reglab/housing_qa huggingface dataset:
DC Code § 31-3251 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 32 - Health Insurance Forms|Subchapter III - Uniform Credentialing Forms|§ 31-3251. Definitions

For the purposes of this subchapter, the term: (1) “Commissioner” means Commissioner of the Department of Insurance and Securities Regulation. (2) “Credentialing intermediary” means a person to whom a health insurer has delegated credentialing or recredentialing authority and responsibility. (3) “Health benefit plan” means any accident and health insurance policy or certificate, hospital and medical services corporation contract, health maintenance organization subscriber contract, plan provided by a multiple employer welfare arrangement, or plan provided by another benefit arrangement. The term “health benefit plan” does not mean accident only, credit, or disability insurance; coverage of Medicare services or federal employee health plans, pursuant to contracts with the United States government; Medicare supplemental or long-term care insurance; dental only or vision only insurance; specified disease insurance; hospital confinement indemnity coverage; limited benefit health coverage; coverage issued as a supplement to liability insurance, insurance arising out of a workers’ compensation or similar law; automobile medical payment insurance; medical expense and loss of income benefits; or insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent self-insurance. (4) “Health care provider” means: (A) An individual who is licensed, certified, or otherwise authorized to provide health care services by the District of Columbia for a practice set forth under § 3-1201.02; or (B) An agency, organization, facility, or distinct part of any of them, licensed under subchapter I of Chapter 5 of Title 44. (5) “Health insurer” means any person that provides one or more health benefit plans or insurance in the District of Columbia, including an insurer, a hospital and medical services corporation, a fraternal benefit society, a health maintenance organization, a multiple employer welfare arrangement, or any other person providing a plan of health insurance subject to the authority of the Commissioner. (6) “Provider panel” means providers that contract with a health insurer to provide health care services to the enrollees under a health benefit plan of the health insurer. (7) “Uniform credentialing form” means the form designed by the Commissioner, by regulation, for use by a health insurer or its credentialing intermediary for credentialing and re-credentialing of a health care provider for participation on a provider panel.  (Apr. 13, 2002, D.C. Law 14-96, § 101, 49 DCR 991.)  Section References This section is referenced in § 31-3255.
DC Code § 31-3252 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 32 - Health Insurance Forms|Subchapter III - Uniform Credentialing Forms|§ 31-3252. Application for becoming credentialed

(a) A health insurer or its credentialing intermediary shall accept the uniform credentialing form as the sole application for a health care provider to become credentialed or recredentialed for a provider panel of the health insurer. (b) A health insurer or its credentialing intermediary shall make the uniform credentialing form available to any health care provider that is to be credentialed or re-credentialed by the health insurer or credentialing intermediary.  (Apr. 13, 2002, D.C. Law 14-96, § 102, 49 DCR 991.)
DC Code § 31-3253 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 32 - Health Insurance Forms|Subchapter III - Uniform Credentialing Forms|§ 31-3253. Penalties

The Commissioner may impose a penalty not to exceed $500 against any health insurer for each violation of this subchapter by the health insurer or its credentialing intermediary.  (Apr. 13, 2002, D.C. Law 14-96, § 103, 49 DCR 991.)
DC Code § 31-3254 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 32 - Health Insurance Forms|Subchapter III - Uniform Credentialing Forms|§ 31-3254. Regulations

The Commissioner shall promulgate rules and regulations to implement the provisions of this subchapter.  (Apr. 13, 2002, D.C. Law 14-96, § 104, 49 DCR 991.)  Section References This section is referenced in § 31-3255.
DC Code § 31-3255 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 32 - Health Insurance Forms|Subchapter III - Uniform Credentialing Forms|§ 31-3255. Applicability

This subchapter shall apply, 120 days after the promulgation of the final regulations pursuant to § 31-3254, to health insurers, as defined in § 31-3251(5), and any agency, organization, facility, or distinct part thereof, licensed pursuant to subchapter I of Chapter 5 of Title 44.  (Apr. 13, 2002, D.C. Law 14-96, § 105, 49 DCR 991.)
DC Code § 31-3302.02 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter II - Individual Health Insurance|§ 31-3302.02. Special rules for network plans

(a) A health insurer that offers health insurance coverage in the individual market may: (1) Limit the individuals who may be enrolled under such coverage to those who live, reside, or work within the service area for such network plan; and (2) Within the service area of such plan, deny such coverage to such individuals if the health insurer has demonstrated to the Commissioner that: (A) It will not have the capacity to deliver services adequately to additional individual enrollees because of its obligations to existing group contract holders, enrollees, and enrollees covered under individual contracts; and (B) It is applying this section uniformly to individuals without regard to any health status-related factor of such individuals and without regard to whether the individuals are eligible individuals. (b) A health insurer, upon denying health insurance coverage in the District of Columbia in accordance with subsection (a)(2) of this section, may not offer coverage in the individual market within such service area for a period of 180 days after such coverage is denied.  (Apr. 13, 1999, D.C. Law 12-209, § 202, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1023. Emergency Legislation See notes to § 31-3301.01. Temporary Legislation See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3302.03 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter II - Individual Health Insurance|§ 31-3302.03. Application of financial capacity limits

(a) A health insurer may deny health insurance coverage in the individual market to an eligible individual if the health insurer has demonstrated to the satisfaction of the Commissioner that: (1) It does not have the financial reserves necessary to underwrite additional coverage; and (2) It is applying this section uniformly to all individuals in the individual market in the District of Columbia consistent with the laws of the District of Columbia and without regard to any health status-related factor of such individuals and without regard to whether the individuals are eligible individuals. (b) A health insurer, upon denying individual health insurance coverage in the District of Columbia in accordance with subsection (a) of this section, may not offer such coverage in the individual market within the District of Columbia for a period of 180 days after the date such coverage is denied or until the health insurer has demonstrated to the satisfaction of the Commissioner that the health insurer has sufficient financial reserves to underwrite additional coverage, whichever is later.  (Apr. 13, 1999, D.C. Law 12-209, § 203, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1024. Emergency Legislation See notes to § 31-3301.01. Temporary Legislation See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3302.04 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter II - Individual Health Insurance|§ 31-3302.04. Market requirements

(a) The provisions of this chapter shall not be construed to require that a health insurer offering health insurance coverage only in connection with group health plans or through one or more bona fide associations, or both, offer such health insurance coverage in the individual market. (b) A health insurer offering health insurance coverage in connection with group health plans under this subchapter shall not be deemed to be a health insurer offering individual health insurance coverage solely because such issuer offers a conversion policy. (c) A health insurer offering individual health insurance coverage solely because such insurer offers any insurance coverage for children as a participant in a pilot program relating to insurance coverage for children shall not be deemed to be a health insurer offering individual health insurance coverage.  (Apr. 13, 1999, D.C. Law 12-209, § 204, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1025. Emergency Legislation See notes to § 31-3301.01. Temporary Legislation See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3302.06 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter II - Individual Health Insurance|§ 31-3302.06. Fair market provision

The provisions of § 31-3303.07(j) shall apply to health insurance coverage offered by a health insurer in the individual market in the same manner as they apply to health insurance coverage offered by a health insurer in connection with a group health plan in the small or large group market.  (Apr. 13, 1999, D.C. Law 12-209, § 206, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1027. Emergency Legislation  For temporary (90 days) creation of new § 31-3302.06a, see § 2(b) of Health Insurance Marketplace Improvement Emergency Amendment Act of 2018 (D.C. Act 22-526, Dec. 10, 2018, 65 DCR 13424).  See notes to § 31-3301.01. Temporary Legislation  For temporary (225 days) creation of new § 31-3302.06a, see § 2(b) of Health Insurance Marketplace Improvement Temporary Amendment Act of 2018 (D.C. Law 22-251, Mar. 15, 2019, 66 DCR 975).  See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3302.06a (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter II - Individual Health Insurance|§ 31-3302.06a. Application to multiple employer welfare arrangements

The individual market requirements of this subchapter shall apply to a health benefit plan offered by a multiple employer welfare arrangement, including an association or any other entity, if the plan covers an individual in the District who is not an employee or dependent of a participating employer.  (Apr. 13, 1999, D.C. Law 12-209, § 206a; as added Mar. 22, 2019, D.C. Law 22-266, § 2(b), 66 DCR 1423.)
DC Code § 31-3302.07 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter II - Individual Health Insurance|§ 31-3302.07. Regulations establishing standards

(a) The Commissioner may adopt regulations to enable him or her to establish and administer such standards relating to the provisions of this chapter as may be necessary to (i) implement the requirements of this chapter, and (ii) assure that the District of Columbia’s regulation of health insurers is not preempted pursuant to the Health Insurance Portability and Accountability Act of 1996, approved August 21, 1996 (P.L. 104-191; 110 Stat. 1936). (b) The Commissioner may revise or amend such regulations and may increase the scope of the regulations to the extent necessary to maintain federal approval of the District of Columbia’s program for regulation of health insurers pursuant to the requirements established by the United States Department of Health and Human Services. (b-1) The Commissioner may issue rules to establish and administer such standards relating to the provisions of this chapter as may be necessary to improve access and affordability of health insurance in the District and to maintain the requirements of the Patient Protection and Affordable Care Act, approved March 23, 2010 (124 Stat. 111; 42 U.S.C. § 18001, note). (c) The Commissioner shall annually advise the Committee on Consumer and Regulatory Affairs, or such other Council committee or committees having subject matter jurisdiction over health insurance, of revisions and amendments made pursuant to subsection (b) of this section.  (Apr. 13, 1999, D.C. Law 12-209, § 207, 45 DCR 8433; Mar. 22, 2019, D.C. Law 22-266, § 2(c), 66 DCR 1423.)  Prior Codifications 1981 Ed., § 35-1028. Emergency Legislation  For temporary (90 days) amendment of this section, see § 2(c) of Health Insurance Marketplace Improvement Emergency Amendment Act of 2018 (D.C. Act 22-526, Dec. 10, 2018, 65 DCR 13424).  See notes to § 31-3301.01. Temporary Legislation  For temporary (225 days) amendment of this section, see § 2(c) of Health Insurance Marketplace Improvement Temporary Amendment Act of 2018 (D.C. Law 22-251, Mar. 15, 2019, 66 DCR 975).  See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3302.08 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter II - Individual Health Insurance|§ 31-3302.08. Applicability

Unless otherwise specifically provided in this chapter, the provisions of this subchapter shall apply to individual health benefit plans issued or renewed on or after January 1, 1998.  (Apr. 13, 1999, D.C. Law 12-209, § 208, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1029. Emergency Legislation See notes to § 31-3301.01. Temporary Legislation See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3302.09 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter II - Individual Health Insurance|§ 31-3302.09. Construction

Nothing in this subchapter shall be construed to: (1) Restrict the amount of the premium rates that an issuer may charge an individual for health insurance coverage provided in the individual market; or (2) Prevent a health insurer offering health insurance coverage in the individual market from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.  (Apr. 13, 1999, D.C. Law 12-209, § 209, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1030. Emergency Legislation See notes to § 31-3301.01. Temporary Legislation See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3303.01 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter III - Group Insurance|§ 31-3303.01. Application of subchapter

(a) This subchapter applies to health insurers offering group health insurance coverage. Each insurer proposing to issue group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, each corporation providing group accident and sickness subscription contracts, and each health maintenance organization or multiple employer welfare arrangement providing health care plans for health care services that offers coverage to the group market in the District of Columbia shall be subject to the provisions of this subchapter if any of the following conditions are met: (1) Any portion of the premiums or benefits is paid by or on behalf of the employer; (2) The eligible employee or dependent is reimbursed, whether through wage adjustments or otherwise, by or on behalf of the employer, for any portion of the premium; or (3) The health benefit plan is treated by the employer or any of the covered individuals as part of a plan or program for the purpose of section 106, 125, or 162 of the United States Internal Revenue Code [26 U.S.C. § 106, 26 U.S.C. § 125, or 26 U.S.C. § 162]. (b) Small group market requirements under this subchapter shall apply to a health benefit plan offered by a multiple employer welfare arrangement, including an association or any other entity, if the plan covers an employee of a small employer, as that term is defined in § 31-3301.01(42), in the District.  (Apr. 13, 1999, D.C. Law 12-209, § 301, 45 DCR 8433; Mar. 22, 2019, D.C. Law 22-266, § 2(d), 66 DCR 1423.)  Prior Codifications 1981 Ed., § 35-1031. Emergency Legislation  For temporary (90 days) amendment of this section, see § 2(d) of Health Insurance Marketplace Improvement Emergency Amendment Act of 2018 (D.C. Act 22-526, Dec. 10, 2018, 65 DCR 13424).  See notes to § 31-3301.01. Temporary Legislation  For temporary (225 days) amendment of this section, see § 2(d) of Health Insurance Marketplace Improvement Temporary Amendment Act of 2018 (D.C. Law 22-251, Mar. 15, 2019, 66 DCR 975).  See Historical and Statutory Notes following § 31-3301.01. References in Text Sections 106, 125, and 162 of the United States Internal Revenue Code, referred to in (3), are 26 U.S.C.S. §§ 106, 125, and 162.
DC Code § 31-3303.02 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter III - Group Insurance|§ 31-3303.02. Availability of health benefit plans to small employers

In order to ensure the broadest availability of health benefit plans to small employers, the Commissioner shall set market conduct and other requirements for health insurers, agents, and third-party administrators, including requirements relating to the following: (1) Registration with the Commissioner by each group health insurer offering group health insurance coverage of its intention to offer health insurance coverage in the small group market under this subchapter; (2) Publication by the Commissioner of a list of all health insurers who offer coverage in the small group market, including a potential requirement applicable to agents, third-party administrators, and health insurers that no health benefit plan may be sold to a small employer by a health insurer not identified as a health insurer in the small group market; (3) The availability of a broadly publicized telephone number for the Department of Insurance, Securities, and Banking for access by small employers to information concerning this subchapter; and (4) Methods concerning periodic demonstration by health insurers offering group health insurance coverage that they are marketing and issuing health benefit plans to small employers.  (Apr. 13, 1999, D.C. Law 12-209, § 302, 45 DCR 8433; June 11, 2004, D.C. Law 15-166, § 4(s)(2), 51 DCR 2817.)  Prior Codifications 1981 Ed., § 35-1032. Effect of Amendments D.C. Law 15-166, in par. (3), substituted “Department of Insurance, Securities, and Banking” for “Department of Insurance and Securities Regulation”. Emergency Legislation See notes to § 31-3301.01. For temporary (90 day) amendment of section, see § 4(s)(2) of Consolidation of Financial Services Emergency Amendment Act of 2004 (D.C. Act 15-381, February 27, 2004, 51 DCR 2653). Temporary Legislation See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3303.04 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter III - Group Insurance|§ 31-3303.04. Reference to plan sponsor

In applying this subchapter in the case of health insurance coverage that is made available by a health insurer in the group market to employers only through one or more associations, a reference to “plan sponsor” is deemed, with respect to coverage provided to an employer member of the association, to include a reference to such employer.  (Apr. 13, 1999, D.C. Law 12-209, § 304, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1034. Emergency Legislation See notes to § 31-3301.01. Editor's Notes Temporary addition of chapter: See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3303.05 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter III - Group Insurance|§ 31-3303.05. Coverage

If coverage to the small or large employer market pursuant to this subchapter ceases to be written, administered, or otherwise provided, such coverage shall continue to be governed by this subchapter with respect to business conducted under this subchapter that was transacted prior to the effective date of termination and that remains in force.  (Apr. 13, 1999, D.C. Law 12-209, § 305, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1035. Emergency Legislation See notes to § 31-3301.01. Temporary Legislation See Historical and Statutory Notes following § 31-3301.01.
DC Code § 31-3303.08 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 33 - Health Insurance Portability and Accountability|Subchapter III - Group Insurance|§ 31-3303.08. Disclosure of information

(a) Any health insurer offering health insurance coverage to a small employer shall make a reasonable disclosure of the availability of information to such an employer, as part of its solicitation and sales materials, and upon request of such an employer, information concerning: (1) The provisions of such coverage concerning the health insurer’s right to change premium rates and the factors that may affect changes in premium rates; (2) The provisions of such coverage relating to renewability of coverage; (3) The provisions of such coverage relating to any preexisting condition exclusion; and (4) The benefits and premiums available under all health insurance coverage for which the employer is qualified. (b) A health insurer is not required under this subchapter to disclose any information that is proprietary and trade secret information.  (Apr. 13, 1999, D.C. Law 12-209, § 308, 45 DCR 8433.)  Prior Codifications 1981 Ed., § 35-1038. Emergency Legislation See notes to § 31-3301.01. Temporary Legislation See Historical and Statutory Notes following § 31-3301.01.