Ind. Code § 27-1-43.2-5 — Indiana Code / Title 27 / Article 1 / Chapter 43.2 / Section 27-1-43.2-5
"Provider"
Status: in_force

Sec. 5. (a) As used in this chapter, "provider" means a person who is contractually obligated to a holder under a service contract.

(b) A merchant or other seller of a service contract is not a "provider" for the purposes of this chapter by virtue of acting as the seller of the service contract.

As added by P.L.129-2014, SEC.10. Amended by P.L.196-2021, SEC.32.
Ind. Code § 27-1-24.5-11 — Indiana Code / Title 27 / Article 1 / Chapter 24.5 / Section 27-1-24.5-11
"Pharmacy"
Status: in_force

Sec. 11. As used in this chapter, "pharmacy" means the physical location:

(1) that is licensed under IC 25-26; and

(2) at which drugs, chemicals, medicines, prescriptions, and poisons are compounded, dispensed, or sold at retail.

As added by P.L.68-2020, SEC.1.
Ind. Code § 27-7-2-30 — Indiana Code / Title 27 / Article 7 / Chapter 2 / Section 27-7-2-30
Rules; adoption
Status: in_force

Sec. 30. The bureau shall, by July 31, 1935, make and adopt such rules as may be necessary to carry out the provisions of this chapter, subject to the approval of the insurance commissioner.

Formerly: Acts 1935, c.323, s.30. As amended by P.L.252-1985, SEC.239.
Ind. Code § 27-17-2-3 — Indiana Code / Title 27 / Article 17 / Chapter 2 / Section 27-17-2-3
Registration; fees; duration; renewal
Status: in_force

Sec. 3. (a) The fee for issuance of a registration under this chapter is five hundred dollars ($500).

(b) A registration issued or renewed under this chapter expires annually on the last day of the month of issuance or renewal.

(c) The fee for renewal of a registration under this chapter is two hundred fifty dollars ($250).

(d) The department shall renew a registration issued under this chapter if:

(1) the fee specified under subsection (c) is paid; and

(2) the commissioner is satisfied that the discount medical card program organization is in compliance with this article.

(e) Fees collected under this section must be deposited in the department of insurance fund established by IC 27-1-3-28.

As added by P.L.73-2006, SEC.3. Amended by P.L.146-2015, SEC.37.
Ind. Code § 27-2-29-7 — Indiana Code / Title 27 / Article 2 / Chapter 29 / Section 27-2-29-7
Written notice of approaching Medicare eligibility
Status: in_force

Sec. 7. (a) An insurer or health maintenance organization that provides coverage under a Marketplace plan shall provide to each individual covered under the Marketplace plan, not earlier than six (6) months and not later than two (2) months before the birthday on which the individual will become sixty-five (65) years of age, a written notice that includes the following:

(1) A statement that the individual may be eligible to enroll in Medicare during the individual's initial enrollment period, which begins three (3) months before the individual becomes sixty-five (65) years of age. The department of insurance shall provide language for the statement required by this subdivision in a bulletin issued under subsection (c).

(2) Detailed instructions that the individual may follow to cancel the individual's Marketplace plan before the individual becomes covered under Medicare, so that there is no overlap between the individual's Marketplace plan coverage and the individual's Medicare coverage.

(b) A written notice described in subsection (a) shall be sent:

(1) by first class mail in the form of a letter addressed to the individual at the address of the individual's residence; or

(2) by electronic notification.

(c) The department of insurance:

(1) shall issue an initial bulletin setting forth language for the statement required by subsection (a)(1); and

(2) whenever the department of insurance revises the language described in subdivision (1), shall issue a bulletin setting forth the revised language.

As added by P.L.226-2023, SEC.21.
Ind. Code § 27-8-13-9.3 — Indiana Code / Title 27 / Article 8 / Chapter 13 / Section 27-8-13-9.3
Prohibition on denying, conditioning, or discriminating in the pricing of Medicare supplement policies for certain applicants
Status: in_force

Sec. 9.3. (a) Except as provided in subsection (b), this section applies to a Medicare supplement policy or certificate delivered, issued, or renewed on or after January 1, 2026.

(b) The amendments made to this section in the 2026 session of the general assembly apply to a Medicare supplement policy or certificate delivered, issued, or renewed on or after March 15, 2026.

(c) This section applies to:

(1) an applicant who submits an application for a Medicare supplement policy or certificate before or during the six (6) month period beginning on the first day of the first month during which the applicant is:

(A) at least sixty-five (65) years of age; and

(B) timely enrolled for benefits under Medicare Part B without penalty under federal law; and

(2) an applicant who:

(A) is at least sixty-five (65) years of age;

(B) is insured under a Medicare supplement policy or certificate;

(C) submits an application for a Medicare supplement policy or certificate:

(i) to an issuer that is different than the issuer of the applicant's current Medicare supplement policy or certificate; and

(ii) during the period beginning one (1) month before the applicant's birthday and ending one (1) month after the applicant's birthday; and

(D) seeks to maintain the same type of lettered Medicare supplement plan, including any variation of the lettered plan.

(d) An issuer of a Medicare supplement policy or certificate shall not deny, condition the issuance or effectiveness of, or discriminate in the pricing of a Medicare supplement policy or certificate because of the health status, claims experience, receipt of health care, or medical condition of an applicant to which subsection (c) applies.

(e) A new Medicare supplement policy or certificate issued to an applicant under subsection (c)(2) must go into effect on the first day of the next month after the signature date on the application for the Medicare supplement policy or certificate.

As added by P.L.56-2025, SEC.1. Amended by P.L.86-2026, SEC.27.
Ind. Code § 27-8-24.3-6 — Indiana Code / Title 27 / Article 8 / Chapter 24.3 / Section 27-8-24.3-6
Prohibited acts by insurer
Status: in_force

Sec. 6. Except as provided in sections 7 and 8 of this chapter, an insurer may not do any of the following:

(1) Deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on an individual under an insurance policy or a health plan because the individual:

(A) has been, is, or has the potential to be a victim of abuse; or

(B) seeks, has sought, or should have sought protection from abuse, shelter from abuse, or medical or psychological treatment for abuse.

(2) Add any surcharge or rating factor to a premium of an insurance policy or a health plan because an individual:

(A) has a history of being;

(B) is; or

(C) has the potential to be;

a victim of abuse.

(3) Exclude or limit coverage for losses or deny a claim incurred by a person covered by an insurance policy or a health plan as a result of abuse or the potential for abuse.

(4) Designate that if an individual:

(A) has a history of being a victim of abuse; or

(B) is a victim of abuse;

the abuse is a preexisting condition that causes coverage to be denied for a specified period.

(5) Ask an individual covered by or applying for an insurance policy or a health plan if the individual:

(A) is, has been, or may be a victim of abuse; or

(B) seeks, has sought, or should have sought protection from abuse, shelter from abuse, or medical or psychological treatment for abuse.

As added by P.L.188-1996, SEC.2.
Ind. Code § 27-1-43.2-14 — Indiana Code / Title 27 / Article 1 / Chapter 43.2 / Section 27-1-43.2-14
Application of chapter provisions
Status: in_force

Sec. 14. Sections 11, 12(4), and 13 of this chapter do not apply to a warranty, service contract, or other agreement:

(1) that is offered or sold by a motor vehicle dealer in connection with a motor vehicle sold by the motor vehicle dealer; and

(2) under which the motor vehicle dealer, motor vehicle manufacturer, or affiliate of the dealer or manufacturer is obligated to perform.

As added by P.L.129-2014, SEC.10.
Ind. Code § 27-4-5-8 — Indiana Code / Title 27 / Article 4 / Chapter 5 / Section 27-4-5-8
Short title
Status: in_force

Sec. 8. This chapter may be cited as the Uniform Unauthorized Insurers Act.

Formerly: Acts 1969, c.194, s.8. As amended by P.L.252-1985, SEC.169.
Ind. Code § 27-1-2.2-9 — Indiana Code / Title 27 / Article 1 / Chapter 2.2 / Section 27-1-2.2-9
Membership requirement
Status: in_force

Sec. 9. An individual may not apply for health coverage provided under this chapter until the individual has been a member of the nonprofit agricultural organization offering the health coverage for at least thirty (30) days.

As added by P.L.136-2020, SEC.1.
Ind. Code § 27-10-1-0.3 — Indiana Code / Title 27 / Article 10 / Chapter 1 / Section 27-10-1-0.3
Validity of licenses issued before September 1, 1985; renewal
Status: in_force

Sec. 0.3. Licenses issued before September 1, 1985, under IC 35-4-5 (before its repeal) remain valid and may be renewed under this article, subject to this article.

As added by P.L.220-2011, SEC.455.
Ind. Code § 27-13-10.1-11 — Indiana Code / Title 27 / Article 13 / Chapter 10.1 / Section 27-13-10.1-11
Medicare review
Status: in_force

Sec. 11. If an enrollee has the right to an external review under Medicare (42 U.S.C. 1395 et seq.) the enrollee may not request an external review under this chapter.

As added by P.L.133-1999, SEC.7.
Ind. Code § 27-1-35-11 — Indiana Code / Title 27 / Article 1 / Chapter 35 / Section 27-1-35-11
Written contract requirement
Status: in_force

Sec. 11. A controlled insurer shall not accept business from a controlling producer and a controlling producer shall not place business with a controlled insurer unless there is a written contract between the controlling producer and the controlled insurer specifying the responsibilities of each party, which contract has been approved by the board of directors of the controlled insurer and contains the following minimum provisions:

(1) The controlled insurer may terminate the contract for cause, upon written notice to the controlling producer. The controlled insurer shall suspend the authority of the controlling producer to write business during the pendency of any dispute regarding the cause for the termination.

(2) The controlling producer shall render accounts to the controlled insurer detailing all material transactions, including information necessary to support all commissions, charges, and other fees received by or owing to the controlling producer.

(3) The controlling producer shall remit all funds due under the terms of the contract to the controlled insurer on at least a monthly basis. The due date shall be fixed so that premiums or installments of premiums collected shall be remitted not later than ninety (90) days after the effective date of any policy placed with the controlled insurer under this contract.

(4) All funds collected for the controlled insurer's account shall be held by the controlling producer in a fiduciary capacity, in one (1) or more appropriately identified bank accounts in banks that are members of the Federal Reserve System, in accordance with the provisions of the insurance law as applicable. However, funds of a controlling producer not required to be licensed in Indiana shall be maintained in compliance with the requirements of the controlling producer's domiciliary jurisdiction.

(5) The controlling producer shall maintain separately identifiable records of business written for the controlled insurer.

(6) The contract shall not be assigned in whole or in part by the controlling producer.

(7) The controlled insurer shall provide the controlling producer with the controlled insurer's underwriting standards, rules, and procedures, manuals setting forth the rates to be charged, and the conditions for the acceptance or rejection of risks. The controlling producer shall adhere to the standards, rules, procedures, rates, and conditions. The standards, rules, procedures, rates, and conditions shall be the same as those applicable to comparable business placed with the controlled insurer by a producer other than the controlling producer.

(8) The rates and terms of the controlling producer's commissions, charges, or other fees, and the purposes for those charges or fees. The rates of the commissions, charges, and other fees shall be no greater than those applicable to comparable business placed with the controlled insurer by producers other than controlling producers. For purposes of this subdivision and subdivision (7), examples of "comparable business" include the same lines of insurance, same kinds of insurance, same kinds of risks, similar policy limits, and similar quality of business.

(9) If the contract provides that the controlling producer, on insurance business placed with the insurer, is to be compensated contingent upon the insurer's profits on that business, then such compensation shall not be determined and paid until at least five (5) years after the premiums on liability insurance are earned and at least one (1) year after the premiums are earned on any other insurance. The commissions may not be paid until the adequacy of the controlled insurer's reserves on remaining claims has been independently verified under section 13 of this chapter.

(10) A limit on the controlling producer's writings in relation to the controlled insurer's surplus and total writings. The insurer may establish a different limit for each line or sub-line of business. The controlled insurer shall notify the controlling producer when the applicable limit is approached and shall not accept business from the controlling producer if the limit is reached. The controlling producer shall not place business with the controlled insurer if the controlling producer has been notified by the controlled insurer that the limit has been reached.

(11) The controlling producer may negotiate but shall not bind reinsurance on behalf of the controlled insurer on business the controlling producer places with the controlled insurer, except that the controlling producer may bind facultative reinsurance contracts under obligatory facultative agreements if the contract with the controlled insurer contains underwriting guidelines, including for both reinsurance assumed and ceded a list of reinsurers with which such automatic agreements are in effect, the coverages and amounts or percentages that may be reinsured, and commission schedules.

As added by P.L.130-1994, SEC.36 and P.L.116-1994, SEC.47.
Ind. Code § 27-1-29-5 — Indiana Code / Title 27 / Article 1 / Chapter 29 / Section 27-1-29-5
Creation; purpose; membership; appointment; term; qualifications; vacancies; per diem and expenses; tax exempt property of commission
Status: in_force

Sec. 5. (a) The Indiana political subdivision risk management commission is created as a separate body corporate and politic, constituting an instrumentality of the state for the public purposes set out in this chapter, but not a state agency. The commission is separate from the state in its corporate and sovereign capacity. The purpose of the commission is aiding political subdivisions in protecting themselves against liabilities. The commission is not subject to IC 27-6-8, and the Indiana guaranty association created by IC 27-6-8-5 has no obligation to insureds or claimants of the commission.

(b) The commission consists of the insurance commissioner, who shall serve as chairman, and nine (9) other commission members. Except for the insurance commissioner, the members of the commission shall be appointed by the governor for a term of four (4) years. No more than five (5) commission members appointed by the governor under this section may be members of the same political party. The commission members appointed by the governor under this section must include one (1) resident of each congressional district in Indiana. The commission shall elect one (1) of the appointed commission members as secretary of the commission.

(c) A commission member may be reappointed to the commission.

(d) In appointing commission members under this section, the governor shall consider the qualifications, expertise, and background that would provide the proper talent to administer this chapter. To the degree possible, the members must have backgrounds in educational administration, risk management, and governance of a political subdivision and must include persons with knowledge of insurance matters.

(e) A vacancy occurring on the commission shall be filled through the appointment of a resident of the same congressional district as the vacating commission member for the unexpired term of the commission member leaving the commission.

(f) Each member of the commission who is not a state employee is entitled to the minimum salary per diem provided by IC 4-10-11-2.1(b). Such a commission member is also entitled to reimbursement for traveling expenses and other expenses actually incurred in connection with the member's duties, as provided in the state travel policies and procedures established by the department of administration and approved by the state budget agency.

(g) Each member of the commission who is a state employee is entitled to reimbursement for traveling expenses and other expenses actually incurred in connection with the commission member's duties, as provided in the state travel policies and procedures established by the department of administration and approved by the state budget agency.

(h) All property of the commission is public property devoted to an essential public and governmental function and purpose and is exempt from all taxes and special assessments of the state or a political subdivision of the state.

(i) The term of a member of the commission expires upon the expiration of this chapter under section 29 of this chapter.

As added by P.L.162-1986, SEC.1. Amended by P.L.272-1987, SEC.1; P.L.53-2014, SEC.141; P.L.46-2023, SEC.1.
Ind. Code § 27-7-2-16 — Indiana Code / Title 27 / Article 7 / Chapter 2 / Section 27-7-2-16
Repealed
Status: repealed

Formerly: Acts 1935, c.323, s.16. Repealed by P.L.249-1989, SEC.19.
Ind. Code § 27-1-47.5-6 — Indiana Code / Title 27 / Article 1 / Chapter 47.5 / Section 27-1-47.5-6
Reporting requirements; records
Status: in_force

Sec. 6. (a) Before March 1, 2024, and before March 1 of each subsequent year, an Indiana nonprofit hospital system shall submit the following:

(1) Information the department or the department's third party contractor determines is necessary to make the assessments required in this chapter.

(2) Standard charge information required to be made public by the federal Centers for Medicare and Medicaid Services for price transparency for each hospital facility within the Indiana nonprofit hospital system.

(b) Information required under this section shall be submitted to the department in a manner prescribed by the department.

(c) Except as provided in section 8 of this chapter, any records or documents disclosed to, received by, or generated by the department for purposes of this chapter are exempt from the requirements of IC 5-14-3.

As added by P.L.203-2023, SEC.21.
Ind. Code § 27-14.5-2-11 — Indiana Code / Title 27 / Article 14.5 / Chapter 2 / Section 27-14.5-2-11
Required contents of proxy solicitation
Status: in_force

Sec. 11. A person soliciting a proxy from a member shall provide all members with a proxy statement that:

(1) identifies the person soliciting the proxy;

(2) informs the member of the right to vote upon the plan of reorganization and the vote required for approval;

(3) briefly describes the proposed plan of reorganization and any voting capital stock to be offered;

(4) explains the use of any new capital to be raised; and

(5) describes any employee benefit plan or stock option plan.

As added by P.L.226-2023, SEC.30.
Ind. Code § 27-2-13-2 — Indiana Code / Title 27 / Article 2 / Chapter 13 / Section 27-2-13-2
Release of information by insurer to investigating authorized agency
Status: in_force

Sec. 2. (a) An authorized agency charged with the responsibility of investigating a fire loss may, in writing, request that an insurer investigating that loss release to the requesting agency any or all relevant information or evidence considered important to the authorized agency, including:

(1) pertinent insurance policy information relevant to a fire loss under investigation and any application for that policy;

(2) policy premium payment records;

(3) history of previous claims made by the insured; and

(4) material relating to the investigation of the loss, including:

(A) statements of any person;

(B) proof of loss; and

(C) other evidence relevant to the investigation.

(b) An insurer shall furnish information requested under this section to the requesting authorized agency.

As added by Acts 1979, P.L.253, SEC.1. Amended by P.L.139-1984, SEC.2.
Ind. Code § 27-1-39-3 — Indiana Code / Title 27 / Article 1 / Chapter 39 / Section 27-1-39-3
"Department" defined
Status: in_force

Sec. 3. As used in this chapter, "department" refers to the department of insurance created by IC 27-1-1-1.

As added by P.L.38-2006, SEC.1.
Ind. Code § 27-15-1-12 — Indiana Code / Title 27 / Article 15 / Chapter 1 / Section 27-15-1-12
"Plan of conversion"
Status: in_force

Sec. 12. "Plan of conversion" means the plan of conversion described in either IC 27-15-2-2 or IC 27-15-2-3.

As added by P.L.94-1999, SEC.3.
Ind. Code § 27-1-29-13 — Indiana Code / Title 27 / Article 1 / Chapter 29 / Section 27-1-29-13
Payment of liabilities of members of fund; primary coverage
Status: in_force

Sec. 13. (a) The commission shall pay liabilities of members of the fund in accordance with rules established by the commission.

(b) Payment from the fund for any liability covered under IC 34-13-3 (or IC 34-4-16.5 before its repeal) or for any other liability designated under rules adopted by the commission is primary coverage in relation to the following:

(1) Any insurance policy issued to a member of the fund that, by its terms, provides coverage secondary to coverage provided through membership in the fund.

(2) A fund member's own program of self insurance.

Payment of a liability identified in this subsection must be made within the limits set forth in section 14(b) of this chapter and irrespective of the existence of an insurance policy described in subdivision (1) or of a self insurance program described in subdivision (2).

As added by P.L.162-1986, SEC.1. Amended by P.L.1-1998, SEC.144.
Ind. Code § 27-4-5-5 — Indiana Code / Title 27 / Article 4 / Chapter 5 / Section 27-4-5-5
Prerequisites to pleading; deposit to secure payment of judgment; procuring certificate of authority; motion to quash
Status: in_force

Sec. 5. (a) Before any unauthorized insurer files or causes to be filed in any pleading in any court action, suit, or proceeding or in any notice, order, pleading, or process in such administrative proceeding before the commissioner instituted against such person or insurer, by services made as provided in section 4 of this chapter, such insurer shall either:

(1) deposit with the clerk in which such action, suit, or proceeding is pending, or with the commissioner of insurance in administrative proceedings before the commissioner, cash or securities, or file with such clerk or commissioner a bond with good and sufficient sureties, to be approved by the clerk or commissioner in an amount to be fixed by the court or commissioner sufficient to secure the payment of any final judgment which may be rendered in such action or administrative proceeding; or

(2) procure a certificate of authority to transact the business of insurance in this state.

In considering the application of an insurer for a certificate of authority, for the purposes of this section the commissioner need not assert the provisions of IC 27-1-20-12 against such insurer with respect to its application if he determines that such company would otherwise comply with the requirements for such certificate of authority.

(b) The commissioner of insurance, in any administrative proceeding in which service is made as provided in section 4 of this chapter, may in his discretion order such postponement as may be necessary to afford the defendant reasonable opportunity to comply with the provisions of subsection (a) and to defend such action.

(c) Nothing in subsection (a) shall be construed to prevent an unauthorized insurer from filing a motion to quash a writ or to set aside service thereof made in the manner provided in section 4 of this chapter on the ground that such unauthorized insurer has not done any of the acts enumerated in section 2 of this chapter.

Formerly: Acts 1969, c.194, s.5. As amended by P.L.252-1985, SEC.168.
Ind. Code § 27-11-5-4 — Indiana Code / Title 27 / Article 11 / Chapter 5 / Section 27-11-5-4
Consolidation or merger
Status: in_force

Sec. 4. (a) A domestic society may consolidate or merge with any other society by complying with this section. It shall file with the commissioner:

(1) a certified copy of the written contract containing in full the terms and conditions of the consolidation or merger;

(2) a sworn statement by the president and secretary or corresponding officers of each society showing the financial condition of the society on a date fixed by the commissioner, but not earlier than December 31 next preceding the date of the contract;

(3) a certificate of the officers, verified by their respective oaths, that the consolidation or merger has been approved by a two-thirds (2/3) vote of the supreme governing body of each society, the vote being conducted at a regular or special meeting of each body, or, if the society's laws permit, by mail; and

(4) evidence that, at least sixty (60) days before the action of the supreme governing body of each society, the text of the contract has been furnished to all members of each society either by mail or by publication in full in the official publication of each society.

(b) If the commissioner finds that:

(1) the contract is in conformity with this section;

(2) the financial statements are correct; and

(3) the consolidation or merger is just and equitable to the members of each society;

the commissioner shall approve the contract and issue a certificate to that effect. Upon approval, the contract shall be in full force and effect unless any society that is a party to the contract is incorporated under the laws of any other state or territory. In that event, the consolidation or merger shall not become effective unless and until it has been approved as provided by the laws of the state or territory and a certificate of approval has been filed with the commissioner or, if the laws of the state or territory contain no such provision, then the consolidation or merger shall not become effective unless and until it has been approved by the commissioner of that state or territory and a certificate of approval has been filed with the commissioner of this state.

(c) Upon the consolidation or merger becoming effective, all the rights, franchises, and interests of the consolidated or merged societies in and to every species of property, real, personal, or mixed, and things in action belonging to the consolidated or merged societies shall be vested in the society resulting from or remaining after the consolidation or merger without any other instrument, except that conveyances of real property may be evidenced by proper deeds, and the title to any real estate or interest in any real estate, vested under the laws of this state in any of the societies consolidated or merged, shall not revert or be in any way impaired by reason of the consolidation or merger, but shall vest absolutely in the society resulting from or remaining after the consolidation or merger.

(d) The affidavit of any officer of the society or of anyone authorized by it to mail any notice or document, stating that the notice or document has been duly addressed and mailed, is prima facie evidence that the notice or document has been furnished the addressees.

As added by P.L.262-1985, SEC.1. Amended by P.L.136-2018, SEC.201.
Ind. Code § 27-13-6-3 — Indiana Code / Title 27 / Article 13 / Chapter 6 / Section 27-13-6-3
Quality management program requirements
Status: in_force

Sec. 3. The quality management program required by section 2 of this chapter must include at least the following:

(1) A written statement of the scope and purpose of the health maintenance organization's quality management program, including a written statement of goals and objectives that emphasizes improved health status in evaluating the quality of care rendered to enrollees.

(2) The organizational structure responsible for quality management activities.

(3) Any contractual arrangements, when appropriate, for delegation of quality management activities.

(4) Confidentiality of policies and procedures.

(5) A system of ongoing evaluation activities.

(6) A system of focused evaluation activities.

(7) A system for credentialing providers and performing peer review activities.

(8) Duties and responsibilities of the designated physician responsible for the quality management activities.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-51-13 — Indiana Code / Title 27 / Article 1 / Chapter 51 / Section 27-1-51-13
Adoption of rules
Status: in_force

Sec. 13. The commissioner may adopt rules under IC 4-22-2 to implement this chapter.

As added by P.L.237-2025, SEC.10.
Ind. Code § 27-8-14.7-3 — Indiana Code / Title 27 / Article 8 / Chapter 14.7 / Section 27-8-14.7-3
"Prostate specific antigen test" defined
Status: in_force

Sec. 3. As used in this chapter, "prostate specific antigen test" means a standard blood test performed to determine the level of prostate specific antigen in the blood.

As added by P.L.170-1999, SEC.4.
Ind. Code § 27-8-20-9 — Indiana Code / Title 27 / Article 8 / Chapter 20 / Section 27-8-20-9
Drugs not requiring coverage; drug's use contraindicated; experimental drugs; alteration of laws limiting coverage on drugs not approved by the FDA
Status: in_force

Sec. 9. This chapter does not do any of the following:

(1) Require coverage for any drug when the federal Food and Drug Administration has determined the drug's use to be contraindicated.

(2) Require coverage for an experimental drug not approved for any indication by the federal Food and Drug Administration.

(3) Alter any other law limiting the coverage of drugs that have not been approved by the federal Food and Drug Administration.

As added by P.L.277-1993(ss), SEC.120.
Ind. Code § 27-1-37.5-17 — Indiana Code / Title 27 / Article 1 / Chapter 37.5 / Section 27-1-37.5-17
Peer to peer review; request
Status: in_force

Sec. 17. (a) As used in this section, "necessary information" includes the results of any face-to-face clinical evaluation, second opinion, or other clinical information that is directly applicable to the requested health care service that may be required.

(b) If a utilization review entity makes an adverse determination on a prior authorization request by a covered individual's health care provider, the utilization review entity must offer the covered individual's health care provider the option to request a peer to peer review by a clinical peer concerning the adverse determination.

(c) A covered individual's health care provider may request a peer to peer review by a clinical peer either in writing or electronically.

(d) If a peer to peer review by a clinical peer is requested under this section:

(1) the utilization review entity's clinical peer and the covered individual's health care provider or the health care provider's designee shall make every effort to provide the peer to peer review not later than forty-eight (48) hours (excluding weekends and state and federal legal holidays) after the utilization review entity receives the request by the covered individual's health care provider for a peer to peer review if the utilization review entity has received the necessary information for the peer to peer review; and

(2) the utilization review entity must have the peer to peer review conducted between the clinical peer and the covered individual's health care provider or the provider's designee.

As added by P.L.190-2023, SEC.18. Amended by P.L.144-2025, SEC.27.
Ind. Code § 27-1-9-11 — Indiana Code / Title 27 / Article 1 / Chapter 9 / Section 27-1-9-11
Effect of merger or consolidation
Status: in_force

Sec. 11. When such merger or consolidation has been effected as provided in this chapter, the following apply:

(a) The several corporations parties to the agreement of merger or consolidation shall be a single corporation, which shall be:

(1) in case of a merger, the surviving corporation a party to the agreement of merger into which it has been agreed the other corporations parties to the agreement shall be merged, which surviving corporation shall survive the merger; or

(2) in case of a consolidation, the new corporation into which it has been agreed the corporations parties to the agreement of consolidation shall be consolidated.

(b) The separate existence of all of the corporations parties to the agreement of merger or consolidation, except the surviving corporation in the case of a merger, shall cease.

(c) Such single corporation shall have all of the rights, privileges, immunities, and powers and shall be subject to all of the duties and liabilities of a corporation organized under this article.

(d) Such single corporation shall thereupon and thereafter possess all the rights, privileges, immunities, powers, and franchises of a public as well as of a private nature of each of the corporations so merged or consolidated, and all property, real, personal, and mixed, and all debts due on whatever account, including subscriptions to shares of capital stock, and all other choses in action and all and every other interest, of or belonging to or due to each of the corporations so merged or consolidated shall be taken and deemed to be transferred to and vested in such single corporation without further act or deed, and the title to any real estate, or any interest therein, under the laws of this state vested in any of such corporations shall not revert or be in any way impaired by reason of such merger or consolidation.

(e) Such single corporation shall thenceforth be responsible and liable for all the liabilities and obligations of each of the corporations so merged or consolidated in the same manner and to the same extent as if such single corporation had itself incurred the same or contracted therefor; any claim existing or action or proceeding pending by or against any of such corporations may be prosecuted to judgment as if such merger or consolidation had not taken place, or such single corporation may be substituted in its place. Neither the rights of creditors nor any liens upon the property of any of such corporations shall be impaired by such merger or consolidation, but such liens shall be limited to the property upon which they were liens immediately prior to the time of such merger or consolidation, unless otherwise provided in the agreement of merger or consolidation.

(f) In case of a merger, the articles of incorporation of the surviving corporation shall be supplanted and superseded to the extent, if any, that any provision or provisions of such articles shall be restated in the agreement of merger as provided by section 3 of this chapter, and such articles of incorporation shall be deemed to be thereby and to that extent amended; and in case of a consolidation, the statements set forth in the agreement of consolidation as provided in section 4 of this chapter shall be deemed to be articles of incorporation of the new corporation formed by such consolidation.

Formerly: Acts 1935, c.162, s.125. As amended by P.L.252-1985, SEC.46.
Ind. Code § 27-8-15-20 — Indiana Code / Title 27 / Article 8 / Chapter 15 / Section 27-8-15-20
Renewal cessation; notice
Status: in_force

Sec. 20. (a) A small employer insurer may cease to renew all small employer plans.

(b) The insurer shall provide notice to all affected health insurance plans and to the commissioner at least one (1) year before termination of coverage unless the coverage is placed with another insurer.

As added by P.L.127-1992, SEC.1.
Ind. Code § 27-6-10.1-6 — Indiana Code / Title 27 / Article 6 / Chapter 10.1 / Section 27-6-10.1-6
Applicability of chapter
Status: in_force

Sec. 6. Reinsurance Agreements Affected. This chapter shall apply to all cessions after June 30, 2020, under reinsurance agreements that have an inception, anniversary, or renewal date not less than six (6) months after July 1, 2020.

As added by P.L.130-2020, SEC.12.
Ind. Code § 27-1-24.5-3 — Indiana Code / Title 27 / Article 1 / Chapter 24.5 / Section 27-1-24.5-3
"Equal access and incentives"
Status: in_force

Sec. 3. As used in this chapter, "equal access and incentives" means that a pharmacy benefit manager allows any willing pharmacy provider to participate as part of any of the pharmacy benefit manager's networks as long as the pharmacy provider agrees to the terms and conditions of the relevant contract applicable to any other pharmacy provider within that network.

As added by P.L.68-2020, SEC.1.
Ind. Code § 27-8-5-25 — Indiana Code / Title 27 / Article 8 / Chapter 5 / Section 27-8-5-25
Maternity benefits; replacement of discontinued policy; prohibition on preexisting condition limitation or exclusion of coverage
Status: in_force

Sec. 25. (a) As used in this section, "employer" means an employer who offers health insurance to the employer's employees.

(b) As used in this section, "insurer" means an insurer subject to IC 27.

(c) When an employer that has a group policy issued by an insurer that contains maternity benefits:

(1) discontinues the group health policy provided by the insurer; and

(2) replaces the discontinued policy with coverage through a succeeding insurer;

the succeeding insurer's policy may not contain a preexisting condition limitation for maternity or exclude coverage due to pregnancy for employees or spouses of employees who were covered under the prior policy on the date the prior plan was discontinued.

(d) Subsection (c) only applies if the employer obtains a new group insurance policy within thirty-one (31) days after the discontinuance of an insurance policy.

As added by P.L.116-1994, SEC.60.
Ind. Code § 27-8-35-3 — Indiana Code / Title 27 / Article 8 / Chapter 35 / Section 27-8-35-3
"Insurer"
Status: in_force

Sec. 3. As used in this chapter, "insurer" means an insurance company that issues a policy of accident and sickness insurance. The term includes an administrator that is licensed under IC 27-1-25 and administers a policy of accident and sickness insurance.

As added by P.L.2-2019, SEC.9.
Ind. Code § 27-1-46-6 — Indiana Code / Title 27 / Article 1 / Chapter 46 / Section 27-1-46-6
"Network plan"
Status: in_force

Sec. 6. As used in this chapter, "network plan" means a plan of a health carrier that:

(1) requires a covered individual to receive; or

(2) creates incentives, including financial incentives, for a covered individual to receive;

health care services from one (1) or more providers that are under contract with, managed by, or owned by the health carrier.

As added by P.L.93-2020, SEC.12.
Ind. Code § 27-1-15.6-9 — Indiana Code / Title 27 / Article 1 / Chapter 15.6 / Section 27-1-15.6-9
Prelicensing education; exemptions
Status: in_force

Sec. 9. (a) An individual who applies for an insurance producer license in Indiana and who was previously licensed for the same lines of authority in another state is not required to complete any prelicensing education or examination. However, the exemption provided by this subsection is available only if:

(1) the individual is currently licensed in the other state; or

(2) the application is received within ninety (90) days after the cancellation of the applicant's previous license and:

(A) the other state issues a certification that, at the time of cancellation, the applicant was in good standing in that state; or

(B) the state's records contained in the centralized insurance producer license registry described in section 7 of this chapter indicate that the producer is or was licensed in good standing for the line of authority requested.

(b) If a person is licensed as an insurance producer in another state and moves to Indiana, the person, to be authorized to act as an insurance producer in Indiana, must make application to become a resident licensee under section 6 of this chapter within ninety (90) days after establishing legal residence in Indiana. However, the person is not required to take prelicensing education or examination to obtain a license for any line of authority for which the person held a license in the other state unless the commissioner determines otherwise by rule.

(c) An individual who:

(1) has attained the designation of chartered life underwriter, certified financial planner, chartered financial consultant, or another nationally recognized designation approved by the commissioner; and

(2) applies for an insurance producer license in Indiana requesting qualification under sections:

(A) 7(a)(1);

(B) 7(a)(2); or

(C) 7(a)(5);

of this chapter;

is not required to complete prelicensing education and is required to take only the portion of the examination required under section 5(b) of this chapter that pertains to Indiana laws and rules.

(d) An individual who:

(1) has attained the designation of chartered property and casualty underwriter, certified insurance counselor, accredited advisor in insurance, or another nationally recognized designation approved by the commissioner; and

(2) applies for an insurance producer license in Indiana requesting qualification under sections:

(A) 7(a)(3);

(B) 7(a)(4); or

(C) 7(a)(6);

of this chapter;

is not required to complete prelicensing education and is required to take only the portion of the examination required under section 5(b) of this chapter that pertains to Indiana laws and rules.

(e) An individual who:

(1) has attained a bachelor's degree in insurance; and

(2) applies for an insurance producer license in Indiana requesting qualification under section 7(a)(1) through 7(a)(6) of this chapter;

is not required to complete prelicensing education and is required to take only the part of the examination required under section 5 of this chapter that pertains to Indiana laws and rules.

As added by P.L.132-2001, SEC.3. Amended by P.L.11-2011, SEC.10; P.L.124-2018, SEC.38.
Ind. Code § 27-7-12-7 — Indiana Code / Title 27 / Article 7 / Chapter 12 / Section 27-7-12-7
Prohibited grounds for termination
Status: in_force

Sec. 7. Termination of property insurance coverage by an insurer is prohibited if the termination is based on any of the following:

(1) Upon the race, religion, nationality, ethnic group, age, sex, or marital status of the applicant or named insured.

(2) Solely upon the lawful occupation or profession of the applicant or named insured. However, this subdivision does not apply to an insurer that limits its market to one (1) lawful occupation or profession or to several related lawful occupations or professions.

(3) Upon the age or location of the residence of the applicant or named insured, unless that decision is for a business purpose that is not a mere pretext for a decision based on factors prohibited in this chapter or any other provision of this title.

(4) Upon the fact that another insurer previously declined to insure the applicant or terminated an existing policy in which the applicant was the named insured.

(5) Upon the fact that the applicant or named insured previously obtained insurance coverage through a residual market insurance mechanism.

As added by P.L.203-2001, SEC.10.
Ind. Code § 27-1-3.1-15 — Indiana Code / Title 27 / Article 1 / Chapter 3.1 / Section 27-1-3.1-15
Confidential information; use in court proceedings
Status: in_force

Sec. 15. (a) All working papers, recorded information, documents, and copies thereof produced by, obtained by, or disclosed to the commissioner or any other person in the course of an examination under this chapter (including trade secrets and information obtained from a federal agency, a foreign country, or the National Association of Insurance Commissioners, or under another state law):

(1) are confidential and privileged;

(2) are not subject to public inspection or copying under IC 5-14-3-3;

(3) are not subject to subpoena;

(4) are not subject to discovery or admissible in evidence in a private civil action; and

(5) may not be made public by the commissioner or any other person, except to the extent provided in section 14 of this chapter.

(b) The commissioner may use the materials and information described in subsection (a) in relation to a regulatory or legal action brought as part of the commissioner's duties. Access to the materials and information described in subsection (a) may also be granted to the National Association of Insurance Commissioners. A party receiving materials or information under this subsection must agree in writing prior to receiving the materials or information to provide to it the same confidential treatment as required by this section, unless the prior written consent of the company to which it pertains has been obtained.

(c) A court order requiring a release or production of materials or information described in subsection (a) that is not authorized under this section is null and void unless the commissioner has been served, in accordance with the Indiana Rules of Trial Procedure, with a pleading or motion requesting the court to order release or production of the materials or information.

As added by P.L.26-1991, SEC.5. Amended by P.L.11-2011, SEC.5; P.L.276-2013, SEC.1.
Ind. Code § 27-7-8-1 — Indiana Code / Title 27 / Article 7 / Chapter 8 / Section 27-7-8-1
Definitions
Status: in_force

Sec. 1. Definitions. As used in this chapter:

"Advertising" means any communication to the public the purpose of which is to convey information purporting to describe a legal insurance plan.

"Commissioner" refers to the commissioner of insurance.

"Department" refers to the department of insurance.

"Employee" means an individual employed or permitted to work or perform services for remuneration under a contract of hire, written or oral, by an employer.

"Employer" means a person who hires an employee.

"Group legal insurance" refers to legal insurance issued under a master policy covering the individuals set out in subdivisions (1) and (2) of section 3 of this chapter, applying a rate that is lower than the rate shown in the insurer's manual for individual policies of the same type and class.

"Insurer" means a person who obtains a certificate of authority under IC 27-1-3-20.

"Legal insurance" means insurance against class 2(m) risk of loss as described in IC 27-1-5-1.

"Person" means an individual, partnership, corporation, limited liability company, business trust, or association.

"Solicitation" means any invitation or request to enroll in a legal insurance plan, or attempt to obtain consideration for the coverage of a legal insurance plan, or any other device the purpose of which is to induce an individual to enroll in, or pay consideration for, a legal insurance plan.

As added by Acts 1978, P.L.129, SEC.2. Amended by P.L.8-1993, SEC.427.
Ind. Code § 27-8-14.7-0.1 — Indiana Code / Title 27 / Article 8 / Chapter 14.7 / Section 27-8-14.7-0.1
Application of chapter
Status: in_force

Sec. 0.1. The addition of this chapter by P.L.170-1999 applies to accident and sickness insurance policies that are issued, delivered, or renewed after June 30, 1999.

As added by P.L.220-2011, SEC.446.
Ind. Code § 27-1-12.8-20 — Indiana Code / Title 27 / Article 1 / Chapter 12.8 / Section 27-1-12.8-20
Annual reserve valuation
Status: in_force

Sec. 20. (a) The commissioner shall annually value, or cause to be valued, the reserves for all outstanding life insurance contracts, annuity and pure endowment contracts, accident and sickness insurance contracts, and deposit-type contracts:

(1) of each company; and

(2) issued on or after the operative date of the valuation manual.

In lieu of the valuation of the reserves required of a foreign or alien company, the commissioner may accept a valuation made, or caused to be made, by the insurance supervisory official of another state or jurisdiction if the valuation complies with the minimum standards provided in sections 19 through 40 of this chapter.

(b) Sections 34 and 35 of this chapter apply to all contracts issued on or after the operative date of the valuation manual.

As added by P.L.276-2013, SEC.10.
Ind. Code § 27-10-3-6 — Indiana Code / Title 27 / Article 10 / Chapter 3 / Section 27-10-3-6
Examination; application
Status: in_force

Sec. 6. (a) The applicant for a bail agent's or recovery agent's license shall be required to appear in person and take a written examination prepared by the commissioner testing the applicant's ability and qualifications to be a bail agent or recovery agent.

(b) An applicant is eligible for examination after the date the application is received by the commissioner, if the commissioner is satisfied as to the applicant's fitness to take the examination. Examinations shall be held at times and places designated by the commissioner, and an applicant shall be given notice of a time and place not less than fifteen (15) days prior to taking the examination.

(c) The failure of an applicant to pass an examination may not preclude the applicant from taking subsequent examinations.

As added by P.L.261-1985, SEC.1. Amended by P.L.224-1993, SEC.17; P.L.348-1995, SEC.4.
Ind. Code § 27-13-24-2 — Indiana Code / Title 27 / Article 13 / Chapter 24 / Section 27-13-24-2
Deficient net worth
Status: in_force

Sec. 2. (a) If the commissioner finds that the net worth maintained by a health maintenance organization subject to this article is less than the minimum net worth required by IC 27-13-12, the commissioner shall:

(1) give written notice to the health maintenance organization of the amount of the deficiency; and

(2) require the health maintenance organization to:

(A) file with the commissioner a plan for correction of the deficiency that is acceptable to the commissioner; and

(B) correct the deficiency within a reasonable time, not to exceed sixty (60) days, unless an extension of time, not to exceed an additional sixty (60) days, is granted by the commissioner.

(b) A deficiency described in subsection (a) is an impairment, and the failure of a health maintenance organization to correct the impairment in the time prescribed by the commissioner under subsection (a) is grounds for:

(1) the suspension or revocation of the certificate of authority of the organization; or

(2) placing the health maintenance organization in rehabilitation or liquidation.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-4.1-15 — Indiana Code / Title 27 / Article 1 / Chapter 4.1 / Section 27-1-4.1-15
Rulemaking
Status: in_force

Sec. 15. The commissioner may adopt rules under IC 4-22-2 to implement this chapter.

As added by P.L.146-2015, SEC.19.
Ind. Code § 27-7-9-6 — Indiana Code / Title 27 / Article 7 / Chapter 9 / Section 27-7-9-6
List of counties in which mine subsidence insurance available
Status: in_force

Sec. 6. The department of natural resources shall identify and maintain a list of counties that are:

(1) at least partially within the Illinois Coal Basin; or

(2) underlain by coal-bearing rock formations of the Pennsylvanian system.

The mine subsidence insurance provided under this chapter is available only to cover structures located in counties identified by the department of natural resources under this section.

As added by P.L.164-1986, SEC.1.
Ind. Code § 27-8-31.2-0.1 — Indiana Code / Title 27 / Article 8 / Chapter 31.2 / Section 27-8-31.2-0.1
Application of chapter
Status: in_force

Sec. 0.1. The addition of this chapter by P.L.251-2003 applies to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2003.

As added by P.L.220-2011, SEC.453.
Ind. Code § 27-15-10-2 — Indiana Code / Title 27 / Article 15 / Chapter 10 / Section 27-15-10-2
Limitations on provisions
Status: in_force

Sec. 2. Any dividend preservation provision may be limited to participating individual life insurance policies and participating individual annuity contracts in force or considered to be in force by the plan of conversion on the effective date of the plan of conversion for which the mutual insurer has an experience based dividend scale due, paid, or accrued by action of the board of directors of the converting mutual in the year in which the plan of reorganization is adopted. However:

(1) policies that would be included but for the fact that their recent issuance results in no dividends for an initial period may be included;

(2) policies that are in force as extended term insurance may be included; and

(3) other categories of policies and benefits not described in this subsection may be included or excluded, subject to the approval of the commissioner.

As added by P.L.94-1999, SEC.3.
Ind. Code § 27-1-25-8 — Indiana Code / Title 27 / Article 1 / Chapter 25 / Section 27-1-25-8
Administrator compensation
Status: in_force

Sec. 8. (a) An administrator may not enter into an agreement or understanding with an insurer if the effect of the agreement or understanding is to make the amount of a:

(1) commission;

(2) fee; or

(3) charge;

that is payable to the administrator contingent on savings effected in the adjustment, settlement, and payment of losses covered by the insurer's obligations.

(b) This section does not prevent an administrator from receiving performance based compensation for providing hospital auditing services or other auditing services.

As added by Acts 1980, P.L.168, SEC.2. Amended by P.L.26-1991, SEC.21; P.L.160-2003, SEC.12.
Ind. Code § 27-1-24.5-5 — Indiana Code / Title 27 / Article 1 / Chapter 24.5 / Section 27-1-24.5-5
"Health plan"
Status: in_force

Sec. 5. As used in this chapter, "health plan" means a plan through which coverage is provided for health care services through insurance, prepayment, reimbursement, or otherwise. The term includes the following:

(1) A state employee health plan (as defined in IC 5-10-8-6.7).

(2) A policy of accident and sickness insurance (as defined in IC 27-8-5-1). However, the term does not include the coverages described in IC 27-8-5-2.5(a).

(3) An individual contract (as defined in IC 27-13-1-21) or a group contract (as defined in IC 27-13-1-16) that provides coverage for basic health care services (as defined in IC 27-13-1-4).

(4) Any other plan or program that provides payment, reimbursement, or indemnification to a covered individual for the cost of prescription drugs.

As added by P.L.68-2020, SEC.1. Amended by P.L.207-2021, SEC.52; P.L.237-2025, SEC.3.
Ind. Code § 27-14.5-1-22 — Indiana Code / Title 27 / Article 14.5 / Chapter 1 / Section 27-14.5-1-22
"Participating policy"
Status: in_force

Sec. 22. "Participating policy" means a policy providing for the distribution of policy dividends.

As added by P.L.226-2023, SEC.30.
Ind. Code § 27-1-2.3-8.1 — Indiana Code / Title 27 / Article 1 / Chapter 2.3 / Section 27-1-2.3-8.1
Health plan operator payment to a nonparticipating ambulance service
Status: in_force

Sec. 8.1. A health plan operator shall provide payment to a nonparticipating ambulance service provider for ambulance service provided to a covered individual:

(1) at a rate set or approved, by contract or ordinance, by the county or municipality in which the ambulance service originated;

(2) at the rate of four hundred percent (400%) of the current published rate for ambulance service as established by the Centers for Medicare and Medicaid Services under Title XVIII of the federal Social Security Act (42 U.S.C. 1395 et seq.) for the same ambulance service provided in the same geographic area; or

(3) according to the nonparticipating ambulance service provider's billed charges;

whichever is less.

As added by P.L.163-2024, SEC.10.
Ind. Code § 27-8-5.9-6 — Indiana Code / Title 27 / Article 8 / Chapter 5.9 / Section 27-8-5.9-6
Use of preferred provider plan
Status: in_force

Sec. 6. (a) This section applies to an insurer that issues a short term insurance plan and undertakes a preferred provider plan under IC 27-8-11 to render health care services to covered individuals under the short term insurance plan.

(b) An insurer described in subsection (a) shall ensure that the preferred provider plan meets the following requirements:

(1) The preferred provider plan includes essential community providers in accordance with PPACA.

(2) The preferred provider plan is sufficient in number and types of providers (other than mental health and substance abuse treatment providers) to assure covered individuals' access to all health care services without unreasonable delay.

(3) The preferred provider plan is consistent with the network adequacy requirements that:

(A) apply to qualified health plan issuers under 45 CFR 156.230(a) and 45 CFR 156.230(b); and

(B) are consistent with subdivisions (1) and (2).

As added by P.L.288-2019, SEC.7.
Ind. Code § 27-8-10-11.2 — Indiana Code / Title 27 / Article 8 / Chapter 10 / Section 27-8-10-11.2
Use of diagnostic or procedure codes
Status: in_force

Sec. 11.2. (a) Not more than ninety (90) days after the date of the version specified in IC 27-1-1.5 of a diagnostic or procedure code described in this subsection:

(1) the association shall begin using the version specified in IC 27-1-1.5 of the:

(A) Current Procedural Terminology (CPT);

(B) International Classification of Diseases (ICD);

(C) American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM);

(D) Current Dental Terminology (CDT);

(E) Healthcare Common Procedure Coding System (HCPCS); and

(F) third party administrator (TPA);

codes under which the association pays claims for services provided under an association policy; and

(2) a health care provider shall begin using the version specified in IC 27-1-1.5 of the:

(A) Current Procedural Terminology (CPT);

(B) International Classification of Diseases (ICD);

(C) American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM);

(D) Current Dental Terminology (CDT);

(E) Healthcare Common Procedure Coding System (HCPCS); and

(F) third party administrator (TPA);

codes under which the health care provider submits claims for payment for services provided under an association policy.

(b) If a health care provider provides services that are covered under an association policy:

(1) after the date of the version specified in IC 27-1-1.5 of a diagnostic or procedure code described in subsection (a); and

(2) before the association begins using the version of the diagnostic or procedure code;

the association shall reimburse the health care provider under the version of the diagnostic or procedure code that was specified in IC 27-1-1.5 on the date that the services were provided.

As added by P.L.161-2001, SEC.3. Amended by P.L.66-2002, SEC.15; P.L.124-2018, SEC.78.
Ind. Code § 27-1-48-3 — Indiana Code / Title 27 / Article 1 / Chapter 48 / Section 27-1-48-3
"Health care service"
Status: in_force

Sec. 3. (a) As used in this chapter, "health care service" means a health care related service or product rendered or sold by a health care provider within the scope of the health care provider's license or legal authorization, including hospital, medical, surgical, mental health, and substance abuse services or products.

(b) The term does not include the following:

(1) Dental services.

(2) Vision services.

(3) Long term rehabilitation treatment.

(4) Pharmaceutical services or products.

As added by P.L.190-2023, SEC.24.
Ind. Code § 27-1-37.1-5 — Indiana Code / Title 27 / Article 1 / Chapter 37.1 / Section 27-1-37.1-5
Notice of amendment of contract
Status: in_force

Sec. 5. A person who enters into a health provider contract with a provider shall provide written notice to the provider of any amendment to the health provider contract not less than forty-five (45) days before the proposed effective date of the amendment.

As added by P.L.196-2001, SEC.1.
Ind. Code § 27-10-1-5.5 — Indiana Code / Title 27 / Article 10 / Chapter 1 / Section 27-10-1-5.5
"Delinquent"
Status: in_force

Sec. 5.5. "Delinquent" means at least:

(1) two thousand dollars ($2,000); or

(2) three (3) months;

past due on payment of court ordered child support.

As added by P.L.23-1996, SEC.26.
Ind. Code § 27-2-19-0.1 — Indiana Code / Title 27 / Article 2 / Chapter 19 / Section 27-2-19-0.1
Application of chapter
Status: in_force

Sec. 0.1. The addition of this chapter by P.L.187-1996 applies only to claims made or a cause of action that arises after June 30, 1996.

As added by P.L.220-2011, SEC.428.
Ind. Code § 27-7-12-5 — Indiana Code / Title 27 / Article 7 / Chapter 12 / Section 27-7-12-5
Sufficiency of explanations; coverage considered renewed where notice not given
Status: in_force

Sec. 5. (a) A written explanation provided under section 3 or 4 of this chapter must be of sufficient clarity and specificity to enable a reasonable lay person to identify the basis for the insurer's decision without further inquiry.

(b) If notice is not provided under section 4 of this chapter, coverage is considered to be renewed only for the ensuing policy period upon payment of the appropriate premiums under the same terms and conditions, and subject to section 6 of this chapter, unless the named insured has accepted replacement coverage with another insurer or unless the named insured has agreed to the nonrenewal.

As added by P.L.203-2001, SEC.10.
Ind. Code § 27-1-7-20 — Indiana Code / Title 27 / Article 1 / Chapter 7 / Section 27-1-7-20
Authority of corporations, boards, and associations to insure with mutual insurance company
Status: in_force

Sec. 20. Any public or private corporation, board or association in this state or elsewhere may make applications, enter into agreements for, and hold policies in, any mutual insurance company. Any officer, stockholder, trustee or legal representative of any such company, board, association, or estate may be recognized as acting for or on its behalf for the purposes of such membership, but shall not be personally liable upon such contract of insurance by reason of acting in such representative capacity.

Formerly: Acts 1935, c.162, s.97a.
Ind. Code § 27-8-9-1 — Indiana Code / Title 27 / Article 8 / Chapter 9 / Section 27-8-9-1
Repealed
Status: repealed

As added by Acts 1980, P.L.174, SEC.1. Repealed by P.L.261-1983, SEC.6.
Ind. Code § 27-9-4-9 — Indiana Code / Title 27 / Article 9 / Chapter 4 / Section 27-9-4-9
Proceedings involving reciprocal states, orders of distribution, and priority of claims; special deposit claims; secured claims
Status: in_force

Sec. 9. (a) In a liquidation proceeding in Indiana involving one (1) or more reciprocal states, the order of distribution of the domiciliary state shall control as to all claims of residents of this and reciprocal states. All claims of residents of reciprocal states shall be given equal priority of payment from general assets regardless of where those assets are located.

(b) The owners of special deposit claims against an insurer for which a liquidator is appointed in this or any other state shall be given priority against the special deposits in accordance with the statutes governing the creation and maintenance of the deposits. If there is a deficiency in any deposit, so that the claims secured by it are not fully discharged from it, the claimants may share in the general assets, but the sharing shall be deferred until general creditors, and also claimants against other special deposits who have received smaller percentages from their respective special deposits, have been paid percentages of their claims equal to the percentage paid from the special deposit.

(c) The owner of a secured claim against an insurer for which a liquidator has been appointed in this or any other state may surrender his security and file his claim as a general creditor, or the claim may be discharged by resort to the security in accordance with IC 27-9-3-39, in which case the deficiency, if any, shall be treated as a claim against the general assets of the insurer on the same basis as claims of unsecured creditors.

As added by Acts 1979, P.L.255, SEC.1.
Ind. Code § 27-5.1-2-8 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-8
Application of Indiana insurance laws
Status: in_force

Sec. 8. The following provisions apply to standard companies and extended companies:

(1) IC 27-1-3.

(2) IC 27-1-3.1.

(3) IC 27-1-5-3.

(4) IC 27-1-7-14 through IC 27-1-7-16.

(5) IC 27-1-7-21 through IC 27-1-7-23.

(6) IC 27-1-9.

(7) IC 27-1-10.

(8) IC 27-1-13-3 through IC 27-1-13-4.

(9) IC 27-1-13-6 through IC 27-1-13-9.

(10) IC 27-1-15.6.

(11) IC 27-1-18-2.

(12) IC 27-1-20-1.

(13) IC 27-1-20-4.

(14) IC 27-1-20-6.

(15) IC 27-1-20-9 through IC 27-1-20-11.

(16) IC 27-1-20-14.

(17) IC 27-1-20-19 through IC 27-1-20-21.3.

(18) IC 27-1-20-23.

(19) IC 27-1-20-30.

(20) IC 27-1-20-35.

(21) IC 27-1-22.

(22) IC 27-4-1.

(23) Except as provided in IC 27-6-1.1-6, IC 27-6-1.1-2.

(24) IC 27-6-2.

(25) IC 27-7-2.

(26) IC 27-9.

(27) IC 34-30-17.

As added by P.L.129-2003, SEC.8. Amended by P.L.137-2006, SEC.14 and P.L.162-2006, SEC.47; P.L.81-2012, SEC.21.
Ind. Code § 27-6-1.1-6 — Indiana Code / Title 27 / Article 6 / Chapter 1.1 / Section 27-6-1.1-6
Application of chapter
Status: in_force

Sec. 6. This chapter does not apply to any of the parties to a contract of merger or consolidation under IC 27-5.1-2-21.

As added by P.L.260-1983, SEC.1. Amended by P.L.129-2003, SEC.9.
Ind. Code § 27-11-3-1 — Indiana Code / Title 27 / Article 11 / Chapter 3 / Section 27-11-3-1
Eligibility standards; admission process; rights and privileges of members; social members
Status: in_force

Sec. 1. (a) A society shall specify in its laws or rules:

(1) eligibility standards for each and every class of membership, provided that if benefits are provided on the lives of children, the minimum age for adult membership shall be set at not less than age fifteen (15) and not greater than age twenty-one (21);

(2) the process for admission to each membership class; and

(3) the rights and privileges of each membership class, provided that only benefit members shall have the right to vote on the management of the insurance affairs of the society.

(b) A society may also admit social members who have no voice or vote in the management of the insurance affairs of the society.

(c) Membership rights in the society are personal to the member and are not assignable.

As added by P.L.262-1985, SEC.1.
Ind. Code § 27-1-33-9 — Indiana Code / Title 27 / Article 1 / Chapter 33 / Section 27-1-33-9
Actions of MGA; examinations
Status: in_force

Sec. 9. The acts of the MGA are considered to be the acts of the insurer on whose behalf the MGA is acting. An MGA may be examined as if it were the insurer.

As added by P.L.1-1992, SEC.148.
Ind. Code § 27-1-35-8 — Indiana Code / Title 27 / Article 1 / Chapter 35 / Section 27-1-35-8
"Producer" defined
Status: in_force

Sec. 8. As used in this chapter, "producer" means an insurance broker or brokers or any other person, firm, association, or corporation, when, for any compensation, commission, or other thing of value, the person, firm, association, or corporation acts or aids in any manner in soliciting, negotiating, or procuring the making of any insurance contract on behalf of an insured other than the person, firm, association, or corporation.

As added by P.L.130-1994, SEC.36 and P.L.116-1994, SEC.47.
Ind. Code § 27-1-46-3 — Indiana Code / Title 27 / Article 1 / Chapter 46 / Section 27-1-46-3
"Health carrier"
Status: in_force

Sec. 3. (a) As used in this chapter, "health carrier" means an entity:

(1) that is subject to IC 27 and the administrative rules adopted under IC 27; and

(2) that enters into a contract to:

(A) provide health care services;

(B) deliver health care services;

(C) arrange for health care services; or

(D) pay for or reimburse any of the costs of health care services.

(b) The term includes the following:

(1) An insurer, as defined in IC 27-1-2-3(x), that issues a policy of accident and sickness insurance, as defined in IC 27-8-5-1(a).

(2) A health maintenance organization, as defined in IC 27-13-1-19.

(3) An administrator (as defined in IC 27-1-25-1(a)) that is licensed under IC 27-1-25.

(4) A state employee health plan offered under IC 5-10-8.

(5) A short term insurance plan (as defined by IC 27-8-5.9-3).

(6) Any other entity that provides a plan of health insurance, health benefits, or health care services.

(c) The term does not include:

(1) an insurer that issues a policy of accident and sickness insurance;

(2) a limited service health maintenance organization (as defined in IC 27-13-34-4); or

(3) an administrator;

that only provides coverage for, or processes claims for, dental or vision care services.

As added by P.L.93-2020, SEC.12.
Ind. Code § 27-13-43-1 — Indiana Code / Title 27 / Article 13 / Chapter 43 / Section 27-13-43-1
Application of chapter
Status: in_force

Sec. 1. (a) Except as provided in subsection (b), this chapter applies to a health maintenance organization that provides basic health care services.

(b) This chapter does not apply to the credentialing of a provider by a health maintenance organization if the provider's application for credentialing is only for purposes of providing health care services to the following:

(1) A Medicaid recipient under a Medicaid risk based managed care program described in IC 12-15-12.

(2) An individual who is covered under the children's health insurance program established under IC 12-17.6-2.

As added by P.L.26-2005, SEC.4.
Ind. Code § 27-8-5-11 — Indiana Code / Title 27 / Article 8 / Chapter 5 / Section 27-8-5-11
Franchise plan; accident and sickness insurance; definitions, limitations, requirements, and standards
Status: in_force

Sec. 11. No policy of accident and sickness insurance on a franchise plan shall be delivered or issued for delivery to any person in this state unless it conforms to the definitions, limitations, requirements and standards in this section prescribed:

(A) Qualified Groups.

(1) Two (2) or more employees of any employer, inclusive of any governmental division, department or agency.

(2) Ten (10) or more members of any trade, occupational or professional association or of a labor union, or of any other association or group which has had an active existence for at least two (2) years and which has a constitution or by-laws and was formed in good faith for purposes other than that of obtaining insurance.

(3) Members of the family and dependents of persons eligible under (1) or (2) above may be included in the group with such eligible persons.

(B) Nature of Insurance Coverage. The insurance policies issued to members of a qualified group shall be written on identical individual policy form or forms, varying only as to amounts and kinds of coverage applied for by such persons, and such policy form or forms shall otherwise fulfill the requirements of sections 2 through 9 of this chapter. The premiums for such policies may be paid to the insurer periodically by the employer, with or without payroll deduction, or by the association for its members, or by some designated person acting on behalf of such employer or association.

(C) Rates, Benefits, Underwriting Procedures. Premium rates, benefits and underwriting procedures relating to such individual policies may differ from those relating to comparable individual policies issued singly, but as between comparable groups such rates, benefits and procedures shall be nondiscriminatory.

Formerly: Acts 1953, c.15, s.169.11. As amended by Acts 1981, P.L.248, SEC.1.
Ind. Code § 27-13-33-2 — Indiana Code / Title 27 / Article 13 / Chapter 33 / Section 27-13-33-2
Provision consistent with 760 IAC 1-38.1
Status: in_force

Sec. 2. If a health maintenance organization adopts a coordination of benefits provision, the provision must be consistent with the coordination of benefits provisions of 760 IAC 1-38.1.

As added by P.L.26-1994, SEC.25. Amended by P.L.124-2018, SEC.95.
Ind. Code § 27-1-44.6-9 — Indiana Code / Title 27 / Article 1 / Chapter 44.6 / Section 27-1-44.6-9
Reimbursement; per diem
Status: in_force

Sec. 9. (a) Each member of the advisory board who is not a state employee is entitled to the minimum financial compensation per diem provided by IC 4-10-11-2.1(b). Such a member is also entitled to reimbursement for mileage, traveling expenses, and other expenses actually incurred in connection with the member's duties, as provided in the state travel policies and procedures established by the Indiana department of administration and approved by the budget agency.

(b) Each member of the advisory board who is a state employee is entitled to reimbursement for traveling expenses and other expenses actually incurred in connection with the member's duties, as provided in the state travel policies and procedures established by the Indiana department of administration and approved by the budget agency.

(c) Amounts paid under subsection (a) or (b) must be paid from money appropriated to the department of insurance for the total operating expense of the all payer claims data base.

(d) Each member of the advisory board who is a member of the general assembly is entitled to receive the same per diem, mileage, and travel allowances paid to legislative members of interim study committees established by the legislative council. Per diem, mileage, and travel allowances paid under this subsection shall be paid from appropriations made to the legislative council or the legislative services agency.

(e) Membership on the advisory board does not constitute the holding of a public office.

As added by P.L.195-2021, SEC.12. Amended by P.L.42-2024, SEC.150.
Ind. Code § 27-8-5.9-5 — Indiana Code / Title 27 / Article 8 / Chapter 5.9 / Section 27-8-5.9-5
Coverage requirements
Status: in_force

Sec. 5. A short term insurance plan must include coverage for the following:

(1) Ambulatory patient services.

(2) Hospitalization.

(3) Emergency services.

(4) Laboratory services.

As added by P.L.288-2019, SEC.7.
Ind. Code § 27-1-22-2 — Indiana Code / Title 27 / Article 1 / Chapter 22 / Section 27-1-22-2
Application of act; exceptions; "inland marine insurance"
Status: in_force

Sec. 2. (a) This chapter applies to all forms of casualty insurance including fidelity, surety, and guaranty bonds, to all forms of motor vehicle insurance, to all forms of fire, marine, and inland marine insurance, to all forms of title insurance, and to any and all combinations of the foregoing or parts thereof, on risks or operations in this state, except:

(1) reinsurance, other than joint reinsurance to the extent stated in section 14 of this chapter;

(2) accident and health insurance;

(3) insurance of vessels or craft, their cargoes, marine builders' risks, marine protection and indemnity, or other risks commonly insured under marine, as distinguished from inland marine, insurance policies;

(4) insurance against loss or damage to aircraft or against liability arising out of the ownership, maintenance, or use of aircraft; and

(5) worker's compensation insurance.

(b) Inland marine insurance includes insurance defined by statute, or by interpretation of statute, or if not so defined or interpreted, by ruling of the commissioner of insurance (referred to as the commissioner), or as established by general custom of the business, as inland marine insurance.

Formerly: Acts 1967, c.133, s.2. As amended by P.L.252-1985, SEC.105; P.L.28-1988, SEC.79; P.L.129-2003, SEC.5; P.L.80-2013, SEC.1.
Ind. Code § 27-8-29-15 — Indiana Code / Title 27 / Article 8 / Chapter 29 / Section 27-8-29-15
Independent review organizations; determinations
Status: in_force

Sec. 15. (a) An independent review organization shall:

(1) for an expedited external grievance filed under section 13(a)(2)(A) of this chapter, within seventy-two (72) hours after the external grievance is filed; or

(2) for a standard external grievance filed under section 13(a)(2)(B) of this chapter, within fifteen (15) business days after the external grievance is filed;

make a determination to uphold or reverse the insurer's appeal resolution under IC 27-8-28-17 based on information gathered from the covered individual or the covered individual's designee, the insurer, and the treating health care provider, and any additional information that the independent review organization considers necessary and appropriate.

(b) When making the determination under this section, the independent review organization shall apply:

(1) standards of decision making that are based on objective clinical evidence; and

(2) the terms of the covered individual's accident and sickness insurance policy.

(c) In an external grievance described in section 12(1)(D) of this chapter, the insurer bears the burden of proving that the insurer properly denied coverage for a condition, complication, service, or treatment because the condition, complication, service, or treatment is directly related to a condition for which coverage has been waived under IC 27-8-5-2.5(e) (expired July 1, 2007, and removed) or IC 27-8-5-19.2 (expired July 1, 2007, and repealed).

(d) The independent review organization shall notify the insurer and the covered individual of the determination made under this section:

(1) for an expedited external grievance filed under section 13(a)(2)(A) of this chapter, within seventy-two (72) hours after the external grievance is filed; and

(2) for a standard external grievance filed under section 13(a)(2)(B) of this chapter, within seventy-two (72) hours after making the determination.

As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14. Amended by P.L.211-2003, SEC.9; P.L.3-2008, SEC.218; P.L.81-2012, SEC.37; P.L.72-2016, SEC.21.
Ind. Code § 27-8-25-9 — Indiana Code / Title 27 / Article 8 / Chapter 25 / Section 27-8-25-9
No cause of action created by chapter
Status: in_force

Sec. 9. This chapter does not create a cause of action against a person for any harm to a covered individual resulting from a clinical trial.

As added by P.L.109-2009, SEC.3.
Ind. Code § 27-1-16.1-2 — Indiana Code / Title 27 / Article 1 / Chapter 16.1 / Section 27-1-16.1-2
"Customer"
Status: in_force

Sec. 2. As used in this chapter, "customer" means a person that obtains the use of storage space from a self-storage facility under the terms of a self-storage rental agreement.

As added by P.L.81-2013, SEC.3.
Ind. Code § 27-2-11.1-2 — Indiana Code / Title 27 / Article 2 / Chapter 11.1 / Section 27-2-11.1-2
Competence to receive insurance payments
Status: in_force

Sec. 2. No person eighteen (18) years of age or over is incompetent because of age to receive and give full acquittance and discharge for payments or execute assignments under the provisions of an insurance contract or under the provisions of a settlement agreement executed in connection with any such contract of insurance.

Formerly: Acts 1973, P.L.275, SEC.5.
Ind. Code § 27-1-38-14 — Indiana Code / Title 27 / Article 1 / Chapter 38 / Section 27-1-38-14
Violation of chapter
Status: in_force

Sec. 14. A person that violates this chapter commits an unfair and deceptive act or practice in the business of insurance under IC 27-4-1-4.

As added by P.L.130-2002, SEC.2.
Ind. Code § 27-8-17-8 — Indiana Code / Title 27 / Article 8 / Chapter 17 / Section 27-8-17-8
"Utilization review determination" defined
Status: in_force

Sec. 8. (a) As used in this chapter, "utilization review determination" means the rendering of a decision based on utilization review that denies or affirms either of the following:

(1) The necessity or appropriateness of the allocation of resources.

(2) The provision or proposed provision of health care services to a covered individual.

(b) The term does not include the identification of alternative, optional medical care that:

(1) requires the approval of the covered individual; and

(2) does not affect coverage or benefits if rejected by the covered individual.

As added by P.L.128-1992, SEC.1.
Ind. Code § 27-5.1-2-10 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-10
Annual policyholder meeting
Status: in_force

Sec. 10. (a) A farm mutual insurance company shall hold an annual meeting of the policyholders of the farm mutual insurance company on the date, time, and location set forth in the articles of incorporation of the farm mutual insurance company. If the articles of incorporation do not specify the date, time, and location of the annual meeting, the meeting shall be held on the first Monday in April at the registered principal office of the farm mutual insurance company.

(b) A quorum for purposes of an annual policyholder meeting must be defined in a farm mutual insurance company's articles of incorporation.

(c) Each policyholder of a farm mutual insurance company is entitled to one (1) vote on any issue voted upon at a policyholder meeting.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-8-12-18 — Indiana Code / Title 27 / Article 8 / Chapter 12 / Section 27-8-12-18
Insurance producer commissions
Status: in_force

Sec. 18. (a) An insurer or other entity that provides a commission to an insurance producer or other representative for the sale of a long term care insurance policy may not violate the following conditions:

(1) The insurer or other entity shall, for at least six (6) years, pay to the insurance producer or other representative an annual commission for selling or servicing the policy.

(2) The amount of commission provided in years after the first year must be determined based on the premium charged for the long term care insurance policy during the first year.

(b) If an existing long term care policy or certificate is replaced, the insurer or other entity that issues the replacement policy may not provide, and its insurance producer may not accept, a commission in an amount greater than the renewal commission payable by the replacing insurer on renewal policies, unless the benefits of the replacement policy or certificate are clearly and substantially greater than the benefits under the replaced policy or certificate.

(c) This section does not apply to the following:

(1) Life insurance policies and certificates.

(2) A policy or certificate that is sponsored by an employer for the benefit of:

(A) the employer's employees; or

(B) the employer's employees and their dependents.

As added by P.L.114-1991, SEC.20. Amended by P.L.178-2003, SEC.67; P.L.173-2007, SEC.29; P.L.115-2011, SEC.10.
Ind. Code § 27-5.1-2-23 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-23
Merger plan performance; surviving company
Status: in_force

Sec. 23. (a) The commissioner may establish the time frame in which a farm mutual insurance company must perform the terms of a merger plan approved under section 22 of this chapter.

(b) After a farm mutual insurance company that is a party to a merger under sections 21 and 22 of this chapter performs the terms of the merger plan, the surviving farm mutual insurance company shall file with the commissioner written notice of the surviving farm mutual insurance company's compliance with the merger plan.

(c) The commissioner shall determine whether the terms of a merger plan are performed adequately by a farm mutual insurance company that is a party to a merger under sections 21 and 22 of this chapter. If the commissioner determines that the terms of the merger plan are met, the commissioner shall issue a certificate of merger to the surviving farm mutual insurance company.

(d) The commissioner may charge a farm mutual insurance company the fee set forth in IC 27-1-3-15 for a filing made under this section.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-8-24.7-2 — Indiana Code / Title 27 / Article 8 / Chapter 24.7 / Section 27-8-24.7-2
"Health insurer" defined
Status: in_force

Sec. 2. As used in this chapter, "health insurer" means an entity referred to in section 1 of this chapter that issues, delivers, or renews a health insurance policy.

As added by P.L.192-1996, SEC.2.
Ind. Code § 27-1-1-1 — Indiana Code / Title 27 / Article 1 / Chapter 1 / Section 27-1-1-1
Creation; functions
Status: in_force

Sec. 1. There is hereby created a department in the state government of the state of Indiana which shall be known as the department of insurance. Said department shall have charge of the organization, supervision, regulation, examination, rehabilitation, liquidation, and/or conservation of all insurance companies to which this title is applicable, shall have charge of the enforcement, administration, and execution of the provisions of this title and the provisions of any other statute applicable to insurance companies, to the insurance department, or to the insurance commissioner, and shall exercise such other powers and perform such other duties as may at any time be imposed or conferred on the department by law. Wherever by any of the provisions of any statute any right, power, or duty is imposed or conferred on the department, the right, power, or duty so imposed or conferred shall be possessed and exercised by the insurance commissioner, unless otherwise provided in that statute, or unless any such right, power, or duty is delegated to the duly appointed deputies, assistants, or employees of the department, or any of them, by an appropriate rule or order of the insurance commissioner.

Formerly: Acts 1945, c.351, s.1. As amended by P.L.252-1985, SEC.1.
Ind. Code § 27-13-14-2 — Indiana Code / Title 27 / Article 13 / Chapter 14 / Section 27-13-14-2
Computation of liabilities
Status: in_force

Sec. 2. The liabilities of a health maintenance organization must be computed:

(1) in accordance with rules adopted by the commissioner; and

(2) upon reasonable consideration of the ascertained experience and character of the health maintenance organization.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-16.1-4 — Indiana Code / Title 27 / Article 1 / Chapter 16.1 / Section 27-1-16.1-4
"Self-storage facility"
Status: in_force

Sec. 4. As used in this chapter, "self-storage facility" means a person that is engaged in the business of providing rented storage space to the public.

As added by P.L.81-2013, SEC.3.
Ind. Code § 27-8-8-2.1 — Indiana Code / Title 27 / Article 8 / Chapter 8 / Section 27-8-8-2.1
Policy, contract, rider descriptions; plan sponsor; residency
Status: in_force

Sec. 2.1. (a) For purposes of this chapter:

(1) a policy or contract issued on a blanket basis is a group policy or group contract;

(2) each individual insured under a policy or contract issued on a blanket basis is a certificate holder under the policy or contract; and

(3) a policy or contract issued on a franchise plan to members of a qualified group is a nongroup policy or nongroup contract.

(b) For purposes of this chapter, a benefit plan may have only one (1) plan sponsor.

(c) For purposes of this chapter, an individual who, on the applicable coverage date:

(1) is a citizen of the United States; and

(2) resides in a:

(A) foreign country; or

(B) United States possession, territory, or protectorate;

that does not have an association similar to the association created by this chapter;

is considered to be a resident of the state of domicile of the insurer that issued the policies or contracts.

(d) For purposes of this chapter, benefits provided under a long term care insurance rider to:

(1) a life insurance policy; or

(2) an annuity contract;

are considered to be the same kind of benefits as the benefits under the life insurance policy or annuity contract to which the rider benefits relate.

As added by P.L.193-2006, SEC.10. Amended by P.L.276-2013, SEC.32; P.L.208-2018, SEC.13.
Ind. Code § 27-2-27-14 — Indiana Code / Title 27 / Article 2 / Chapter 27 / Section 27-2-27-14
"Risk assessment"
Status: in_force

Sec. 14. As used in this chapter, "risk assessment" means the assessment a licensee is required to conduct under section 17 of this chapter.

As added by P.L.130-2020, SEC.10.
Ind. Code § 27-1-50-10 — Indiana Code / Title 27 / Article 1 / Chapter 50 / Section 27-1-50-10
Decrease of defined cost sharing
Status: in_force

Sec. 10. Nothing in this chapter prohibits an insurer from decreasing a covered individual's defined cost sharing by an amount greater than the amount required under section 8 of this chapter.

As added by P.L.166-2023, SEC.3.
Ind. Code § 27-13-23-2 — Indiana Code / Title 27 / Article 13 / Chapter 23 / Section 27-13-23-2
Quality management program examination
Status: in_force

Sec. 2. The commissioner may make an examination concerning the quality management program of a health maintenance organization whenever necessary for the protection of the citizens of Indiana. However, an examination of the quality management program of a health maintenance organization domiciled in Indiana must be conducted at least once every five (5) years.

As added by P.L.26-1994, SEC.25. Amended by P.L.226-2023, SEC.28.
Ind. Code § 27-7-10-5 — Indiana Code / Title 27 / Article 7 / Chapter 10 / Section 27-7-10-5
"Insurance" defined
Status: in_force

Sec. 5. As used in this chapter, "insurance" means primary insurance, excess insurance, reinsurance, surplus lines insurance, and any other arrangement for shifting and distributing risk that is determined to be insurance under the laws of Indiana.

As added by P.L.162-1988, SEC.2.
Ind. Code § 27-8-23-2 — Indiana Code / Title 27 / Article 8 / Chapter 23 / Section 27-8-23-2
Applicability of chapter
Status: in_force

Sec. 2. Notwithstanding any other law, this chapter applies to the duty of an insurer to provide family health coverage to a child in accordance with this chapter.

As added by P.L.46-1995, SEC.68 and P.L.133-1995, SEC.20.
Ind. Code § 27-1-7-13 — Indiana Code / Title 27 / Article 1 / Chapter 7 / Section 27-1-7-13
Officers; secretary; duties; resignation; removal; contract rights
Status: in_force

Sec. 13. (a) A corporation has the officers described in its bylaws. However, a corporation must have at least one (1) officer.

(b) An officer of a corporation may appoint one (1) or more officers or assistant officers if authorized to do so by the bylaws or the board of directors.

(c) The bylaws or the board of directors must delegate to one (1) of the officers responsibility for preparing minutes of the directors' and shareholders' meetings and for authenticating records of the corporation, and that officer is the secretary for purposes of this article. The same individual may simultaneously hold more than one (1) office in the corporation.

(d) Each officer of a corporation has the authority and shall perform the duties set forth in the bylaws, to the extent consistent with the bylaws or, the duties prescribed by the board of directors or by direction of an officer authorized by the board of directors to prescribe the duties of other officers.

(e) An officer of a corporation may resign at any time by delivering notice to the board of directors, its chairman, the secretary of the corporation or, if the articles of incorporation or bylaws so provide, to another designated officer. A resignation is effective when the notice is delivered unless the notice specifies a later date. If a resignation is made effective at a later date and the corporation accepts the future effective date, its board of directors may fill the pending vacancy before the effective date if the board of directors provides that the successor does not take office until the effective date.

(f) The board of directors of a corporation may remove an officer of the corporation at any time with or without cause. An officer who appoints another officer or assistant officer may remove the appointed officer or assistant officer at any time with or without cause.

(g) The election or appointment of an officer of a corporation does not itself create contract rights.

(h) The removal of an officer of a corporation does not affect the officer's contract rights, if any, with the corporation. An officer's resignation does not affect the corporation's contract rights, if any, with the officer.

Formerly: Acts 1935, c.162, s.91. As amended by P.L.266-1987, SEC.5.
Ind. Code § 27-1-12-1 — Indiana Code / Title 27 / Article 1 / Chapter 12 / Section 27-1-12-1
Particular rights, privileges, and powers
Status: in_force

Sec. 1. In addition to the general rights, privileges, and powers conferred by IC 27-1-5 through IC 27-1-13 and IC 27-11, and subject to the limitations and restrictions contained in this article and in the articles of incorporation, every life insurance company shall possess and may exercise the rights, privileges, and powers enumerated in this chapter and IC 27-1-12.8.

Formerly: Acts 1935, c.162, s.146. As amended by P.L.252-1985, SEC.59; P.L.3-1990, SEC.96; P.L.276-2013, SEC.2.
Ind. Code § 27-1-8-10 — Indiana Code / Title 27 / Article 1 / Chapter 8 / Section 27-1-8-10
Effect of amendment
Status: in_force

Sec. 10. Upon the issuance of the amended certificate of authority by the commissioner, the amendment shall become effective and the articles of incorporation shall be deemed to be amended accordingly. No amendment shall effect any existing cause of action in favor of or against such corporation, or any pending suit in which such corporation shall be a party, or the existing rights of persons other than shareholders of a stock company, or the members or policyholders in companies other than stock companies; and in the event the corporate name shall be changed by any amendment, no suit brought against such corporation under its former name shall be abated for that reason.

Formerly: Acts 1935, c.162, s.110.
Ind. Code § 27-2-27-27 — Indiana Code / Title 27 / Article 2 / Chapter 27 / Section 27-2-27-27
Suspension; revocation
Status: in_force

Sec. 27. If a licensee violates this chapter, the insurance commissioner may, after notice and hearing under IC 4-21.5, suspend or revoke the license, certificate of authority, or registration of the licensee.

As added by P.L.130-2020, SEC.10.
Ind. Code § 27-1-37.5-19 — Indiana Code / Title 27 / Article 1 / Chapter 37.5 / Section 27-1-37.5-19
Publishing prior authorization requirements and restrictions and information about prior authorization approvals and denials; implementing new or amending current prior authorization requirements or restrictions; annual report
Status: in_force

Sec. 19. (a) A utilization review entity shall make any current prior authorization requirements and restrictions, including written clinical criteria, readily accessible on the utilization review entity's website to covered individuals, health care providers, and the general public. The prior authorization requirements and restrictions must be described in detail and in easily understandable language.

(b) A utilization review entity may not implement a new prior authorization requirement or restriction or amend an existing requirement or restriction unless:

(1) the utilization review entity's website has been updated to reflect the new or amended requirement or restriction; and

(2) the utilization review entity provides written notice to covered individuals and health care providers at least sixty (60) days before the requirement or restriction is implemented.

(c) A utilization review entity shall make statistics available regarding prior authorization approvals and denials on the utilization review entity's website in a readily accessible format, including statistics for the following categories:

(1) Health care provider specialty.

(2) Medication or diagnostic test or procedure.

(3) Indication offered.

(4) Reason for denial.

(5) If a decision was appealed.

(6) If a decision was approved or denied on appeal.

(7) The time between submission and the response.

(d) Not later than December 31 of each year, a utilization review entity shall:

(1) prepare a report of the statistics compiled under subsection (c); and

(2) submit the report to the department.

As added by P.L.144-2025, SEC.28.
Ind. Code § 27-8-13.5-3 — Indiana Code / Title 27 / Article 8 / Chapter 13.5 / Section 27-8-13.5-3
"Insured"
Status: in_force

Sec. 3. As used in this chapter, "insured" means an individual who is entitled to coverage under a policy of accident and sickness insurance.

As added by P.L.126-2013, SEC.4.
Ind. Code § 27-13-6-4 — Indiana Code / Title 27 / Article 13 / Chapter 6 / Section 27-13-6-4
Written statement of quality management activities
Status: in_force

Sec. 4. The quality management program required by section 2 of this chapter must contain a written statement describing the system of ongoing quality management activities, including the following:

(1) Problem assessment, identification, selection, and study.

(2) Corrective action, monitoring, evaluation, and reassessment.

(3) Interpretation and analysis of patterns of care rendered to individual patients by individual providers.

(4) Comparison between patterns of care, including outcomes, rendered to patients by providers and the cost to the health maintenance organization of that care.

(5) A written statement describing the system of focused quality assurance activities based on representative samples of the enrolled population that identifies method of topic selection, study, data collection, analysis, interpretation, and report format.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-36-14 — Indiana Code / Title 27 / Article 1 / Chapter 36 / Section 27-1-36-14
"Negative trend"
Status: in_force

Sec. 14. As used in this chapter, "negative trend" means, with respect to an insurer, a negative trend over a period of time, as determined in accordance with the trend test calculation included in the RBC instructions.

As added by P.L.186-1996, SEC.1. Amended by P.L.276-2013, SEC.23.
Ind. Code § 27-13-9-3 — Indiana Code / Title 27 / Article 13 / Chapter 9 / Section 27-13-9-3
Termination of provider
Status: in_force

Sec. 3. (a) A health maintenance organization shall notify an enrollee in writing of the termination of:

(1) the provider who currently provides primary health care services to that enrollee;

(2) any other participating provider seen by the enrollee during the previous year; and

(3) a hospital.

(b) After the termination of the provider who provided primary health care services to an enrollee, the health maintenance organization shall assist the enrollee in transferring to another participating primary care provider.

(c) If a health maintenance organization notifies an enrollee of the termination of a hospital, the notice must include the names of all participating providers employed by the hospital.

As added by P.L.26-1994, SEC.25. Amended by P.L.133-1999, SEC.3; P.L.196-2001, SEC.2.
Ind. Code § 27-1-9-10 — Indiana Code / Title 27 / Article 1 / Chapter 9 / Section 27-1-9-10
Hearing on petition of members or policyholders of mutual company in opposition to merger or consolidation; revocation of approval
Status: in_force

Sec. 10. If not less than five percent (5%) of the members or policyholders in a mutual corporation who did not vote in favor of such merger or consolidation at the meeting at which the agreement of merger or consolidation was adopted by the members or policyholder of such corporation shall, at any time within thirty (30) days after the filing of the affidavit of notice of the adoption of the agreement of merger or consolidation as provided for in sections 3 and 4 of this chapter, file a petition with the department for a hearing upon the adoption of such agreement or merger or consolidation, the department shall order a hearing upon said petition and give notice fixing the time and place of such hearing to the corporations which are parties to the merger or consolidation fifteen (15) days before the date of such hearing. The company whose policyholders file such petition shall give notice by mail to each member or policyholder of such company, at least ten (10) days before such hearing. At the time and place fixed in such notice, or at the time or times and place or places to which such hearing shall be adjourned, the commissioner shall proceed with the hearing and make or order such examination into the affairs and condition of each of such corporations as he may deem proper. The commissioner shall have the power to summon and compel the attendance and testimony of witnesses and the production of books and papers before him at such hearing. Any member or policyholder, as the case may be, of the corporation so petitioning may appear before the commissioner and be heard with reference to said contract. If, upon such hearing being had, the commissioner is not satisfied that the interests of the members or policyholders, as the case may be, of such company are properly protected, or if he finds that any reasonable objection exists to such contract, he shall revoke the approval already given, and the said agreement of merger or consolidation shall thereupon become null and void. The commissioner shall have like power to revoke any approval of any such agreement of merger or consolidation if any officer, director, or employee of either corporation party to such agreement of merger or consolidation shall, after reasonable notice, fail or refuse to attend and testify at such hearing, or to produce any books or papers called for by said commissioner.

Formerly: Acts 1935, c.162, s.124; Acts 1941, c.115, s.6. As amended by P.L.252-1985, SEC.45.
Ind. Code § 27-8-8-11 — Indiana Code / Title 27 / Article 8 / Chapter 8 / Section 27-8-8-11
Distributions to affiliates; recovery
Status: in_force

Sec. 11. (a) Subject to subsections (b) through (d), if an order for liquidation or rehabilitation of a member insurer domiciled in Indiana has been entered, the receiver appointed under the order shall have a right to recover on behalf of the member insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the member insurer on its capital stock, made at any time during the five (5) years preceding the filing of the petition for liquidation or rehabilitation.

(b) A distribution described in subsection (a) is not recoverable if the member insurer shows that when the distribution was paid the distribution was lawful and reasonable, and that the member insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the member insurer to fulfill the member insurer's policy and contract obligations.

(c) A person who was an affiliate that controlled the member insurer at the time a distribution described in subsection (a) was paid is liable up to the amount of distributions the person received. A person who was an affiliate that controlled the member insurer at the time the distributions were declared shall be liable up to the amount of distributions that would have been received if the distributions had been paid immediately. If two (2) or more persons are liable with respect to the same distributions, they are jointly and severally liable.

(d) The maximum amount recoverable under this section shall be the amount needed in excess of all other available assets of the insolvent insurer to pay the policy and contract obligations of the insolvent insurer.

(e) If a person liable under subsection (c) is insolvent, the affiliates that controlled the person at the time the distribution was paid shall be jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate.

As added by Acts 1978, P.L.129, SEC.3. Amended by P.L.193-2006, SEC.25; P.L.208-2018, SEC.23.
Ind. Code § 27-1-27-10 — Indiana Code / Title 27 / Article 1 / Chapter 27 / Section 27-1-27-10
Validity of resident certificates of authority
Status: in_force

Sec. 10. A resident certificate of authority issued to a person claiming residency is void if that person:

(1) holds a resident certificate of authority issued by another state;

(2) makes application for a resident certificate of authority from another state; or

(3) ceases to be a resident of Indiana.

As added by P.L.257-1983, SEC.1.
Ind. Code § 27-1-12-23 — Indiana Code / Title 27 / Article 1 / Chapter 12 / Section 27-1-12-23
Procedure for converting domestic stock life insurance company into mutual life insurance company
Status: in_force

Sec. 23. Any domestic stock life insurance company may become a mutual life insurance company and to that end may carry out a plan for the acquisition of shares of its capital stock by amending its articles of incorporation and complying with the following requirements:

(a) Such plan shall be approved by a two-thirds (2/3) vote of the policyholders, present and voting at a meeting called for that purpose. For the purpose of this section a quorum shall consist of at least ten per cent (10%) of the policyholders of such company. Each policyholder whose insurance shall have been in force for at least one (1) year prior to such meeting shall have one (1) vote, regardless of the number of policies or amount of insurance he may have with such company. Notice of such meeting shall be given by mailing from the principal office of such company at least thirty (30) days prior to the date set for such meeting in a sealed envelope, postage prepaid, addressed to such policyholders at their last known post-office addresses. Voting shall be by ballot, in person or by proxy, or by mail under the direction of inspectors appointed by the commissioner and in accordance with such other regulations as he may prescribe. Such inspectors shall have the power to determine all questions concerning the verification of the ballots, the ascertainment of the validity thereof, the qualifications of the voters, and to canvass the vote. They shall certify to the commissioner and to the company the result of such election. All necessary expenses incurred by the commissioner or by the inspectors appointed by him shall be certified by him to and paid by the company.

(b) Such plan shall be submitted to and approved by the commissioner. The commissioner shall not approve said plan unless in his opinion the rights and interests of all policyholders are preserved. In carrying out said plan a company may acquire any shares of its own stock by gift, bequest or purchase. Any shares thus acquired shall be held in trust for the policyholders of the company as hereinafter provided and shall be assigned and transferred on the books of the company to three (3) trustees who shall hold in trust and shall vote them at all company meetings until all the capital stock of such company is acquired, when the entire capital stock shall be cancelled, and thereupon, the company shall be and become a mutual life insurance company without capital stock. Such trustees shall be appointed and vacancies shall be filled as provided in the plan adopted under the provisions of this section. Such trustees shall file with the company a verified acceptance of their appointments and declarations that they will faithfully discharge their duties as such trustees. All dividends and other sums acquired, after paying the necessary expenses of executing said trust, shall be immediately repaid to said company for the benefit of all who are or may become policyholders of said company and entitled to participate in the profits thereof, and shall be added to and become a part of the surplus earned by said company and be apportionable accordingly as a part of said surplus among said policyholders.

Formerly: Acts 1935, c.162, s.162.
Ind. Code § 27-1-28-20 — Indiana Code / Title 27 / Article 1 / Chapter 28 / Section 27-1-28-20
Contracts
Status: in_force

Sec. 20. An independent adjuster shall:

(1) maintain a copy of each contract between the independent adjuster and an insurer or a self-insurer; and

(2) comply with the record retention policy agreed to in the contract described in subdivision (1).

As added by P.L.11-2011, SEC.22.
Ind. Code § 27-16-4-9 — Indiana Code / Title 27 / Article 16 / Chapter 4 / Section 27-16-4-9
Forms
Status: in_force

Sec. 9. The department may prescribe forms necessary to promote the efficient administration of this chapter.

As added by P.L.245-2005, SEC.7.
Ind. Code § 27-1-45-7 — Indiana Code / Title 27 / Article 1 / Chapter 45 / Section 27-1-45-7
Exception to good faith estimate requirement
Status: in_force

Sec. 7. A facility or a practitioner is not required to provide the good faith estimate if the health care service to be provided to the covered individual is scheduled to be performed within two (2) business days after the health care service is ordered.

As added by P.L.93-2020, SEC.11. Amended by P.L.202-2021, SEC.9; P.L.165-2022, SEC.7; P.L.215-2025, SEC.55.
Ind. Code § 27-5.1-2-22 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-22
Merger files; commissioner review; notice and hearing; approval; modification; experts; costs
Status: in_force

Sec. 22. (a) Each farm mutual insurance company that decides to merge under section 21 of this chapter shall file the following documents with the commissioner:

(1) A petition for merger.

(2) The farm mutual insurance company's merger plan.

(3) Articles of merger.

(4) A copy of the minutes of a meeting at which the merger plan was approved.

(5) Proof of compliance with section 21 of this chapter.

(b) The commissioner shall:

(1) review a filing submitted under subsection (a); and

(2) schedule a hearing under IC 4-21.5 if the commissioner considers a hearing necessary.

The commissioner may waive a hearing under this subsection if the commissioner determines that a proposed merger does not prejudice the interests of policyholders of the farm mutual insurance company.

(c) If the commissioner determines under subsection (b) that a hearing is necessary, the commissioner shall provide written notice of the hearing to the farm mutual insurance company that filed the petition for merger. The commissioner may require the farm mutual insurance company to provide the farm mutual insurance company's policyholders with written notice of the hearing, including the date, time, and place of the hearing.

(d) If the commissioner requires a farm mutual insurance company to provide the farm mutual insurance company's policyholders with notice of a hearing under subsection (c), the notice must meet the following requirements:

(1) Be published in at least two (2) daily newspapers that the commissioner may designate.

(2) Be published in the newspapers designated under subdivision (1):

(A) not less than one (1) time per week;

(B) for two (2) successive weeks; and

(C) on the same day of the week.

(3) The last publication of notice must appear not more than five (5) calendar days before the date of the hearing.

(e) The commissioner may require a farm mutual insurance company to provide more notice than is required by subsection (d) if the commissioner determines that more notice is required under the circumstances concerning the farm mutual insurance company.

(f) In a hearing conducted under this section, the commissioner may examine a farm mutual insurance company's business affairs by:

(1) requiring and compelling the production of documents, records, books, papers, contracts, or other evidence; and

(2) compelling the attendance of, and examining under oath, a director, an officer, an agent, an employee, a solicitor, or an attorney of the farm mutual insurance company, or another person.

(g) A person who has an interest in a hearing conducted under this section may appear and testify at the hearing.

(h) The commissioner shall approve and authorize a proposed merger if the commissioner determines the following:

(1) That the interests of policyholders of the merging farm mutual insurance companies are properly protected.

(2) That a reasonable objection to the proposed merger does not exist.

(i) The commissioner may order a modification of the merger plan or articles of merger for a proposed merger if the commissioner determines that the modification is in the best interest of policyholders.

(j) The commissioner may hire experts the commissioner considers necessary to review a merger plan filed under this section.

(k) A farm mutual insurance company that files a petition for merger shall pay the costs of a hearing under this section.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-2-21-0.1 — Indiana Code / Title 27 / Article 2 / Chapter 21 / Section 27-2-21-0.1
Application of chapter
Status: in_force

Sec. 0.1. The addition of this chapter by P.L.201-2003 applies to a personal insurance policy:

(1) application that is submitted; or

(2) that is issued, delivered, amended, or renewed;

after December 31, 2003.

As added by P.L.220-2011, SEC.429.
Ind. Code § 27-8-16-1.5 — Indiana Code / Title 27 / Article 8 / Chapter 16 / Section 27-8-16-1.5
"Claim review consultant" defined
Status: in_force

Sec. 1.5. (a) As used in this chapter, "claim review consultant" means a person who:

(1) makes a recommendation or provides consultation to:

(A) an entity engaged in performing medical claims review; or

(B) an insurance company, a health maintenance organization, or another benefit program providing payment, reimbursement, or indemnification for health care costs to an enrollee;

concerning the appropriateness of a health care service or the amount charged for a health care service delivered to an enrollee in Indiana; and

(2) is not an employee of an entity referred to in subdivision (1)(A) or (1)(B).

(b) Making a recommendation or providing consultation concerning a health care service does not render a person a claim review consultant under this section if the recommendation or consultation concerns:

(1) coverage provided; or

(2) medical services rendered;

under IC 22.

(c) The term "claim review consultant" does not include the following:

(1) An insurance company authorized under IC 27 to do business in Indiana.

(2) An entity acting on behalf of the federal or state government. However, an agent described in this subdivision who performs medical claims review for a person other than the federal or state government is a claim review agent who is subject to the requirements of this chapter.

(3) A health maintenance organization or limited service health maintenance organization that holds a certificate of authority to operate under IC 27-13.

(4) An insurance administrator that is licensed under IC 27-1-25.

(5) An individual qualified and acting as an expert witness under the Indiana Rules of Trial Procedure.

(6) A person who engages in the prospective, concurrent, or retrospective utilization review of health care services.

(7) A person who engages in the identification of alternative, optional medical care that:

(A) requires the approval of the enrollee or covered individual; and

(B) does not affect coverage or benefits if rejected by the enrollee or covered individual.

(8) An individual who is a licensed health care provider who makes a recommendation or provides consultation concerning the appropriateness of health care service. However, this exception does not apply if the individual:

(A) makes any recommendations or provides consultation concerning the amount charged for a health care service delivered in Indiana;

(B) makes any recommendations or provides consultation concerning the appropriateness of hospital services provided by a hospital licensed under IC 12-25 or IC 16-21;

(C) is employed by or under contract with an entity that is required to be registered under this chapter; or

(D) has received more than five thousand dollars ($5,000) in compensation during the present calendar year for providing consultation services concerning the appropriateness of health care services delivered to enrollees in Indiana.

(9) A claim review agent under section 1 of this chapter.

As added by P.L.260-1995, SEC.2. Amended by P.L.160-2003, SEC.26.
Ind. Code § 27-8-30-1 — Indiana Code / Title 27 / Article 8 / Chapter 30 / Section 27-8-30-1
"Accident and sickness insurance policy" defined
Status: in_force

Sec. 1. As used in this chapter, "accident and sickness insurance policy" means a policy that:

(1) provides the kinds of coverage described in Class 1(b) or Class 2(a) of IC 27-1-5-1; and

(2) includes a prescription drug benefit.

As added by P.L.107-2002, SEC.29.
Ind. Code § 27-8-24-5 — Indiana Code / Title 27 / Article 8 / Chapter 24 / Section 27-8-24-5
Conditions warranting shorter period of inpatient care; at-home postdelivery care visit
Status: in_force

Sec. 5. (a) If the patients’ attending physician determines further inpatient care is not necessary for the mother or newborn child, a policy or group contract that provides maternity benefits under this chapter may provide under the policy or group contract a shorter length of postpartum hospital stay than the period under section 4 of this chapter if all the following conditions are met:

(1) in the patients' attending physician's opinion the newborn meets the criteria for medical stability in the Guidelines for Perinatal Care prepared by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists that determine the appropriate length of stay based upon evaluation of:

(A) the antepartum, intrapartum, and postpartum course of the mother and infant;

(B) the gestational stage, birth weight, and clinical condition of the infant;

(C) the demonstrated ability of the mother to care for the infant after discharge; and

(D) the availability of postdischarge follow-up to verify the condition of the infant after discharge; and

(2) the policy or contract authorizes for the mother and the newborn one (1) at-home postdelivery care visit described in subsection (b).

(b) The at-home postdelivery care visit shall be conducted not later than forty-eight (48) hours following the discharge of the woman and her newborn child from a licensed hospital. However, at the mother's discretion, the visit may occur at the facility of the provider subject to the terms of the policy or group contract.

(c) The provider of the policy or group contract described in this chapter shall provide notice to each enrollee under the policy or group contract regarding the coverage provided under this chapter.

As added by P.L.194-1996, SEC.1. Amended by P.L.2-1997, SEC.66.
Ind. Code § 27-13-13-3 — Indiana Code / Title 27 / Article 13 / Chapter 13 / Section 27-13-13-3
Deposits considered admitted asset
Status: in_force

Sec. 3. Deposits made under this chapter shall be considered an admitted asset of the health maintenance organization in the determination of the net worth of the organization.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-51-2 — Indiana Code / Title 27 / Article 1 / Chapter 51 / Section 27-1-51-2
"Administrator"
Status: in_force

Sec. 2. As used in this chapter, "administrator" means a person who, directly or indirectly and on behalf of an insurer:

(1) underwrites; or

(2) collects charges or premiums from or adjusts or settles claims on:

(A) residents of Indiana; or

(B) residents of another state from offices in Indiana;

in connection with health insurance coverage offered or provided by an insurer.

As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-36-18 — Indiana Code / Title 27 / Article 1 / Chapter 36 / Section 27-1-36-18
"RBC level"
Status: in_force

Sec. 18. As used in this chapter, "RBC level" means an insurer's:

(1) company action level RBC;

(2) regulatory action level RBC;

(3) authorized control level RBC; or

(4) mandatory control level RBC.

As added by P.L.186-1996, SEC.1.
Ind. Code § 27-1-22-3.1 — Indiana Code / Title 27 / Article 1 / Chapter 22 / Section 27-1-22-3.1
Senior citizens participating in motor vehicle accident prevention courses; reduced premiums
Status: in_force

Sec. 3.1. (a) As used in this section, "motor vehicle insurance" means any type of insurance described in IC 27-1-5-1, Class 2(f).

(b) A motor vehicle insurance rate filed under section 4 of this chapter may provide for an appropriate reduction in premium charges for a policy if the principal operator of the motor vehicle covered under the policy:

(1) is at least fifty-five (55) years of age; and

(2) has, within three (3) years before the issuance or renewal of the policy, successfully completed a motor vehicle accident prevention course approved by the bureau of motor vehicles.

(c) A reduction in premium charges need not be provided under this section if the principal operator of the motor vehicle covered under the policy participated in the motor vehicle accident prevention course under the order of a court.

(d) This section does not prevent an insurer from withholding or rescinding the reduction in premium charges for a motor vehicle insurance policy if the principal operator of the motor vehicle covered under the policy is involved in a motor vehicle accident for which the principal operator is at fault.

As added by P.L.121-1989, SEC.11.
Ind. Code § 27-1-29.1-8 — Indiana Code / Title 27 / Article 1 / Chapter 29.1 / Section 27-1-29.1-8
Reserve account; issuance of bonds to establish account; use of funds
Status: in_force

Sec. 8. (a) The commission shall establish a reserve account in the fund. A balance of at least five million dollars ($5,000,000) must remain in the reserve account. To provide money to establish the reserve account, the commission may issue bonds under IC 27-1-29-17(b)(1). The bonds issued to provide money for the establishment of the reserve account may not exceed a total amount of forty million dollars ($40,000,000).

(b) Money in the reserve account shall be held and applied solely to pay claims against the fund that cannot be paid from other money in the fund.

As added by P.L.272-1987, SEC.7.
Ind. Code § 27-5.1-2-19 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-19
Application for coverage; policyholder status
Status: in_force

Sec. 19. (a) A person, including a person described in subsection (b), that has a risk that is insurable under this article in a territory in which a farm mutual insurance company operates may apply for insurance coverage with the farm mutual insurance company. If the farm mutual insurance company accepts the person as a policyholder, the person becomes a policyholder of the farm mutual insurance company and is entitled to all the rights and privileges of a policyholder.

(b) Any of the following that own property within the territory of a farm mutual insurance company may apply for insurance, enter into an agreement for an insurance policy, and hold an insurance policy issued by a farm mutual insurance company:

(1) A corporation.

(2) An estate.

(3) An association.

(c) An officer, a trustee, a board member, or a legal representative of an entity described in subsection (b) may be recognized as acting for or on behalf of the entity for the purpose of membership.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-1-44.5-11 — Indiana Code / Title 27 / Article 1 / Chapter 44.5 / Section 27-1-44.5-11
Adoption of rules
Status: in_force

Sec. 11. (a) Except as provided in subsection (c), the department shall adopt rules under IC 4-22-2 to implement this chapter. The rules must include a requirement that health payer data sources submit necessary information to the administrator. Rules enacted under this subsection must cover all health payer data sources as follows:

(1) The department shall adopt rules that apply to health payers regulated under IC 27.

(2) The office of the secretary of family and social services shall adopt rules that apply to health payers regulated under IC 12.

(b) The department shall adopt provisional rules under IC 4-22-2-37.1 establishing a fee formula for data licensing and the collection and release of claims data.

(c) The department may adopt rules under IC 4-22-2 concerning the:

(1) requirement that health payers submit required data under section 5 of this chapter; and

(2) establishment of a fee formula for data licensing, collection, and release of claims described in section 9 of this chapter.

(d) The department may impose a civil penalty on a health payer that is required to submit information under this chapter and fails to comply. A civil penalty collected under this section must be deposited in the department of insurance fund created by IC 27-1-3-28.

As added by P.L.195-2021, SEC.11. Amended by P.L.190-2023, SEC.21; P.L.225-2023, SEC.2; P.L.249-2023, SEC.81.
Ind. Code § 27-4-3-2 — Indiana Code / Title 27 / Article 4 / Chapter 3 / Section 27-4-3-2
Insurance producer's agreement not to represent additional companies; exclusive representation of single company
Status: in_force

Sec. 2. (a) It is unlawful for any insurance producer representing or acting for two (2) or more insurance companies writing the same class or classes, of risks to enter, either directly or indirectly, into any agreement, arrangement, contract or understanding with one (1) or more of such companies that the insurance producer will refrain from representing any other like company or companies, and it is unlawful for any such insurance company, not having a contract requiring an insurance producer to represent the insurance company alone, in any manner to require, coerce, or induce any insurance producer to refrain from representing any other like company or companies.

(b) This section does not prevent any insurance company or insurance producer from at any time entering into a bona fide contract whereby an insurance producer agrees that the insurance producer will thereafter represent a single company exclusively.

Formerly: Acts 1937, c.46, s.2. As amended by P.L.178-2003, SEC.37.
Ind. Code § 27-14.5-1-20 — Indiana Code / Title 27 / Article 14.5 / Chapter 1 / Section 27-14.5-1-20
"Mutual insurance company"
Status: in_force

Sec. 20. "Mutual insurance company" means a mutual insurer that is:

(1) submitting; or

(2) subject to;

a plan of reorganization or plan to issue stock under this article.

As added by P.L.226-2023, SEC.30.
Ind. Code § 27-1-12.8-35 — Indiana Code / Title 27 / Article 1 / Chapter 12.8 / Section 27-1-12.8-35
Principal based valuation for contracts on and after operative date of Valuation Manual
Status: in_force

Sec. 35. (a) This section applies on and after the operative date of the Valuation Manual specified in section 34 of this chapter.

(b) A company shall, using a principle based valuation, establish reserves that meet the following conditions for contracts, as specified in the Valuation Manual:

(1) The reserves quantify the benefits, guarantees, and funding associated with the contracts and the contracts' risks at a level of conservatism that:

(A) reflects conditions that include unfavorable events that have a reasonable probability of occurring during the lifetime of the contracts; and

(B) for polices or contracts with significant tail risk, reflects conditions appropriately adverse to quantify the tail risk.

(2) The reserves incorporate assumptions, risk analysis methods, and financial models and management techniques that are consistent with the assumptions, risk analysis methods, and financial models and management techniques used within the company's overall risk assessment process, while recognizing potential differences in financial reporting structures and prescribed assumptions or methods.

(3) The reserves incorporate assumptions that are derived in one (1) of the following manners:

(A) The assumption is prescribed in the Valuation Manual.

(B) For an assumption that is not prescribed in the Valuation Manual, the assumption must:

(i) be established using the company's available experience to the extent the experience is relevant and statistically credible; or

(ii) to the extent that company data is not available, relevant, or statistically credible, be established using other relevant, statistically credible experience.

(4) The reserves provide margins for uncertainty, including adverse deviation and estimation error, such that the greater the uncertainty, the larger the margin and resulting reserve.

(c) A company using a principle based valuation for at least one (1) contract that is subject to this section, as specified in the Valuation Manual, shall do the following:

(1) Establish procedures for corporate governance and oversight of the actuarial valuation function consistent with the procedures described in the Valuation Manual.

(2) Provide to the commissioner and the board of directors an annual certification of the effectiveness of the internal controls with respect to the principle based valuation. The internal controls must be designed to assure that:

(A) all material risks inherent in the liabilities and associated assets that are subject to the valuation are included in the valuation; and

(B) valuations are made in accordance with the Valuation Manual.

The certification must be based on the controls in place as of the end of the preceding calendar year.

(3) Develop, and file with the commissioner upon request, a principle based valuation report that complies with standards prescribed in the Valuation Manual.

(d) A principle based valuation may include a prescribed formulaic reserve component.

As added by P.L.276-2013, SEC.10. Amended by P.L.124-2018, SEC.28.
Ind. Code § 27-3-1-4 — Indiana Code / Title 27 / Article 3 / Chapter 1 / Section 27-3-1-4
Filing; time plan becomes effective
Status: in_force

Sec. 4. Not earlier than thirty-one (31) days after the date of the meeting of shareholders of the domestic company at which the plan of exchange was approved by such shareholders, a certificate setting forth the plan of exchange, the manner of the approval thereof by the directors of the acquiring corporation and the domestic company and the manner of its adoption and the vote by which adopted by the shareholders of the domestic company or setting forth that the plan of exchange has been abandoned shall be signed on behalf of each such corporation by its president or a vice-president and shall then be presented in triplicate to the department at its office for filing. The department shall file one (1) copy of such certificate in its offices and shall deliver copies bearing the date and time of filing endorsed thereon to the domestic company and the acquiring corporation. Upon the filing of such certificate, the plan of exchange and the issuance and exchange provided for therein shall become effective, unless a later date and time is specified in the plan of exchange, in which event the plan of exchange and the issuance and exchange provided for therein shall become effective upon such later date and time.

Formerly: Acts 1967, c.61, s.4.
Ind. Code § 27-7-10-32 — Indiana Code / Title 27 / Article 7 / Chapter 10 / Section 27-7-10-32
Insurance producers for risk retention groups; residence; notice
Status: in_force

Sec. 32. (a) For purposes of acting as an insurance producer for a risk retention group or purchasing group under section 30 or 31 of this chapter, the requirement of residence in Indiana does not apply.

(b) Every individual, firm, association, or corporation licensed under IC 27-1-15.6, in regard to business placed with risk retention groups or written through a purchasing group, shall inform each prospective insured of the provisions of the notice required by section 18 of this chapter in the case of a risk retention group and section 27(c) of this chapter in the case of a purchasing group.

As added by P.L.162-1988, SEC.2. Amended by P.L.132-2001, SEC.13; P.L.178-2003, SEC.54.
Ind. Code § 27-19-2-10 — Indiana Code / Title 27 / Article 19 / Chapter 2 / Section 27-19-2-10
"Health plan"
Status: in_force

Sec. 10. (a) "Health plan" means a policy or contract that provides health insurance coverage.

(b) The term includes a group health plan.

As added by P.L.278-2013, SEC.27.
Ind. Code § 27-13-12-4 — Indiana Code / Title 27 / Article 13 / Chapter 12 / Section 27-13-12-4
Net worth schedule
Status: in_force

Sec. 4. A health maintenance organization licensed before July 1, 1994, must maintain a net worth equal to the following:

(1) Twenty-five percent (25%) of the amount required under section 3 of this chapter by December 31, 1994.

(2) Fifty percent (50%) of the amount required under section 3 of this chapter by December 31, 1995.

(3) Seventy-five percent (75%) of the amount required under section 3 of this chapter by December 31, 1996.

(4) One hundred percent (100%) of the amount required under section 3 of this chapter by December 31, 1997.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-11-2 — Indiana Code / Title 27 / Article 1 / Chapter 11 / Section 27-1-11-2
Articles; approval by directors
Status: in_force

Sec. 2. The board of directors of such company desiring to reorganize under this article shall, by resolution adopted by a majority vote of the members of such board, approve the articles of reorganization setting forth:

(1) the name of the corporation;

(2) the location of its principal office;

(3) the date of its incorporation or organization;

(4) a designation of the statute under which it was organized;

(5) a declaration that it accepts all of the terms and provisions of this article; and

(6) a restatement of such provisions of its articles of incorporation or association as may be deemed desirable so long as the provisions restated would have been authorized by this article as provisions of original articles of incorporation for a corporation organized under this article.

Formerly: Acts 1935, c.162, s.140. As amended by P.L.252-1985, SEC.54.
Ind. Code § 27-10-3-15 — Indiana Code / Title 27 / Article 10 / Chapter 3 / Section 27-10-3-15
Insurers; deposits; engaging in bail bond business
Status: in_force

Sec. 15. All insurers must deposit with the commissioner cash, United States treasury notes, or bonds in bearer form with coupons attached having a par value of at least seventy-five thousand dollars ($75,000) in order to obtain a license to engage in the bail bond business, out of which the commissioner shall satisfy judgment on all forfeitures which have not been paid. Such deposit shall be subject to all laws and rules as are deposits by domestic insurance companies.

As added by P.L.261-1985, SEC.1. Amended by P.L.255-1995, SEC.12.
Ind. Code § 27-7-3.7-8 — Indiana Code / Title 27 / Article 7 / Chapter 3.7 / Section 27-7-3.7-8
Disbursements; requirements for funds less than $10,000 received from single party
Status: in_force

Sec. 8. A closing agent may not make disbursements from an escrow account in connection with a real estate transaction unless any funds that:

(1) are received from any single party to the real estate transaction; and

(2) in the aggregate are less than ten thousand dollars ($10,000);

are good funds.

As added by P.L.92-2009, SEC.1.
Ind. Code § 27-2-17-5 — Indiana Code / Title 27 / Article 2 / Chapter 17 / Section 27-2-17-5
Discrimination based on geographical location prohibited
Status: in_force

Sec. 5. (a) This chapter applies to an insurer that obtains a certificate of authority under IC 27-1-3-20 as:

(1) a domestic insurer formed under IC 27-1-6;

(2) a foreign insurer that has become a domestic insurer under IC 27-1-6.5; or

(3) a foreign or an alien insurer under IC 27-1-17.

(b) An insurer that:

(1) obtains a certificate of authority authorizing the insurer to provide property or casualty insurance in Indiana; and

(2) provides property or casualty insurance covering risks in any location in Indiana;

may not cancel or refuse to issue or renew a policy of property or casualty insurance based solely on the geographical location of the risk within Indiana. This subsection does not preclude an insurer from refusing to issue or renew or from canceling a policy based on sound underwriting or actuarial principles reasonably related to actual or anticipated loss experience or any other sound business purpose.

(c) If an insurer is found by the commissioner to have violated subsection (b), the commissioner may, after a hearing, suspend or revoke the certificate of authority of the insurer.

(d) Any determination made by the commissioner under this section is subject to IC 4-21.5.

(e) Except as provided in subsection (f), the department has exclusive jurisdiction to investigate any alleged violation of this section.

(f) Subsection (e) is not intended to restrict the jurisdiction, if any, the civil rights commission may have under IC 22-9-1-4.

As added by P.L.130-1994, SEC.37 and P.L.116-1994, SEC.48.
Ind. Code § 27-1-47.5-1 — Indiana Code / Title 27 / Article 1 / Chapter 47.5 / Section 27-1-47.5-1
"Governmental hospital"
Status: in_force

Sec. 1. As used in this chapter, "governmental hospital" means an acute care hospital licensed under IC 16-21-2 that is governed by:

(1) IC 16-22-2;

(2) IC 16-22-8; or

(3) IC 16-23.

As added by P.L.203-2023, SEC.21.
Ind. Code § 27-7-18-11 — Indiana Code / Title 27 / Article 7 / Chapter 18 / Section 27-7-18-11
Application; third party access to network; conditions; exception; not required to provide access
Status: in_force

Sec. 11. (a) This section applies if a contracting entity seeks to grant a third party access to:

(1) a provider network contract;

(2) dental services provided pursuant to a provider network contract; or

(3) contractual discounts provided pursuant to a provider network contract.

(b) Except as provided in subsection (c) and section 17 of this chapter, in order for a contracting entity to grant a third party access as described in subsection (a), the following conditions must be satisfied:

(1) When a provider network contract is entered into or renewed, or when there are material modifications to a provider network contract relevant to granting access to a third party as described in subsection (a):

(A) any provider that is a party to the provider network contract must be allowed to choose not to participate in the third party access as described in subsection (a); or

(B) if third party access is to be provided through the acquisition of the provider network by a health insurer, any provider that is a party to the provider network contract must be allowed to enter into a contract directly with the health insurer that acquired the provider network.

(2) The provider network contract must specifically authorize the contracting entity to enter into an agreement with third parties allowing the third parties to obtain the contracting entity's rights and responsibilities as if the third party were the contracting entity.

(3) If the contracting entity seeking to grant a third party access as described in subsection (a) is a dental carrier, a provider that is a party to the provider network contract must have chosen to participate in third party access at the time the provider network contract was entered into or renewed.

(4) If the contracting entity seeking to grant a third party access as described in subsection (a) is a health insurer, the provider network contract must contain a third party access provision specifically granting third party access to the provider network.

(5) If the contracting entity seeking to grant a third party access as described in subsection (a) is a dental carrier, the provider network contract must state that the provider has a right to choose not to participate in the third party access.

(6) The third party being granted access as described in subsection (a) must agree to comply with all of the terms of the provider network contract.

(7) The contracting entity seeking to grant third party access as described in subsection (a) must identify to each provider that is a party to the provider network contract, in writing or electronic form, all third parties in existence as of the date on which the provider network contract is entered into or renewed.

(8) The contracting entity granting third party access as described in subsection (a) must identify, in a list on its website that is updated at least once every ninety (90) days, all third parties to which third party access has been granted.

(9) If third party access as described in subsection (a) is to be granted through the sale or leasing of the network established by the provider network contract, the contracting entity must notify all providers that are parties to the provider network contract of the leasing or sale of the network at least thirty (30) days before the sale or lease of the network takes effect.

(10) The contracting entity seeking to grant third party access to contractual discounts as described in subsection (a)(3) must require each third party to identify the source of the discount on all remittance advices or explanations of payment under which a discount is taken. However, this subdivision does not apply to electronic transactions mandated by the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191).

(c) A contracting entity may grant a third party access as described in subsection (a) even if the conditions set forth in subsection (b)(1) are not satisfied if the contracting entity is not a health insurer or a dental carrier.

(d) Except as provided in subsection (c) and section 17 of this chapter, a provider that is a party to a provider network contract is not required to provide dental services pursuant to third party access granted as described in subsection (a) unless all of the applicable conditions set forth in subsection (b) are satisfied.

As added by P.L.17-2024, SEC.19.
Ind. Code § 27-13-39-3 — Indiana Code / Title 27 / Article 13 / Chapter 39 / Section 27-13-39-3
Written explanation of denial of coverage of experimental treatment; review
Status: in_force

Sec. 3. (a) If a health maintenance organization denies coverage for a treatment, procedure, drug, or device on the grounds that the treatment, procedure, drug, or device is experimental, the health maintenance organization shall provide the enrollee with a written explanation that includes the following:

(1) The basis for the denial.

(2) The enrollee's right to appeal the health maintenance organization's decision as provided in IC 27-8-16-8, IC 27-8-17-12, and IC 27-13-10.

(3) The telephone number of:

(A) an individual employed by the health maintenance organization whom; or

(B) a department of the health maintenance organization that;

the enrollee may contact for assistance in initiating an appeal of the health maintenance organization's decision.

(b) An enrollee is entitled to a review that takes not more than seventy-two (72) hours if the enrollee's health situation is life threatening or is an emergency.

As added by P.L.69-1998, SEC.17.
Ind. Code § 27-8-3-21 — Indiana Code / Title 27 / Article 8 / Chapter 3 / Section 27-8-3-21
Fraudulent representations; offenses
Status: in_force

Sec. 21. A person who knowingly makes a false or fraudulent statement or representation in or with reference to any application for insurance, or for the purpose of obtaining any money or benefit in or to any corporation, association, or society transacting business under this chapter, commits a Class A misdemeanor.

Formerly: Acts 1897, c.195, s.21. As amended by Acts 1978, P.L.2, SEC.2726.
Ind. Code § 27-13-15-4 — Indiana Code / Title 27 / Article 13 / Chapter 15 / Section 27-13-15-4
Participating provider agreement prohibitions
Status: in_force

Sec. 4. (a) As used in this section, "health maintenance organization" includes the following:

(1) A limited service health maintenance organization.

(2) A person that pays or administers claims on behalf of a health maintenance organization or a limited service health maintenance organization.

(b) An agreement between a health maintenance organization and a participating provider under this chapter may not contain a provision that:

(1) prohibits, or grants the health maintenance organization an option to prohibit, the participating provider from contracting with another health maintenance organization to accept lower payment for health care services than the payment specified in the agreement;

(2) requires, or grants the health maintenance organization an option to require, the participating provider to accept a lower payment from the health maintenance organization if the participating provider agrees with another health maintenance organization to accept lower payment for health care services;

(3) requires, or grants the health maintenance organization an option of, termination or renegotiation of the agreement if the participating provider agrees with another health maintenance organization to accept lower payment for health care services; or

(4) requires the participating provider to disclose the participating provider's reimbursement rates under contracts with other health maintenance organizations.

(c) A contract provision that violates this section is void.

As added by P.L.74-2007, SEC.2.
Ind. Code § 27-6-9-22 — Indiana Code / Title 27 / Article 6 / Chapter 9 / Section 27-6-9-22
Binding of retrocessions on behalf of reinsurers by RM; conditions; reinsurance syndicates; appointment of producers; payment of claims; collection of payment; settlements; employment of reinsurer employee; sub-RMs
Status: in_force

Sec. 22. (a) A RM may not bind retrocessions on behalf of the reinsurer, except that the RM may bind facultative retrocessions pursuant to obligatory facultative agreements if the contract with the reinsurer contains reinsurance underwriting guidelines for such retrocessions. Guidelines referred to in this subsection must include a list of reinsurers with which the automatic agreements are in effect, and, for each such reinsurer, the coverages and amounts or percentages that may be reinsured, and commission schedules.

(b) A RM may not commit the reinsurer to participate in reinsurance syndicates.

(c) A RM may not appoint any producer without assuring that the producer is lawfully licensed to transact the type of reinsurance for which the producer is appointed.

(d) A RM may not, without prior approval of the reinsurer, pay or commit the reinsurer to pay a claim, net of retrocessions, that exceeds the lesser of:

(1) an amount specified by the reinsurer; or

(2) one percent (1%) of the reinsurer's policyholder's surplus as of December 31 of the last complete calendar year before the payment or commitment.

(e) A RM may not collect any payment from a retrocessionaire or commit the reinsurer to any claim settlement with a retrocessionaire without prior approval of the reinsurer. If prior approval is given, a report must be promptly forwarded to the reinsurer.

(f) A RM may not jointly employ an individual who is employed by the reinsurer.

(g) A RM may not appoint a sub-RM.

As added by P.L.26-1991, SEC.26.
Ind. Code § 27-13-22-1 — Indiana Code / Title 27 / Article 13 / Chapter 22 / Section 27-13-22-1
Operation of health maintenance organization by insurer or hospital
Status: in_force

Sec. 1. (a) A licensed insurer or a hospital authorized to conduct business in Indiana may, through a subsidiary or an affiliate, organize and operate a health maintenance organization under this article.

(b) This section does not apply to a health maintenance organization granted a certificate of authority under this article before July 1, 2001.

As added by P.L.26-1994, SEC.25. Amended by P.L.203-2001, SEC.28.
Ind. Code § 27-17-1-1 — Indiana Code / Title 27 / Article 17 / Chapter 1 / Section 27-17-1-1
Application of definitions
Status: in_force

Sec. 1. The definitions in this chapter apply throughout this article.

As added by P.L.73-2006, SEC.3.
Ind. Code § 27-2-4-1 — Indiana Code / Title 27 / Article 2 / Chapter 4 / Section 27-2-4-1
Powers of attorney general
Status: in_force

Sec. 1. No suit or action seeking the appointment of a receiver for any domestic insurance company, whether stock or mutual, organized and doing business under the laws of Indiana and subject to supervision and examination of the insurance commissioner or other department of state, shall be instituted or maintained, or a receiver appointed by any court, except and only in an action instituted by the attorney general, on the request of the insurance commissioner or other department of state having supervision of such corporation; provided, nothing in this section shall affect any litigation pending on May 15, 1919, in any court of record.

Formerly: Acts 1919, c.101, s.1. As amended by P.L.252-1985, SEC.127.
Ind. Code § 27-8-10-0.1 — Indiana Code / Title 27 / Article 8 / Chapter 10 / Section 27-8-10-0.1
Application of certain amendments to chapter
Status: in_force

Sec. 0.1. The following amendments to this chapter apply as follows:

(1) The addition of section 10 of this chapter by P.L.93-1995 applies to all small employer health insurance plans issued or renewed under IC 27-8-15, as amended by P.L.93-1995, after December 31, 1995.

(2) The addition of sections 3.5 and 3.6 of this chapter by P.L.193-2003 applies to an association policy that is issued, delivered, amended, or renewed after June 30, 2003.

(3) The amendments made to sections 2.1, 5.1, and 6 of this chapter by P.L.193-2003 apply to an association policy that is issued, delivered, amended, or renewed after June 30, 2003.

(4) The addition of section 3.2 of this chapter by P.L.51-2004 applies to any billing that occurs on or after March 16, 2004, regardless of when the health care services to which the bill applies were provided.

As added by P.L.220-2011, SEC.440.
Ind. Code § 27-8-5.9-3 — Indiana Code / Title 27 / Article 8 / Chapter 5.9 / Section 27-8-5.9-3
"Short term insurance plan"
Status: in_force

Sec. 3. As used in this chapter, "short term insurance plan" means a policy of accident and sickness insurance (as defined in IC 27-8-5-1) that:

(1) may be renewed for the greater of:

(A) thirty-six (36) months; or

(B) the maximum period permitted under federal law;

(2) has a term of not more than three hundred sixty-four (364) days; and

(3) has an annual limit of at least two million dollars ($2,000,000).

As added by P.L.288-2019, SEC.7.
Ind. Code § 27-8-34-3 — Indiana Code / Title 27 / Article 8 / Chapter 34 / Section 27-8-34-3
"Policy"
Status: in_force

Sec. 3. As used in this chapter, "policy" means a policy of accident and sickness insurance (as defined in IC 27-8-5-1). The term does not include dental insurance or vision insurance.

As added by P.L.185-2015, SEC.25.
Ind. Code § 27-5.1-2-35 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-35
Payment of losses and judgments; insufficient funds; assessments
Status: in_force

Sec. 35. (a) A farm mutual insurance company that operates on a premium plus assessment basis must pay losses and judgments of the farm mutual insurance company from premiums received or amounts collected on promissory notes. The amount:

(1) deducted from a policyholder's premium paid; or

(2) demanded from a policyholder's promissory note;

must bear the same relationship to the total loss as the policyholder's total premium bears to the total premiums collected in the calendar year that the loss is incurred.

(b) If funds collected under subsection (a) are insufficient to cover a loss or judgment, the directors of the farm mutual insurance company may, subject to the limitation set forth in the farm mutual insurance company's bylaws under section 30 of this chapter, assess each policyholder in the same manner. However, a farm mutual insurance company may not assess policyholders more than one (1) time in a calendar year for losses incurred by the farm mutual insurance company.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-13-24-4 — Indiana Code / Title 27 / Article 13 / Chapter 24 / Section 27-13-24-4
Action by commissioner after hearing
Status: in_force

Sec. 4. (a) After a hearing, or upon failure of the health maintenance organization or applicant to appear at the hearing, the commissioner shall:

(1) take whatever action the commissioner finds necessary and appropriate based on written findings; and

(2) mail the decision to the health maintenance organization or applicant.

(b) The action of the commissioner under this chapter is subject to review under IC 4-21.5.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-14.5-5-3 — Indiana Code / Title 27 / Article 14.5 / Chapter 5 / Section 27-14.5-5-3
Rights and obligations of mutual insurance holding company members
Status: in_force

Sec. 3. The members of a mutual insurance holding company have the rights and obligations specified in:

(1) this article; and

(2) the articles of incorporation and bylaws of the mutual insurance holding company.

As added by P.L.226-2023, SEC.30.
Ind. Code § 27-1-46.5-11 — Indiana Code / Title 27 / Article 1 / Chapter 46.5 / Section 27-1-46.5-11
Provision of claims data by third party administrator; compliance with federal law; complaint process
Status: in_force

Sec. 11. (a) Not later than thirty (30) days after a request by a contract holder of a direct to employer health care arrangement, a third party administrator that has contracted to administer a direct to employer health care arrangement shall provide claims data to the contract holder. The claims data must include the following:

(1) The effective date of coverage.

(2) The total number of covered individuals.

(3) The total monthly earned premium.

(4) The total monthly dollar value of paid claims, regardless of the period in which the claims were incurred.

(5) The:

(A) beginning and end date of the period for which claims were paid; and

(B) percentage of claims that were paid in:

(i) less than thirty (30) days;

(ii) thirty (30) days to sixty (60) days;

(iii) sixty-one (61) to ninety (90) days; and

(iv) over ninety (90) days.

(6) The reserve value as of the beginning of the period and the reserve value as of the date through which the paid claims data was obtained.

(7) A description of each large or catastrophic claim exceeding fifty thousand dollars ($50,000), including:

(A) the diagnosis;

(B) the dollar amount of the claim;

(C) whether the claim is opened or closed; and

(D) the length of time the claim was open.

(8) Any other claims data requested by the contract holder.

(b) Information provided under this section must be provided in accordance with the federal Health Insurance Portability and Accountability Act, including 45 CFR Part 160 and Part 164, Subparts A and E.

(c) Before January 1, 2026, the department shall establish a process for a contract holder of a direct to employer health care arrangement to file a complaint with the department that a third party administrator violated this section. The department shall conduct an examination under IC 27-1-3.1 upon receiving a complaint under this subsection.

As added by P.L.216-2025, SEC.46.
Ind. Code § 27-4-1.5-7 — Indiana Code / Title 27 / Article 4 / Chapter 1.5 / Section 27-4-1.5-7
"Used body part" defined
Status: in_force

Sec. 7. As used in this chapter, "used body part" means a body part that has previously been attached to a motor vehicle.

As added by P.L.194-1991, SEC.2.
Ind. Code § 27-1-20-32 — Indiana Code / Title 27 / Article 1 / Chapter 20 / Section 27-1-20-32
Effect of captions
Status: in_force

Sec. 32. No caption of any section or set of sections of Acts 1935, c.162 shall in any way affect the interpretation of this article or any provision of this article.

Formerly: Acts 1935, c.162, s.275. As amended by P.L.252-1985, SEC.102.
Ind. Code § 27-1-1.5-29 — Indiana Code / Title 27 / Article 1 / Chapter 1.5 / Section 27-1-1.5-29
"Third party administrator"; "TPA"
Status: in_force

Sec. 29. "Third party administrator" or "TPA" refers to the coding system that is:

(1) maintained by an applicable third party administrator; and

(2) in effect on January 1, 2018.

As added by P.L.124-2018, SEC.1.
Ind. Code § 27-1-43.2-16 — Indiana Code / Title 27 / Article 1 / Chapter 43.2 / Section 27-1-43.2-16
Administrative hearing
Status: in_force

Sec. 16. (a) If a person is aggrieved by an order issued under section 15(3) of this chapter, the person may, not more than twenty (20) days after the effective date of the order, request a hearing under IC 4-21.5.

(b) If a person requests a hearing under subsection (a) the commissioner shall suspend the effective date of the order pending the outcome of the hearing.

(c) In a hearing requested under subsection (a), the burden is on the commissioner to show cause why the order is justified.

As added by P.L.129-2014, SEC.10.
Ind. Code § 27-1-24.2-9 — Indiana Code / Title 27 / Article 1 / Chapter 24.2 / Section 27-1-24.2-9
"Net amount"
Status: in_force

Sec. 9. As used in this chapter, "net amount" means the amount paid to a pharmacy or pharmacist by the insurer, pharmacy benefit manager, or other administrator minus:

(1) any fees;

(2) any price concessions; and

(3) all other revenue;

passing from the pharmacy or pharmacist to the insurer, pharmacy benefit manager, or other administrator.

As added by P.L.189-2025, SEC.1.
Ind. Code § 27-1-41-1 — Indiana Code / Title 27 / Article 1 / Chapter 41 / Section 27-1-41-1
"Certificate"
Status: in_force

Sec. 1. As used in this chapter, "certificate" means a document issued to an individual group member as evidence of the group member's coverage under a master group insurance policy.

As added by P.L.32-2012, SEC.2.
Ind. Code § 27-5.1-2-4 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-4
Proposed farm mutual insurance company requirements for certificate of authority
Status: in_force

Sec. 4. A farm mutual insurance company that is established after June 30, 2003, must have at least:

(1) two hundred fifty (250) applications for insurance policies; and

(2) one hundred thousand dollars ($100,000) in annual direct written premiums;

before issuing an insurance policy.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-7-9-10 — Indiana Code / Title 27 / Article 7 / Chapter 9 / Section 27-7-9-10
Premiums
Status: in_force

Sec. 10. (a) Premiums for mine subsidence insurance under this chapter shall be established by the commissioner, who shall review at least annually the premium level and the experience data concerning operation of the fund and make changes in the premiums as required.

(b) Premiums shall be established at a rate or within a schedule of rates sufficient to:

(1) satisfy all foreseeable claims on the mine subsidence insurance fund during the period of coverage, giving due consideration to relevant loss or claims experience or trends;

(2) cover normal costs of operation of the mine subsidence insurance fund; and

(3) provide a reasonable reserve fund for unexpected contingencies.

(c) Deviations from the premium level or premiums set by the commissioner may not be allowed.

As added by P.L.164-1986, SEC.1.
Ind. Code § 27-1-28-9 — Indiana Code / Title 27 / Article 1 / Chapter 28 / Section 27-1-28-9
Repealed
Status: repealed

As added by P.L.11-2011, SEC.22. Repealed by P.L.124-2018, SEC.52.
Ind. Code § 27-9-1-3 — Indiana Code / Title 27 / Article 9 / Chapter 1 / Section 27-9-1-3
Jurisdiction of court and commissioner; actions by receivers; place of action
Status: in_force

Sec. 3. (a) A delinquency proceeding under this chapter may only be commenced by the commissioner. A court may not entertain, hear, or determine a proceeding commenced by any other person.

(b) A court may not entertain, hear, or determine any complaint requesting:

(1) the dissolution, liquidation, rehabilitation, sequestration, conservation, or receivership of any insurer; or

(2) an injunction, restraining order, or other relief preliminary to, incidental to, or relating to those proceedings other than in accordance with this article.

(c) In addition to other grounds for jurisdiction provided by the law, an Indiana court having jurisdiction of the subject matter has jurisdiction over a person served under the Indiana rules of court or other applicable law in an action brought by the receiver of a domestic insurer or an alien insurer domiciled in Indiana if the person served is:

(1) obligated to the insurer in any way as an incident to any agency or brokerage arrangement that may exist or has existed between the insurer and the insurance producer or broker, in any action on or incident to the obligation;

(2) a reinsurer who:

(A) has at any time written a policy of reinsurance for an insurer against which a rehabilitation or liquidation order is in effect when the action is commenced; or

(B) is an insurance producer or broker of, or for, the reinsurer in any action on or incident to the reinsurance contract; or

(3) or has been an officer, manager, trustee, organizer, promoter, or person in a position of comparable authority or influence in an insurer against which a rehabilitation or liquidation order is in effect when the action is commenced in any action resulting from such a relationship with the insurer.

(d) If it appears to a receiver appointed in a proceeding under this article that there has been criminal or tortious conduct, breach of any contractual or fiduciary obligation, or other unlawful conduct detrimental to the insurer by any director, officer, manager, insurance producer, broker, employee, or other person or entity, the receiver may pursue all appropriate legal remedies on behalf of the insurer.

(e) If the court on motion of any party finds that any action should as a matter of substantial justice be tried in a forum outside Indiana, the court may enter an order to stay further proceedings on the action in Indiana.

(f) All action authorized by this section must be brought in the Marion County circuit court.

As added by Acts 1979, P.L.255, SEC.1. Amended by P.L.167-1986, SEC.1; P.L.178-2003, SEC.73.
Ind. Code § 27-1-23-7 — Indiana Code / Title 27 / Article 1 / Chapter 23 / Section 27-1-23-7
Rules
Status: in_force

Sec. 7. The commissioner may adopt rules under IC 4-22-2 to carry out this chapter.

Formerly: Acts 1971, P.L.387, SEC.1. As amended by Acts 1981, P.L.244, SEC.7; P.L.26-1991, SEC.15; P.L.93-2024, SEC.195.
Ind. Code § 27-1-1-2 — Indiana Code / Title 27 / Article 1 / Chapter 1 / Section 27-1-1-2
Insurance commissioner
Status: in_force

Sec. 2. (a) The powers, duties, management and control of the department of insurance are hereby conferred on and vested in the "insurance commissioner". The insurance commissioner shall be appointed by the governor, and shall be familiar with and known to possess a knowledge of the subject of insurance and be skilled in matters pertaining thereto and shall be chosen solely for fitness, irrespective of political beliefs or affiliations. The commissioner shall serve and may be removed at the pleasure of the governor, and shall be the chief executive and administrative officer of the department. The commissioner shall take an oath of office and give bond in the sum of fifty thousand dollars ($50,000) with surety to be approved by the governor for the faithful performance of his duties.

(b) The commissioner is authorized to attend and participate in the meetings of the national convention of insurance commissioners and of the committees thereof and may require the deputies, actuaries, and assistants that the commissioner may designate to attend and participate in such meetings. If the commissioner deems it advisable, the commissioner may request the attorney general or a deputy attorney general to attend and participate in such meetings. The commissioner and the deputies, actuaries, assistants, and attorneys of the department of insurance shall aid in promoting improvements in the insurance laws and the uniformity thereof in the several states. The expense of such attendance by the commissioner, and the deputies, actuaries, assistants, and attorneys shall be paid by the treasurer of state upon the warrant of the commissioner certifying that the commissioner has examined and approved the charges for such expenses.

Formerly: Acts 1945, c.351, s.2; Acts 1959, c.351, s.1. As amended by P.L.100-2012, SEC.62.
Ind. Code § 27-15-2-2 — Indiana Code / Title 27 / Article 15 / Chapter 2 / Section 27-15-2-2
Required provisions
Status: in_force

Sec. 2. The plan of conversion, other than a simple plan of conversion, must do the following in accordance with this article:

(1) Describe the manner in which the proposed conversion will occur and the insurance and any other companies that will result from or be directly affected by the conversion, including the former mutual and any parent company.

(2) Provide that the membership interests in the converting mutual will be extinguished as of the effective date of the conversion.

(3) Require the distribution to the eligible members, upon the extinguishing of their membership interests, of aggregate consideration equal to the fair value of the converting mutual.

(4) Describe the manner in which the fair value of the converting mutual has been or will be determined.

(5) Describe the form or forms and amount, if known, of consideration to be distributed to the eligible members.

(6) Specify relevant classes, categories, or groups of eligible members, and describe and explain any differences in the form or forms and amount of consideration to be distributed to or among the eligible members.

(7) Require and describe the method or formula for the fair and equitable allocation of the consideration among the eligible members.

(8) Provide for the determination and preservation of the reasonable dividend expectations of eligible members and other policyholders with policies that provide for the distribution of policy dividends, through establishment of a closed block or other method acceptable to the commissioner.

(9) Provide that each member and other policyholder of the converting mutual will receive notification of the address and telephone number of the converting mutual and the former mutual, if different, along with the notice of hearing outlined in IC 27-15-4-4.

(10) Include other provisions as the converting mutual determines to be necessary.

As added by P.L.94-1999, SEC.3.
Ind. Code § 27-1-33-8 — Indiana Code / Title 27 / Article 1 / Chapter 33 / Section 27-1-33-8
Independent financial examination; loss reserves; on-site review of underwriting and claims; reinsurance; termination of contracts; review of books and records; board of directors
Status: in_force

Sec. 8. (a) An insurer shall have on file an independent financial examination, in a form acceptable to the commissioner, of each MGA with which it has done business.

(b) If an MGA establishes loss reserves, the insurer shall annually obtain the opinion of an actuary attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the MGA. This requirement is in addition to any other required loss reserve certification.

(c) The insurer shall periodically (at least semiannually) conduct an on-site review of the underwriting and claims processing operations of the MGA.

(d) Binding authority for all reinsurance contracts or participation in insurance or reinsurance syndicates shall rest with an officer of the insurer, who may not be affiliated with the MGA.

(e) Within thirty (30) days after entering into or terminating a contract with an MGA, the insurer shall provide written notification of the appointment or termination to the commissioner. Notices of appointment of an MGA must include a statement of duties that the applicant is expected to perform on behalf of the insurer, the lines of insurance for which the applicant is to be authorized to act, and any other information the commissioner may request.

(f) An insurer shall review its books and records each quarter to determine if any producer (as defined by section 4 of this chapter) has become, by operation of section 4 of this chapter, an MGA. If the insurer determines that a producer has become an MGA pursuant to section 4 of this chapter, the insurer shall promptly notify the producer and the commissioner of that determination, and the insurer and producer shall fully comply with the provisions of this chapter within thirty (30) days.

(g) An insurer shall not appoint to its board of directors an officer, a director, an employee, a subproducer, or a controlling shareholder of its MGAs. This subsection does not apply to relationships governed by IC 27-1-23.

(h) An insurance holding company system regulated under IC 27-1-23 may perform the obligations imposed by this section for insurers affiliated in the system by submitting, in a form acceptable to the commissioner, consolidated information concerning the MGAs with whom the insurers have done business.

As added by P.L.1-1992, SEC.148. Amended by P.L.116-1994, SEC.45.
Ind. Code § 27-8-15-26 — Indiana Code / Title 27 / Article 8 / Chapter 15 / Section 27-8-15-26
Suspension of premium rate provisions
Status: in_force

Sec. 26. The commissioner may suspend all or any part of section 16 of this chapter as to the premium rates applicable to one (1) small employer for at least one (1) rating period upon a filing by the small employer insurer and a finding by the commissioner that either:

(1) the suspension is reasonable in light of the financial condition of the insurer; or

(2) the suspension would enhance the efficiency and fairness of the marketplace for small employer health insurance.

As added by P.L.127-1992, SEC.1.
Ind. Code § 27-13-36.2-8 — Indiana Code / Title 27 / Article 13 / Chapter 36.2 / Section 27-13-36.2-8
Limitations on recouping, auditing, and correcting payment errors
Status: in_force

Sec. 8. (a) A health maintenance organization may not, more than one hundred eighty (180) days after the date on which an overpayment on a provider claim was made to the provider by the health maintenance organization:

(1) request that the provider repay the overpayment; or

(2) adjust a subsequent claim filed by the provider as a method of obtaining reimbursement of the overpayment from the provider.

(b) A health maintenance organization may not recoup a paid claim more than one hundred eighty (180) days after the date on which the claim was initially paid.

(c) A health maintenance organization may not retroactively audit a paid claim more than three (3) years after the date on which the claim was initially paid.

(d) A health maintenance organization may not be required to correct a payment error to a provider if notice of the payment error is not provided within one hundred eighty (180) days after payment for a fully adjudicated claim is received.

(e) Subsections (a), (b), and (d) do not apply in cases of fraud by the provider, the enrollee, or the health maintenance organization with respect to the health benefits claim on which the overpayment or underpayment was made when a final determination of fraud has been made by a court.

(f) Notwithstanding subsections (a) through (d), a health maintenance organization and a hospital licensed under IC 16-21 may enter into a separate written agreement that provides for different time frames than those specified in this section.

As added by P.L.55-2006, SEC.3. Amended by P.L.88-2026, SEC.15.
Ind. Code § 27-11-6-3 — Indiana Code / Title 27 / Article 11 / Chapter 6 / Section 27-11-6-3
Limitation on use of benefits to pay debts or liabilities of members, beneficiaries, or other persons
Status: in_force

Sec. 3. No money or other benefit, charity, relief, or aid to be paid, provided, or rendered by any society shall be liable to attachment, garnishment, or other process or to be seized, taken, appropriated, or applied by any legal or equitable process or operation of law to pay any debt or liability of a member, beneficiary, or any other person who may have a right thereunder, either before or after payment by the society.

As added by P.L.262-1985, SEC.1.
Ind. Code § 27-1-4.5-8 — Indiana Code / Title 27 / Article 1 / Chapter 4.5 / Section 27-1-4.5-8
Annual report of the violations assessed and fines waived
Status: in_force

Sec. 8. (a) Before December 1 of each year, the department shall submit to the legislative council an annual report of the:

(1) violations assessed; and

(2) fines waived;

under section 7 of this chapter in the previous calendar year.

(b) A report described in this section must be submitted in an electronic format under IC 5-14-6.

As added by P.L.239-2025, SEC.11.
Ind. Code § 27-6-9-16 — Indiana Code / Title 27 / Article 6 / Chapter 9 / Section 27-6-9-16
Refusal to issue license; conditions; summary
Status: in_force

Sec. 16. (a) The commissioner may refuse to issue a reinsurance intermediary license if, in the commissioner's judgment:

(1) the applicant, anyone named on the application, or any member, principal, officer, or director of the applicant, is not trustworthy;

(2) any controlling person of the applicant is not trustworthy to act as a reinsurance intermediary; or

(3) any of the foregoing has given cause for revocation or suspension of such license, or has failed to comply with any prerequisite for the issuance of such license.

(b) Upon written request therefor, the commissioner shall furnish a summary of the basis for refusal to issue a license. A summary furnished under this subsection is declared confidential for the purposes of IC 5-14-3-4(a)(1) and is not subject to inspection and copying as a public record.

As added by P.L.26-1991, SEC.26. Amended by P.L.1-2002, SEC.110.
Ind. Code § 27-16-3-1 — Indiana Code / Title 27 / Article 16 / Chapter 3 / Section 27-16-3-1
Effect on collective bargaining agreement or federal rights or obligations
Status: in_force

Sec. 1. This article and a professional employer agreement do not affect, modify, or amend:

(1) a collective bargaining agreement; or

(2) rights or obligations of a client, PEO, or covered employee under:

(A) the federal National Labor Relations Act (29 U.S.C. 151 et seq.);

(B) the federal Railway Labor Act (45 U.S.C. 151 et seq.); or

(C) IC 22-7.

As added by P.L.245-2005, SEC.7.
Ind. Code § 27-1-30.4-4 — Indiana Code / Title 27 / Article 1 / Chapter 30.4 / Section 27-1-30.4-4
Permitting provision of property and casualty insurance on a group basis
Status: in_force

Sec. 4. (a) An insurer authorized under IC 27-1-3-20 to transact business as a property and casualty insurance company may provide property and casualty insurance to a permitted group on a group basis.

(b) A policy may not be issued or renewed to provide group coverage under this chapter to a group that includes fewer than ten (10) commercial, business, or not-for-profit entities as part of the group.

As added by P.L.165-2022, SEC.5.
Ind. Code § 27-8-24.3-0.1 — Indiana Code / Title 27 / Article 8 / Chapter 24.3 / Section 27-8-24.3-0.1
Application of chapter
Status: in_force

Sec. 0.1. The addition of this chapter by P.L.188-1996 applies only to an insurance policy or a health plan issued, renewed, or entered into after June 30, 1996.

As added by P.L.220-2011, SEC.451.
Ind. Code § 27-8-31-14 — Indiana Code / Title 27 / Article 8 / Chapter 31 / Section 27-8-31-14
Effectiveness of compact; amendments
Status: in_force

Sec. 14. (a) Any state is eligible to become a compacting state. The compact becomes effective and binding upon legislative enactment of the compact into law by two (2) compacting states. However, the commission shall become effective for purposes of adopting uniform standards for, reviewing, and giving approval or disapproval of products filed with the commission that satisfy applicable uniform standards only after twenty-six (26) states are compacting states or, alternatively, by states representing greater than forty percent (40%) of the premium volume for life insurance, annuity, disability income, and long term care insurance products, based on records of the NAIC for the prior year. Thereafter, it becomes effective and binding as to any other compacting state upon enactment of the compact into law by that state.

(b) Amendments to the compact may be proposed by the commission for enactment by the compacting states. An amendment does not become effective and binding upon the commission and the compacting states unless and until all compacting states enact the amendment into law.

As added by P.L.138-2005, SEC.3.
Ind. Code § 27-8-14.1-3 — Indiana Code / Title 27 / Article 8 / Chapter 14.1 / Section 27-8-14.1-3
"Morbid obesity" defined
Status: in_force

Sec. 3. As used in this chapter, "morbid obesity" means:

(1) a body mass index of at least thirty-five (35) kilograms per meter squared, with comorbidity or coexisting medical conditions such as hypertension, cardiopulmonary conditions, sleep apnea, or diabetes; or

(2) a body mass index of at least forty (40) kilograms per meter squared without comorbidity.

For purposes of this section, body mass index is equal to weight in kilograms divided by height in meters squared.

As added by P.L.78-2000, SEC.2. Amended by P.L.196-2005, SEC.4.
Ind. Code § 27-8-15-6 — Indiana Code / Title 27 / Article 8 / Chapter 15 / Section 27-8-15-6
"Case characteristics"
Status: in_force

Sec. 6. As used in this chapter, "case characteristics" means demographic or other relevant characteristics of a small employer, as determined by a small employer insurer, that are considered by the insurer in the determination of premium rates for the small employer. Claim experience, health status, and duration of coverage since issue are not case characteristics.

As added by P.L.127-1992, SEC.1.
Ind. Code § 27-14.5-4-6 — Indiana Code / Title 27 / Article 14.5 / Chapter 4 / Section 27-14.5-4-6
Insurance commissioner findings upon which plan of reorganization may be disapproved
Status: in_force

Sec. 6. The commissioner shall approve a plan submitted under this article unless the commissioner makes at least one (1) of the following findings with respect to the plan:

(1) Disapproval of the plan is necessary to prevent practices that will cause material financial impairment to the applicant or its subsidiaries.

(2) The financial position or management resources and capabilities of the applicant or its subsidiaries or affiliates warrant disapproval.

(3) The plan does not comply with this article.

(4) The proposed plan would not be fair and equitable to the members.

As added by P.L.226-2023, SEC.30.
Ind. Code § 27-1-37.2-5 — Indiana Code / Title 27 / Article 1 / Chapter 37.2 / Section 27-1-37.2-5
Establishment of position
Status: in_force

Sec. 5. The department shall establish the position of health insurance educator within the department.

As added by P.L.258-2001, SEC.1.
Ind. Code § 27-11-2-3 — Indiana Code / Title 27 / Article 11 / Chapter 2 / Section 27-11-2-3
Operation for benefit of members and beneficiaries
Status: in_force

Sec. 3. A society shall operate for the benefit of members and their beneficiaries by:

(1) providing benefits as specified in IC 27-11-6-1; and

(2) operating for one (1) or more social, intellectual, educational, charitable, benevolent, moral, fraternal, patriotic, or religious purposes for the benefit of its members that may also be extended to others. These purposes may be carried out directly by the society, or indirectly through subsidiary corporations or affiliated organizations.

As added by P.L.262-1985, SEC.1.
Ind. Code § 27-1-8-9 — Indiana Code / Title 27 / Article 1 / Chapter 8 / Section 27-1-8-9
Amended certificate of authority
Status: in_force

Sec. 9. When the provisions of sections 2 through 8 of this chapter have been complied with, then the commissioner may issue an amended certificate of authority, which shall license the company to transact the kind or kinds of insurance specified in its articles of incorporation and in the amendment to its articles of incorporation, and which shall expire at midnight, April 30, next following the date of issuance.

Formerly: Acts 1935, c.162, s.109. As amended by P.L.252-1985, SEC.36.
Ind. Code § 27-1-23-5.1 — Indiana Code / Title 27 / Article 1 / Chapter 23 / Section 27-1-23-5.1
Supervisory college
Status: in_force

Sec. 5.1. (a) The commissioner may participate in a supervisory college for a domestic insurer that is part of an insurance holding company system that has international operations, and any affiliate of the insurer, to do the following:

(1) Determine whether the insurer or affiliate is in compliance with this chapter.

(2) Assess the business strategy, financial position, legal and regulatory position, risk exposure, risk management, and governance processes that apply to the insurer or affiliate.

(3) Examine the insurer or affiliate.

(b) The powers of the commissioner under subsection (a) include the following:

(1) Initiation of the establishment of the supervisory college.

(2) Clarification of the membership and participation of other supervisors in the supervisory college.

(3) Clarification of the functions of the supervisory college and the role of other regulators, including the establishment of a group wide supervisor.

(4) Coordination of the activities of the supervisory college, including planning meetings, supervisory activities, and information sharing procedures.

(5) Establishment of a crisis management plan.

(c) An insurer that is described in subsection (a) shall pay the commissioner's reasonable expenses of participation in a supervisory college, including travel expenses. The commissioner may establish a regular assessment to the insurer for payment of the expenses.

(d) The commissioner may enter into agreements in accordance with the requirements that apply to an agreement entered into with the NAIC under section 6 of this chapter to specify the activities of the commissioner and other regulators participating in the supervisory college.

(e) This section does not delegate to a supervisory college a commissioner's authority to regulate or supervise the insurer described in subsection (a) or the insurer's affiliates within the commissioner's jurisdiction.

As added by P.L.81-2012, SEC.17. Amended by P.L.72-2016, SEC.13.
Ind. Code § 27-2-27-24 — Indiana Code / Title 27 / Article 2 / Chapter 27 / Section 27-2-27-24
Powers of commissioner
Status: in_force

Sec. 24. (a) The commissioner may examine and investigate into the affairs of any licensee to determine whether the licensee has been or is engaged in any conduct in violation of this chapter. This power is in addition to the other powers the commissioner has under this title. Any investigation or examination of a licensee under this section shall be conducted pursuant to IC 27-1.

(b) Whenever the commissioner has reason to believe that a licensee has been or is engaged in conduct in Indiana that violates this chapter, the commissioner may take action that is necessary or appropriate to enforce this chapter.

As added by P.L.130-2020, SEC.10.
Ind. Code § 27-1-44.5-3 — Indiana Code / Title 27 / Article 1 / Chapter 44.5 / Section 27-1-44.5-3
Issue of request for information by department; requirements; deadline
Status: in_force

Sec. 3. (a) Before July 1, 2020, the department shall issue a request for information in compliance with IC 5-23-4.5 concerning the creation, operation, and maintenance of a data base.

(b) The request for information must include the following questions:

(1) How the person would collect all relevant claims data for the data base from a health payer in a manner that would minimize technical barriers for a health payer to submit a claim.

(2) How the person would promote and encourage self-funded plans to voluntarily submit claims data for inclusion in the data base.

(3) What funding sources the person would seek to offset costs to implement and maintain the data base.

(4) How the person would make data from the data base available, including what sufficient fee would need to be assessed, to researchers, companies, and other interested parties in analyzing the data.

(5) How the person would ensure the following:

(A) That data is submitted and released in a machine readable format.

(B) That the data from the data base is used in an ethical manner.

(C) That the data is not personally identifiable and is properly secured and maintained, and that the person complies with federal and state health care privacy laws.

(6) How the person would establish a public web portal for individuals to quickly and easily compare prices for the full spectrum of medical billing codes as well as check quality ratings of providers.

(7) What threshold should be set for health payers to submit data for the data base.

(8) How the person would work with other states and relevant stakeholders to either:

(A) use a data language that is already available; or

(B) facilitate the establishment of a common data language to be used by states for the data.

(9) Whether any changes to state law would increase the functionality and effectiveness of the data base and recommendations of the statutes and necessary changes.

(10) Any other questions the department determines are relevant to the implementation of a robust and transparent data base.

(c) The department shall set the deadline for submissions of the request for information under this section that may be not later than November 30, 2020.

As added by P.L.50-2020, SEC.6.
Ind. Code § 27-8-11-7.5 — Indiana Code / Title 27 / Article 8 / Chapter 11 / Section 27-8-11-7.5
Provisional credentialing for independent primary care practice physicians; criteria
Status: in_force

Sec. 7.5. (a) A physician licensed under IC 25-22.5 who was credentialed to provide services under Medicaid within the previous twelve (12) months shall be considered provisionally credentialed if the physician:

(1) is in good standing with the office or a managed care organization or contractor of the office; and

(2) establishes or joins an independent primary care practice.

(b) The insurer shall complete the credentialing process for an individual who is provisionally credentialed under subsection (a).

As added by P.L.203-2023, SEC.23.
Ind. Code § 27-1-48.5-7 — Indiana Code / Title 27 / Article 1 / Chapter 48.5 / Section 27-1-48.5-7
Credit; deductible and out-of-pocket expenses
Status: in_force

Sec. 7. A health plan shall credit toward a covered individual's deductible and annual maximum out-of-pocket expenses any amount the covered individual pays directly to any health care provider for a medically necessary covered health care service if a claim for the health care service is not submitted to the health plan and the amount paid by the covered individual to the health care provider is less than the average discounted rate for the health care service paid to a health care provider in the health plan's network.

As added by P.L.237-2025, SEC.9.
Ind. Code § 27-3-3-5 — Indiana Code / Title 27 / Article 3 / Chapter 3 / Section 27-3-3-5
Application of chapter
Status: in_force

Sec. 5. The method authorized by this chapter for acquiring voting stock of a subsidiary insurer is not exclusive, but is in addition to any other lawful method for the acquisition of such voting stock.

Formerly: Acts 1973, P.L.278, SEC.1.
Ind. Code § 27-2-18-4 — Indiana Code / Title 27 / Article 2 / Chapter 18 / Section 27-2-18-4
"Material acquisition" defined
Status: in_force

Sec. 4. As used in this chapter, "material acquisition" means an asset acquisition or a series of related asset acquisitions during any thirty (30) day period that:

(1) is nonrecurring;

(2) is not in the normal course of business; and

(3) involves more than five percent (5%) of the reporting insurer's total admitted assets as reported in the insurer's most recent statutory statement filed with the department.

As added by P.L.251-1995, SEC.17.
Ind. Code § 27-5.1-2-17 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-17
Commissioner examination
Status: in_force

Sec. 17. (a) The commissioner may examine the affairs of a farm mutual insurance company under IC 27-1-3.1.

(b) The commissioner may take an action that may protect a policyholder's interest if the commissioner determines that a farm mutual insurance company conducts business in a manner that is:

(1) contrary to law applying to a farm mutual insurance company; or

(2) detrimental to policyholder interests.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-1-52-9 — Indiana Code / Title 27 / Article 1 / Chapter 52 / Section 27-1-52-9
Limitation on use of automated process, system, or tool
Status: in_force

Sec. 9. (a) An insurer may not use an automated:

(1) process;

(2) system; or

(3) tool, including artificial intelligence;

as the sole basis to downcode a claim based on medical necessity without the review of the covered individual's medical record by an employee or contractor of the insurer.

(b) A provider may not use an automated:

(1) process;

(2) system; or

(3) tool, including artificial intelligence;

to submit a health benefits claim without the review of a provider or other person involved in the development of the claim for submission.

(c) An insurer must disclose in an easily accessible and readable manner when artificial intelligence is used to:

(1) make an adverse determination on a prior authorization request; or

(2) downcode a claim.

As added by P.L.88-2026, SEC.6.
Ind. Code § 27-8-5.9-7 — Indiana Code / Title 27 / Article 8 / Chapter 5.9 / Section 27-8-5.9-7
Disclosures
Status: in_force

Sec. 7. (a) An insurer that issues a short term insurance plan shall disclose to an applicant, in bold, 10 point type, the following:

(1) That the short term insurance plan does not include coverage for the ten (10) essential health benefits required under PPACA.

(2) That the short term insurance plan does not provide the coverage that is required under PPACA.

(3) That enrollment in health coverage that provides the coverage that is required under PPACA may be done during the next PPACA open enrollment period.

(4) The dates of the next PPACA open enrollment period during which the applicant may enroll in coverage described in subdivision (3).

(b) An insurer shall obtain the signature of an applicant to whom the disclosures required by subsection (a) are made.

As added by P.L.288-2019, SEC.7.
Ind. Code § 27-3-2-6 — Indiana Code / Title 27 / Article 3 / Chapter 2 / Section 27-3-2-6
Officers; election; bond
Status: in_force

Sec. 6. Said directors shall, upon the receipt by the company of said certificate of incorporation, immediately elect a president, vice-president, secretary and treasurer from their number, who shall be sworn to perform faithfully the duties of their respective offices, and who shall give bond for a sum and in a manner to be prescribed in the by-laws of such company.

Formerly: Acts 1895, c.158, s.6.
Ind. Code § 27-1-20-24 — Indiana Code / Title 27 / Article 1 / Chapter 20 / Section 27-1-20-24
Repealed
Status: repealed

Formerly: Acts 1935, c.162, s.271. Repealed by Acts 1978, P.L.2, SEC.2728.
Ind. Code § 27-1-3.5-3.4 — Indiana Code / Title 27 / Article 1 / Chapter 3.5 / Section 27-1-3.5-3.4
"Section 404"
Status: in_force

Sec. 3.4. As used in this chapter, "Section 404" refers to Section 404 of the federal Sarbanes-Oxley Act of 2002 (Public Law 107-204).

As added by P.L.146-2015, SEC.8.
Ind. Code § 27-17-8-2 — Indiana Code / Title 27 / Article 17 / Chapter 8 / Section 27-17-8-2
Notice of right to cancel; restrictions
Status: in_force

Sec. 2. A discount medical card program organization:

(1) shall ensure that a cardholder receives, with the cardholder's identification card, notice that the written agreement may be canceled as provided in section 1 of this chapter; and

(2) may not charge or collect a fee, including a cancellation fee, after a cardholder provides notice to the discount medical card program organization of the cardholder's intention to cancel the written agreement under section 1 of this chapter.

As added by P.L.73-2006, SEC.3.
Ind. Code § 27-5.1-2-24 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-24
Certificate of merger
Status: in_force

Sec. 24. Upon the commissioner's issuance of a certificate of merger under section 23 of this chapter, the farm mutual insurance companies that are parties to the merger plan become a single surviving farm mutual insurance company. The separate existence of each farm mutual insurance company that is a party to the merger plan ceases upon the issuance of the certificate of merger.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-13-13-2 — Indiana Code / Title 27 / Article 13 / Chapter 13 / Section 27-13-13-2
Deposit schedule
Status: in_force

Sec. 2. A health maintenance organization that is in operation on July 1, 1994, shall make:

(1) a deposit with the commissioner equal to two hundred fifty thousand dollars ($250,000) on July 1, 1994; and

(2) an additional deposit with the commissioner equal to two hundred fifty thousand dollars ($250,000) by December 31, 1995.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-37.5-1.8 — Indiana Code / Title 27 / Article 1 / Chapter 37.5 / Section 27-1-37.5-1.8
"Clinical criteria"
Status: in_force

Sec. 1.8. As used in this chapter, "clinical criteria" means:

(1) written policies;

(2) written screen procedures;

(3) drug formularies or lists of covered drugs;

(4) determination rules;

(5) determination abstracts;

(6) clinical protocols;

(7) practice guidelines;

(8) medical protocols; and

(9) any other criteria or rationale;

used by the utilization review entity to determine the medical necessity of a health care service.

As added by P.L.144-2025, SEC.6.
Ind. Code § 27-8-31-3 — Indiana Code / Title 27 / Article 8 / Chapter 31 / Section 27-8-31-3
Interstate insurance product regulation commission
Status: in_force

Sec. 3. (a) The compacting states hereby establish a joint public agency known as the interstate insurance product regulation commission. Under section 4 of this chapter, the commission may:

(1) develop uniform standards for product lines;

(2) receive and provide prompt review of products filed with the commission; and

(3) give approval to product filings satisfying applicable uniform standards.

However, it is not intended for the commission to be the exclusive entity for receipt and review of insurance product filings. This chapter does not prohibit an insurer from filing the insurer's product in a state where the insurer is licensed to conduct the business of insurance and any such filing is subject to the laws of the state where filed.

(b) The commission is a body corporate and politic, and an instrumentality of the compacting states.

(c) The commission is solely responsible for the commission's liabilities except as otherwise specifically provided in this compact.

(d) Venue is proper, and judicial proceedings by or against the commission shall be brought solely and exclusively, in a court with jurisdiction where the principal office of the commission is located.

As added by P.L.138-2005, SEC.3.
Ind. Code § 27-1-24.2-18 — Indiana Code / Title 27 / Article 1 / Chapter 24.2 / Section 27-1-24.2-18
State employee health plan use of a pharmacy benefit manager
Status: in_force

Sec. 18. (a) This section applies to a state employee health plan (as defined in IC 5-10-8-6.7). If a pharmacy benefit manager is used with regard to a state employee health plan, the state personnel department shall either:

(1) create a pharmacy benefit manager within the state personnel department; or

(2) contract with an insurer, a pharmacy benefit manager, or any other administrator of pharmacy benefits.

(b) All data collected by a contractor while administering a contract under subsection (a)(2) is the property of the state.

As added by P.L.189-2025, SEC.1.
Ind. Code § 27-1-3.5-3 — Indiana Code / Title 27 / Article 1 / Chapter 3.5 / Section 27-1-3.5-3
"Independent auditor"
Status: in_force

Sec. 3. As used in this chapter, "independent auditor" means a certified public accountant or a certified public accounting firm that conducts an annual audit of a domestic insurer as required by this chapter.

As added by P.L.244-1989, SEC.2.
Ind. Code § 27-8-5.7-9 — Indiana Code / Title 27 / Article 8 / Chapter 5.7 / Section 27-8-5.7-9
Repealed
Status: repealed

As added by P.L.178-2003, SEC.61. Repealed by P.L.1-2007, SEC.248.
Ind. Code § 27-8-13-10.1 — Indiana Code / Title 27 / Article 8 / Chapter 13 / Section 27-8-13-10.1
Model Medicare supplement policy standards
Status: in_force

Sec. 10.1. (a) The commissioner shall adopt rules under IC 4-22-2 to establish standards for model Medicare supplement policies. The standards must include standards for benefits.

(b) An insurer may issue a Medicare supplement policy or certificate in Indiana only if the policy or certificate is one (1) of the model policies adopted by the department under subsection (a).

As added by P.L.195-1991, SEC.2. Amended by P.L.126-1992, SEC.9.
Ind. Code § 27-2-23-4 — Indiana Code / Title 27 / Article 2 / Chapter 23 / Section 27-2-23-4
"Annuity"
Status: in_force

Sec. 4. (a) As used in this chapter, "annuity" refers to an annuity contract issued in Indiana after June 30, 2015.

(b) The term does not include an annuity contract used to fund an employment based retirement plan, the sponsor or administrator of which directs the insurer that issues the annuity contract.

As added by P.L.90-2014, SEC.1. Amended by P.L.166-2015, SEC.2.
Ind. Code § 27-1-37.6-17 — Indiana Code / Title 27 / Article 1 / Chapter 37.6 / Section 27-1-37.6-17
Notice of participation requirements
Status: in_force

Sec. 17. (a) A health plan shall notify a health care provider of any requirements that a health care provider must meet to participate in a program under section 16 of this chapter.

(b) If a health plan determines that a health care provider is qualified to participate in a program established under section 16 of this chapter, the health plan shall send a notice to the health care provider that contains the following information:

(1) A statement that the health care provider qualifies to participate in the program.

(2) A list of each type of health care service that is subject to the elimination or reduction of prior authorization requirements under the program.

As added by P.L.203-2023, SEC.19.