Title 58 — INSURANCE

The small employer carrier shall provide notice to employees regarding the coverage required by §§ 58-18B-50 and 58-18B-51 in accordance with rules adopted by the director of the Division of Insurance pursuant to chapter 1-26 . The notice shall be in writing and prominently posit…

Every small employer health benefit plan that is delivered, issued for delivery, or renewed in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall provide, in writing, coverage for the treatment and diagnosis of bio…

The provisions of § 58-18B-53 do not apply to any plan, policy, or contract that provides coverage only for: (1) Specified disease; (2) Hospital indemnity; (3) Fixed indemnity; (4) Accident - only; (5) Credit; (6) Dental; (7) Vision; (8) Prescription drug; (9) Medicare supplement…

Any policy or certificate of specified disease, short - term hospital - surgical care of six months or less duration, hospital confinement indemnity, limited benefit health insurance, or other policy or certificate that provide benefits less than that of a major medical plan that…

Every small employer health benefit plan delivered, issued for delivery, or renewed in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall provide, in writing, coverage for equipment, supplies, and self - management…

The provisions of § 58-18B-56 do not apply to any plan, policy, or contract that provides coverage only for: (1) Specified disease; (2) Hospital indemnity; (3) Fixed indemnity; (4) Accident - only; (5) Credit; (6) Dental; (7) Vision; (8) Prescription drug; (9) Medicare supplement…

Every health benefit plan of a small employer carrier that covers a male and that is delivered, issued for delivery, or renewed in this state shall provide the following coverage for diagnostic screening for prostate cancer: (1) An annual medically recognized diagnostic examinati…

Each small employer carrier shall make reasonable disclosure in solicitation and sales materials provided to small employers of the following: (1) The extent to which premium rates for a specific small employer are established or adjusted due to the claim experience, health statu…

Any qualified health plan issued on or after January 1, 2015, that offers coverage for professional audiology services shall include coverage for medically necessary physician services appropriate for the treatment of hearing impairment to a person under the age of nineteen. This…

Each small employer carrier shall maintain at the carrier's principal place of business a complete and detailed description of the carrier's rating practices and renewal underwriting practices, including information and documentation which demonstrate that the carrier's rating me…

The director may suspend all or any part of the premium rate requirements of § 58-18B-3 applicable to one or more small employers for one or more rating periods upon a filing by the small employer carrier and a finding by the director that either the suspension is reasonable in l…

The provisions of this chapter apply to each health benefit plan for a small employer that is delivered, issued for delivery, renewed or continued in this state after July 1, 1992. The date a plan is continued is the first rating period which commences after July 1, 1992. Source:…

Every policy of group health insurance providing benefits for hospital or medical expenses delivered or issued for delivery in this state, by a commercial health insurance company, by a nonprofit medical and surgical service plan corporation, by a nonprofit hospital service plan …

58-18C-11 Enforceability of chapter under Employee Retirement Income Security Act.

Nothing in this chapter is enforceable to the extent such enforcement violates the Employee Retirement Income Security Act. Source: SL 1998, ch 294 , § 11.

58-18C-3 Eligibility requirements. 58-18C-4 Notice of termination required. 58-18C-5 Exercising continuation rights--Option to decrease benefits. 58-18C-6

Continuation is only available to an employee who has been continuously insured under the group policy or under any creditable coverage which it replaced during the entire six-month period ending with such termination. Source: SL 1998, ch 294 , § 3; SL 2005, ch 270 , § 2; SL 2008…

Written notice of termination of group coverage shall be provided by the employer to each employee having coverage within ten days of termination. The notice shall contain such information as required by the director. Source: SL 1998, ch 294 , § 4.

Any employee may exercise the right to continuation within thirty days of receipt of due notice of termination of coverage of the group and upon payment of premiums from the date of termination. Any insurer providing continuation coverage pursuant to § 58-18C-1 shall offer to all…

58-18C-7 Continuation policy not required in certain circumstances. 58-18C-8 Premiums for continuation policies. 58-18C-9 Notification of continuation rights. 58-18C-10

No insurer may be required to offer or renew a continuation policy covering any person if: (1) The person is covered for similar benefits by another individual or group policy; (2) Similar benefits are provided for or available to such person, by reason of any state or federal la…

The premium for a continuation policy may not be greater than one hundred twenty-five percent of the group rate under which a person is covered. Source: SL 1998, ch 294 , § 8; SL 2005, ch 270 , § 5.

A notification of the continuation rights shall be included in each certificate of coverage. Source: SL 1998, ch 294 , § 9; SL 2005, ch 270 , § 6. 58-18C-10. Repealed by SL 2005, ch 270 , § 9.

The purpose of this chapter is to promote the public welfare by regulating credit life insurance, credit health insurance, credit unemployment insurance, and credit property including group personal property coverages authorized through credit cards. Nothing in this chapter is in…

Where evidence of insurability is required and such evidence is furnished more than thirty days after the date when the debtor becomes obligated to the creditor, the term of credit life insurance or credit health insurance may commence on the date on which the insurance company d…

The term of credit life insurance or credit health insurance shall not extend more than fifteen days beyond the scheduled maturity date of the indebtedness except when extended without additional cost to the debtor. If the indebtedness is discharged due to renewal or refinancing …

Any insurer may revise its schedules of premium rates from time to time, and shall file such revised schedules with the director. Source: SL 1966, ch 111 , ch 27, § 8 (1).

No insurer shall issue any credit life insurance policy or credit health insurance policy for which the premium rate exceeds that determined by the schedules of such insurer as then on file with the director. Violation of this section is a Class 2 misdemeanor. Source: SL 1966, ch…

The amount charged to a debtor for any credit life or credit health insurance shall not exceed the premiums charged by the insurer, as computed at the time the charge to the debtor is determined. Violation of this section is a Class 2 misdemeanor. Source: SL 1966, ch 111 , ch 27,…

Each individual policy, or group certificate shall provide that in the event of termination of the insurance prior to the scheduled maturity date of the indebtedness, any refund of an amount paid by the debtor for insurance shall be paid or credited promptly to the person entitle…

If a creditor requires a debtor to make any payment for credit life insurance or credit health insurance and an individual policy or group certificate of insurance is not issued, the creditor shall immediately give written notice to such debtor and shall promptly make an appropri…

All policies of credit life insurance and credit health insurance shall be delivered or issued for delivery in this state only by an insurer authorized to do an insurance business therein, and shall be issued only through holders of licenses or authorizations issued by the direct…

All credit life insurance and credit health insurance sold shall be evidenced by an individual policy, or in the case of group insurance by a certificate of insurance, which individual policy, or group certificate of insurance shall be delivered to the debtor. Source: SL 1966, ch…

Each individual policy or group certificate of credit life insurance, or credit health insurance shall, in addition to other requirements of law, set forth the name and home office address of the insurer, the name or names of the debtor or in the case of a certificate under a gro…

Terms used in this chapter mean: (1) "Credit health insurance," insurance on a debtor to provide indemnity for payments becoming due on a specific loan, lease, or other credit transaction while the debtor is disabled as defined in the policy; (2) "Credit life insurance," insuranc…

Each individual policy or group certificate of credit life insurance or credit health insurance shall be delivered to the insured debtor at the time the indebtedness is incurred except as provided in §§ 58-19-21 to 58-19-23 , inclusive. Source: SL 1966, ch 111 , ch 27, § 6 (3).

If said individual policy or group certificate of insurance is not delivered to the debtor at the time the indebtedness is incurred, a copy of the application for such policy or a notice of proposed insurance, signed by the debtor and setting forth the name and home office addres…

Upon acceptance of the insurance by the insurer and within thirty days of the date upon which the indebtedness is incurred, the insurer shall cause the individual policy or group certificate of insurance to be delivered to the debtor. Source: SL 1966, ch 111 , ch 27, § 6 (4).

If the named insurer does not accept the risk, then and in such event the debtor shall receive a policy or certificate of insurance setting forth the name and home office address of the substituted insurer and the amount of the premium to be charged, and if the amount of premium …

All policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements, and riders delivered or issued for delivery in this state and the schedules of premium rates pertaining thereto shall be filed with the director. Source: SL 1966, ch …

If a group policy of credit life insurance or credit health insurance has been delivered in this state before July 1, 1966, or has been or is delivered in another state before or after said date, the insurer shall be required to file only the group certificate and notice of propo…

The director shall within thirty days after the filing of any such policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements, and riders, disapprove any such form if the premium rates charged or to be charged are excessive in rel…

If the director notifies the insurer that the form is disapproved, it is unlawful thereafter for such insurer to issue or use such form. In such notice, the director shall specify the reason for his disapproval and state that a hearing will be granted within twenty days after req…

The director may, at any time after a hearing held not less than twenty days after written notice to the insurer, withdraw his approval of any such form on any ground set forth in §

It is not lawful for the insurer to issue such forms or use them after the effective date of such withdrawal. Source: SL 1966, ch 111 , ch 27, § 7 (5).

All life insurance and all health insurance in connection with loans or other credit transactions shall be subject to the provisions of this chapter, except such insurance in connection with a loan or other credit transaction of more than ten years' duration; nor shall insurance …

Any order or final determination of the director under the provisions of §§ 58-19-24 to 58-19-29 , inclusive, shall be subject to judicial review. Source: SL 1966, ch 111 , ch 27, § 7 (7).

All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All claims shall be settled as soon as possible and in accordance with the terms of the insurance contract. Source: SL 1966, ch 111 , …

No plan or arrangement shall be used whereby any person, firm or corporation other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in adjusting cla…

All claims shall be paid either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of such claimant to one specified. Source: SL 1966, ch 111 , ch 27, § 1…