code Ann. § 33-30-1007 Conversion On Termination Of Eligibility

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(1) The group hospital or medical service plan contract issued or renewed by a health service corporation after October 1, 1981, must contain a provision that if the insurance or any portion of it on a person or a person's dependents or family members covered under the policy cea…

Mont. Code Ann. § 33-30-1008 Preexisting Conditions

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The converted policy may not exclude, as a preexisting condition, any conditions covered by the group contract.

Mont. Code Ann. § 33-30-1009 Insured's Family -- Conversion Entitlement

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Subject to the conditions set forth in this section, the conversion privilege is also available: (1) to the surviving spouse, if any, at the death of the employee or member, with respect to the spouse and children whose coverage under the group policy terminates by reason of the …

Mont. Code Ann. § 33-30-101 Definitions

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As used in this chapter, the following definitions apply: (1) (a) "Health service corporation" means a nonprofit corporation organized or operating for the purposes of establishing and operating a nonprofit plan or plans under which prepaid hospital care, medical-surgical care, a…

Mont. Code Ann. § 33-30-1011 Dentists Performing Services Common To Both Medicine And Dentistry

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A contract or plan may exclude coverage for dental care or services, but no individual or group membership contract or plan issued or renewed on or after October 1, 1983, may disallow payment to a dentist for health care or services for which a physician would be paid, provided t…

Mont. Code Ann. § 33-30-1013 Coverage Required For Services Provided By Nurse Specialists

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A health service corporation shall provide, in group and individual insurance contracts, coverage for health services provided by a nurse specialist, as specifically listed in 37-8-202, if health care services that nurse specialists are licensed to perform are covered by the cont…

Mont. Code Ann. § 33-30-1014 Coverage For Well-Child Care

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(1) Each disability insurance plan or group disability insurance plan that is delivered, issued for delivery, renewed, extended, or modified in this state by a health service corporation and that provides coverage for a family member of the insured or subscriber must provide cove…

Mont. Code Ann. § 33-30-1015 Limitation Of Eligibility On Conversion

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A person who purchases a policy of insurance under 33-30-1007 ceases to be eligible for a conversion policy if the person insured by the policy: (1) fails to pay the premium on the policy purchased under 33-30-1007; or (2) enrolls under another major medical disability insurance …

Mont. Code Ann. § 33-30-1016 Coverage For Adopted Children From Time Of Placement -- Preexisting Conditions

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(1) Each individual or group membership contract issued or amended by a health service corporation in this state that provides coverage of dependent children of a member must provide coverage for an adopted child of the member to the same extent as for natural children of the mem…

Mont. Code Ann. § 33-30-1017 Coverage Required For Services Provided By Naturopathic Physicians

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A health service corporation shall provide, in group and individual insurance contracts or certificates, coverage for health services provided by a naturopathic physician licensed pursuant to Title 37, chapter 26, if the health care services that naturopathic physicians are licen…

Mont. Code Ann. § 33-30-1018 Coverage Required For Services Provided By Physical Therapist

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A health service corporation shall provide, in group and individual insurance contracts or certificates, coverage for health services provided by a physical therapist licensed pursuant to Title 37, chapter 11, if the health care services that physical therapists are licensed to p…

Mont. Code Ann. § 33-30-1019 Coverage For Services Provided Under Freedom Of Choice For Auxiliary Health Services

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A health service corporation shall provide, in group and individual insurance contracts or certificates, coverage for health services provided by a speech-language pathologist or audiologist licensed pursuant to Title 37, chapter 15, or an addiction counselor licensed under Title…

Mont. Code Ann. § 33-30-102 Application Of Chapter -- Construction Of Other Related Laws

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(1) All health service corporations are subject to the provisions of this chapter. In addition to the provisions contained in this chapter, other chapters and provisions of this title apply to health service corporations as follows: 33-2-714; 33-2-1212; 33-3-307; 33-3-308; 33-3-4…

Mont. Code Ann. § 33-30-1020 Coverage For Services Provided Under Freedom Of Choice For Mental Health Services

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A health service corporation shall provide, in group and individual insurance contracts, coverage for health services provided by marriage and family therapists licensed under Title 37, chapter 39, if the health care services that marriage and family therapists are licensed to pe…

Mont. Code Ann. § 33-30-1021 Applicability

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Notwithstanding any provision of Title 33 or other law to the contrary, it shall be lawful for an insurer and insured to agree to any terms in an insurance contract that provides more favorable terms for the benefit of the insured than authorized in Title 33 or other provisions o…

Mont. Code Ann. § 33-30-103 Purposes Of Health Service Corporation

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A health service corporation may be organized for the purposes of: (1) (a) establishing and operating a voluntary, nonprofit plan or plans under which health services, or reimbursement therefor, are furnished to persons who become members or beneficiaries; or (b) acting as agent …

Mont. Code Ann. § 33-30-104 No Profit Organization May Be A Health Service Corporation

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No group, association, or organization created for or engaged in business or activity for profit, provision for the incorporation of which is made by any of the corporation laws of this state, may be organized or operated, directly or indirectly, as a health service corporation u…

Mont. Code Ann. § 33-30-105 Examination Of Health Service Corporation

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(1) If the commissioner believes a health service corporation is unable or potentially unable to fulfill its contractual obligations to its members, the commissioner may conduct an examination of that corporation. (2) In addition to the examination authorized in subsection (1), a…

Mont. Code Ann. § 33-30-106 Montana Administrative Procedure Act Applicable

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All final administrative actions or decisions of the commissioner under this chapter are subject to judicial review under and in accordance with the Montana Administrative Procedure Act.

Mont. Code Ann. § 33-30-107 Annual Statement

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(1) On or before March 1 of each year, each health service corporation shall file an annual statement for the preceding year on the national association of insurance commissioners' health blank form with the commissioner of insurance. This annual statement must be completed in ac…

Mont. Code Ann. § 33-30-108 Certificate Required

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(1) A person may not act as a health service corporation and a health service corporation may not conduct business in this state except as authorized by a certificate of authority issued by the commissioner. (2) The commissioner may issue a certificate of authority after the pers…

Mont. Code Ann. § 33-30-109 Health Service Corporation Amended Articles

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A health service corporation shall submit a copy of any articles of amendment to the commissioner within 5 business days after the articles have been filed with the office of the secretary of state.

Mont. Code Ann. § 33-30-1101 Subrogation Rights

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A hospital or medical service plan contract issued by a health service corporation may contain a provision providing that, to the extent necessary for reimbursement of benefits paid to or on behalf of the insured, the health service corporation is entitled to subrogation, as prov…

Mont. Code Ann. § 33-30-1102 Notice -- Shared Costs Of Third-Party Action -- Limitation

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(1) If an insured intends to institute an action for damages against a third party, the insured shall give the health service corporation reasonable notice of the intention to institute the action. (2) The insured may request that the health service corporation pay a proportionat…

Mont. Code Ann. § 33-30-111 Notice Of Violation -- Conference

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If the commissioner shall for any reason have cause to believe that violation of this chapter has occurred or is threatened, the commissioner may give written notice to the health service corporation and to the representatives or other persons who appear to be involved in the sus…

Mont. Code Ann. § 33-30-112 Cease And Desist Order

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(1) The commissioner acting in the name of the state may issue an order directing a health service corporation or a representative of a health service corporation to cease and desist from engaging in any act or practice in violation of the provisions of this chapter. (2) Within 1…

Mont. Code Ann. § 33-30-113 Injunctive Relief

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In the case of any violation of the provisions of this chapter if the commissioner elects not to issue a cease and desist order or in the event of noncompliance with a cease and desist order issued under this chapter, the commissioner may institute a proceeding to obtain injuncti…

Mont. Code Ann. § 33-30-201 Reserves -- Requirements Suspended

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(1) The corporation shall maintain at all times unobligated funds adequate to: (a) provide the hospital, medical-surgical, and other health services made available to its members and beneficiaries; and (b) meet all costs and expenses. (2) In addition, reserves of a health service…

Mont. Code Ann. § 33-30-202 Annual Report By Certified Public Accountant

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(1) All corporations subject to the provisions of this chapter shall file annually with the commissioner, on or before June 1, a financial statement audited by a certified public accountant pursuant to rules promulgated by the commissioner. (2) (a) The commissioner may establish …

Mont. Code Ann. § 33-30-203 Premium Tax Exemption

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A health service corporation is exempt from all premium taxes.

Mont. Code Ann. § 33-30-204 Fees

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(1) Every health service corporation subject to the provisions of this chapter shall pay the following fees to the commissioner for enforcement of the provisions of this chapter: (a) for a certified copy of any document or other paper filed in the office of the commissioner, per …

Mont. Code Ann. § 33-30-301 Forms -- Filing, Approval

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A copy of all forms of the membership contract or any type of endorsement or rider shall be filed with and approved by the commissioner of this state and the insurance regulator of the state of domicile of the health service corporation in accordance with chapter 1, part 5.

Mont. Code Ann. § 33-30-302 Allowed Contracts

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(1) A corporation subject to the provisions of this chapter may enter into contracts for the rendering of health services on behalf of its members or beneficiaries with: (a) hospitals maintained by a governmental body or agency; (b) hospitals maintained by a nonprofit corporation…

Mont. Code Ann. § 33-30-303 Grievance Procedure For Members

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Any individual member of a corporation, subject to the provisions of this chapter, who believes that the member is aggrieved by any act or omission of the corporation or its officers, directors, or employees may file a statement in writing of the grievance in the office of the co…

Mont. Code Ann. § 33-30-304 Nonliability For Injuries Caused By Contractees

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A health service corporation is not liable for injuries resulting from neglect, misfeasance, malfeasance, or malpractice on the part of any person, organization, agency, or corporation rendering health services to the health service corporation's members and beneficiaries.

Mont. Code Ann. § 33-30-305 Prohibited Trade Practices

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In order to regulate trade practices of health service corporations the following practices are prohibited: (1) No person may make, issue, circulate, or cause to be made, issued, or circulated any estimate, circular, or statement misrepresenting: (a) the terms of any health servi…

Mont. Code Ann. § 33-30-306 Discrimination Between Individuals -- Restrictions -- Ratesetting By Commissioner Prohibited

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(1) No person may knowingly make or permit any unreasonable discrimination between individuals in any classification which may be established by a health service corporation and of essentially the same condition of health in the amount of dues or rates charged for any membership …

Mont. Code Ann. § 33-30-311 Insurance Producer

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A person who, for compensation, solicits membership in a prepayment health service plan offered by a corporation subject to the provisions of this chapter is an insurance producer of that corporation and is subject to the provisions of 33-2-708 and Title 33, chapter 17.