reglab/housing_qa huggingface dataset:
MT Code § 33-22-129 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-129. Coverage for outpatient self-management training and education for treatment of diabetes -- limited benefit for medically necessary equipment and supplies

  33-22-129. Coverage for outpatient self-management training and education for treatment of diabetes -- limited benefit for medically necessary equipment and supplies. (1) Each group disability policy, certificate of insurance, and membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for outpatient self-management training and education for the treatment of diabetes. Any education must be provided by a licensed health care professional with expertise in diabetes.   (2) (a) Coverage must include a $250 benefit for a person each year for medically necessary and prescribed outpatient self-management training and education for the treatment of diabetes.   (b) Nothing in subsection (2)(a) prohibits an insurer from providing a greater benefit.   (3) Each group disability policy, certificate of insurance, and membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for diabetic equipment and supplies that is limited to insulin, syringes, injection aids, devises for self-monitoring of glucose levels (including those for the visually impaired), test strips, visual reading and urine test strips, one insulin pump for each warranty period, accessories to insulin pumps, one prescriptive oral agent for controlling blood sugar levels for each class of drug approved by the United States food and drug administration, and glucagon emergency kits.   (4) Annual copayment and deductible provisions are subject to the same terms and conditions applicable to all other covered benefits within a given policy.   (5) This section does not apply to disability income, hospital indemnity, medicare supplement, accident-only, vision, dental, specific disease, or long-term care policies.   (6) (a) This section does not apply to any employee group insurance program of a city, town, county, school district, or other political subdivision of this state that on January 1, 2002, provides substantially equivalent or greater coverage for outpatient self-management training and education for the treatment of diabetes and certain diabetic equipment and supplies provided for in subsection (3).   (b) Any employee group insurance program of a city, town, county, school district, or other political subdivision of this state that reduces or discontinues substantially equivalent or greater coverage after January 1, 2002, is subject to the provisions of this section.   History: En. Sec. 1, Ch. 450, L. 2001; amd. Sec. 3, Ch. 54, L. 2011.
MT Code § 33-22-130 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-130. Coverage for adopted children from time of placement -- preexisting conditions

  33-22-130. Coverage for adopted children from time of placement -- preexisting conditions. (1) Each group and individual disability policy, certificate of insurance, or membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for an adopted child of the insured or subscriber to the same extent as for natural children of the insured or subscriber.   (2) The coverage required by this section must be effective from the date of placement for the purpose of adoption and must continue unless the placement is disrupted prior to legal adoption and the child is removed from placement. Coverage at the time of placement must include the necessary care and treatment of medical conditions existing prior to the date of placement and may not impose a preexisting condition exclusion.   (3) As used in this section, "placement" means the transfer of physical custody of a child who is legally free for adoption to a person who intends to adopt the child.   History: En. Sec. 1, Ch. 387, L. 1991; amd. Sec. 27, Ch. 451, L. 1993; amd. Sec. 6, Ch. 416, L. 1997; amd. Sec. 161, Ch. 480, L. 1997.
MT Code § 33-22-131 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-131. Coverage for treatment of inborn errors of metabolism

  33-22-131. Coverage for treatment of inborn errors of metabolism. (1) Each group or individual medical expense disability policy, certificate of insurance, and membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for the treatment of inborn errors of metabolism that involve amino acid, carbohydrate, and fat metabolism and for which medically standard methods of diagnosis, treatment, and monitoring exist.   (2) Coverage must include expenses of diagnosing, monitoring, and controlling the disorders by nutritional and medical assessment, including but not limited to clinical services, biochemical analysis, medical supplies, prescription drugs, corrective lenses for conditions related to the inborn error of metabolism, nutritional management, and medical foods used in treatment to compensate for the metabolic abnormality and to maintain adequate nutritional status.   (3) For purposes of this section:   (a) "medical foods" means nutritional substances in any form that are:   (i) formulated to be consumed or administered enterally under supervision of a physician;   (ii) specifically processed or formulated to be distinct in one or more nutrients present in natural food;   (iii) intended for the medical and nutritional management of patients with limited capacity to metabolize ordinary foodstuffs or certain nutrients contained in ordinary foodstuffs or who have other specific nutrient requirements as established by medical evaluation; and   (iv) essential to optimize growth, health, and metabolic homeostasis;   (b) "treatment" means licensed professional medical services under the supervision of a physician.   (4) These services are subject to the terms of the applicable group or individual disability policy, certificate, or membership contract that establishes durational limits, dollar limits, deductibles, and copayment provisions as long as the terms are not less favorable than for physical illness generally.   (5) This section does not apply to disability income, hospital indemnity, medicare supplement, accident-only, vision, dental, or specified disease policies.   History: En. Sec. 1, Ch. 80, L. 1989; amd. Sec. 28, Ch. 451, L. 1993; amd. Sec. 56, Ch. 379, L. 1995; amd. Sec. 2, Ch. 434, L. 1999.
MT Code § 33-22-132 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-132. Coverage for mammography examinations

  33-22-132. Coverage for mammography examinations. (1) Each group or individual medical expense and blanket disability policy, certificate of insurance, and membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide minimum mammography examination coverage.   (2) For the purpose of this section, "minimum mammography examination" means:   (a) one baseline mammogram for a woman who is 35 years of age or older and under 40 years of age;   (b) a mammogram every 2 years for any woman who is 40 years of age or older and under 50 years of age or more frequently if recommended by the woman's physician; and   (c) a mammogram each year for a woman who is 50 years of age or older.   (3) A minimum $70 payment or the actual charge if the charge is less than $70 must be made for each mammography examination performed before the application of the terms of the applicable group or individual disability policy, certificate of insurance, or membership contract that establish durational limits, deductibles, and copayment provisions as long as the terms are not less favorable than for physical illness generally.   (4) This section does not apply to disability income, hospital indemnity, medicare supplement, accident-only, vision, dental, or specified disease policies.   History: En. Sec. 1, Ch. 663, L. 1991; amd. Sec. 29, Ch. 451, L. 1993; amd. Sec. 57, Ch. 379, L. 1995; amd. Sec. 17, Ch. 63, L. 2015.
MT Code § 33-22-133 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-133. Coverage for minimum hospital stay following childbirth

  33-22-133. Coverage for minimum hospital stay following childbirth. (1) For the purposes of this section, "attending health care provider" means a person licensed under Title 37 who is responsible for providing obstetrical and pediatric care to a mother and newborn infant.   (2) Each group or individual policy, certificate of disability insurance, subscriber contract, membership contract, or health care services agreement that provides coverage for maternity services, including benefits for childbirth, must provide coverage for at least 48 hours of inpatient hospital care following a vaginal delivery and at least 96 hours of inpatient hospital care following delivery by cesarean section for a mother and newborn infant in a health care facility as defined in 50-5-101.   (3) A decision to shorten the length of inpatient stay to less than that provided under subsection (2) must be made by the attending health care provider and the mother. A health benefit plan, as defined in 33-22-1803, may not terminate the service of an attending health care provider or penalize or otherwise provide financial disincentives to an attending health care provider in response to orders by the attending health care provider for care consistent with the provisions of this section.   (4) A health benefit plan that provides coverage for postdelivery care that is provided to a mother and newborn infant in the home may not be required to provide coverage of inpatient care under subsection (2) unless the inpatient care is determined to be medically necessary by the attending health care provider.   (5) A health benefit plan, as defined in 33-22-243, must provide written notice, in a manner consistent with the provisions of this chapter, to all enrollees, insureds, or subscribers regarding the coverage required by this section.   History: En. Sec. 1, Ch. 183, L. 1997.
MT Code § 33-22-134 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-134. Postmastectomy care

  33-22-134. Postmastectomy care. Each group and individual disability policy, certificate of insurance, or membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for hospital inpatient care for a period of time as is determined by the attending physician and, in the case of a health maintenance organization, also the primary care physician, in consultation with the patient, to be medically necessary following a mastectomy, a lumpectomy, or a lymph node dissection for the treatment of breast cancer. This section also applies to any employee group insurance program of a city, town, county, school district, or other political subdivision of the state, and any self-funded multiple employer welfare arrangement that is not regulated by the Employee Retirement Income Security Act of 1974.   History: En. Sec. 1, Ch. 410, L. 1997; amd. Sec. 4, Ch. 54, L. 2011.
MT Code § 33-22-135 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-135. Coverage for reconstructive breast surgery after mastectomy -- benefits and conditions

  33-22-135. Coverage for reconstructive breast surgery after mastectomy -- benefits and conditions. (1) Each group and individual disability policy, certificate of insurance, or membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for:   (a) all stages of reconstruction of the breast on which a mastectomy has been performed;   (b) surgery and reconstruction of the other breast to produce a symmetrical appearance; and   (c) prostheses and physical complications of a mastectomy, including lymphedemas.   (2) The treatment covered under subsection (1) must be determined in consultation with the attending physician and the patient.   (3) The coverage required under this section may be subject to annual deductibles and coinsurance provisions consistent with those established for other benefits under an insurance policy, a membership contract, or a certificate of insurance.   (4) For the purposes of this section:   (a) "mastectomy" means the surgical removal of all or part of a breast;   (b) "reconstructive breast surgery" means surgery performed as a result of a mastectomy to reestablish symmetry between the breasts. The term includes but is not limited to augmentation mammoplasty, reduction mammoplasty, and mastopexy.   (5) Benefits for reconstructive breast surgery under any contract providing outpatient x-ray or radiation therapy include benefits for outpatient chemotherapy following surgical procedures in connection with the treatment of breast cancer that must be included as a part of the outpatient x-ray or radiation therapy benefit.   (6) An insurer shall provide written notice in compliance with the model language of the Women's Health and Cancer Rights Act of 1998 to a covered person of the availability of benefits with respect to the Women's Health and Cancer Rights Act of 1998 upon enrollment and subsequently on an annual basis.   (7) (a) An insurer may not deny to an individual eligibility or continued eligibility to enroll or to renew coverage under the terms of a plan solely for the purpose of avoiding the requirements of this section.   (b) An insurer may not penalize or otherwise reduce or limit the reimbursement of an attending health care provider or provide incentives to an attending health care provider to induce the health care provider to provide care for a covered person in a manner that is inconsistent with this section.   History: En. Sec. 2, Ch. 410, L. 1997; amd. Sec. 1, Ch. 67, L. 2009.
MT Code § 33-22-136 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-136. Insurance for spouse and dependents of deceased peace officer, game warden, or firefighter

  33-22-136. Insurance for spouse and dependents of deceased peace officer, game warden, or firefighter. (1) Any insurer, health service corporation, or health maintenance organization issuing group disability coverage to the spouse or dependents of a peace officer as defined in 45-2-101, a game warden as defined in 19-8-101, a firefighter as defined in 19-13-104, or a volunteer firefighter as defined in 19-17-102 shall renew the coverage of the spouse or dependents if the peace officer, game warden, firefighter, or volunteer firefighter dies within the course and scope of employment. This section also applies to an employee group insurance program of a city, town, county, school district, or other political subdivision of the state, and any self-funded multiple employer welfare arrangement not regulated by the Employee Retirement Income Security Act of 1974 that provides coverage for a peace officer, game warden, firefighter, or volunteer firefighter. Except as provided in subsection (2), the continuation of the coverage is at the option of the spouse or dependents. Renewals of coverage under this section must provide for the same level of benefits as are available to other members of the group. Premiums charged to a spouse or dependent under this section must be the same as premiums charged to other similarly situated members of the group. Dependent special enrollment must be allowed under the terms of 33-22-523(2) and (3). The provisions of this subsection are applicable to a spouse or dependent who is insured under a COBRA continuation provision.   (2) A disability insurance issuer subject to the provisions of subsection (1) may discontinue or not renew the coverage of a spouse or dependent only if:   (a) the spouse or dependent has failed to pay premiums or contributions in accordance with the terms of the disability insurance coverage or if the disability insurer has not received timely premium payments;   (b) the spouse or dependent has performed an act or practice that constitutes fraud or has made an intentional misrepresentation of a material fact under the terms of the coverage; or   (c) the disability insurance issuer is ceasing to offer coverage in the group disability market in accordance with applicable state law.   History: En. Sec. 1, Ch. 178, L. 1999; amd. Sec. 5, Ch. 54, L. 2011.
MT Code § 33-22-137 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-137. Cost-sharing requirements -- applicability

  33-22-137. Cost-sharing requirements -- applicability. (1) Each group or individual health insurance policy, certificate of insurance, and membership contract that covers prescription drugs and that is delivered, issued for delivery, renewed, extended, or modified in this state must provide that after the applicable deductible is met, the insured shall pay only the required copayment or other cost-sharing requirement for a covered prescription drug at the time of purchase if the prescription drug dispenser, third-party administrator, or health insurance issuer can determine that amount at the time of purchase.   (2) This section applies to blanket policies issued pursuant to Title 33, chapter 22, part 6.   (3) This section does not apply to disability income, hospital indemnity, medicare supplement, accident-only, vision, dental, or long-term care policies.   History: En. Sec. 24, Ch. 271, L. 2009.
MT Code § 33-22-141 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-141. Crediting previous coverage

  33-22-141. Crediting previous coverage. (1) (a) A period of creditable coverage may not be counted, with respect to enrollment of an individual under a group health plan, if there was a 63-day break in coverage.   (b) The 63-day period provided for in subsection (1)(a) must be counted from the date that the certificate of creditable coverage was issued to the individual.   (2) The time that an individual is in a waiting period for coverage under a group health plan or for group health insurance coverage or is in an affiliation period, as defined in 33-31-102, may not be considered in determining the continuous period under subsection (1).   (3) Except as provided in subsection (4), for the purposes of applying 33-22-514, a group health plan or a health insurance issuer offering group health insurance coverage shall count a period of creditable coverage without regard to the specific benefits coverage during the period.   (4) (a) A group health plan or a health insurance issuer offering group health insurance may elect to apply the provisions of 33-22-514 based on coverage of benefits within each of several classes or categories of benefits specified in regulations implementing Public Law 104-191, rather than as provided under subsection (3). If electing to apply the provisions of 33-22-514 pursuant to this subsection (4), a group health plan or a health insurance issuer shall:   (i) make the election on a uniform basis for all participants and beneficiaries; and   (ii) count a period of creditable coverage with respect to any class or category of benefits if any level of benefits is covered within the class or category.   (b) In the case of an election under this subsection (4), a group health plan shall:   (i) prominently state in a disclosure statement concerning the group health plan to each enrollee at the time of enrollment that the group health plan has made an election; and   (ii) include a description of the effect of the election in the statement.   (c) In the case of an election under this subsection (4), a health insurance issuer shall:   (i) prominently state in a disclosure statement concerning the health insurance coverage to each employer at the time of the offer or sale of the health insurance coverage that the health insurance issuer has made an election; and   (ii) include a description of the effect of the election in the statement.   (5) Periods of creditable coverage with respect to an individual must be established through presentation of certifications described in 33-22-142 or in such other manner as may be specified in regulations implementing Public Law 104-191.   History: En. Sec. 34, Ch. 416, L. 1997; amd. Sec. 4, Ch. 384, L. 2003.
MT Code § 33-22-142 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 1. General Provisions|33-22-142. Certification of creditable coverage

  33-22-142. Certification of creditable coverage. (1) (a) A group health plan and a health insurance issuer offering group or individual health insurance coverage shall issue the certification described in subsection (3) within 10 days after a request by an individual who ceases to be covered under the group or individual health plan.   (b) A request for the certification may be made no later than 24 months after the date of termination of coverage.   (2) The certification may be provided, to the extent practicable, at a time consistent with notices required under any applicable COBRA continuation provision.   (3) Certification is the written:   (a) certification of the period of creditable coverage of the individual under a group or individual health plan and the coverage under any applicable COBRA continuation provision;   (b) certification of the waiting period, if any, and affiliation period, as defined in 33-31-102, if applicable, imposed with respect to the individual for any coverage under a group health plan;   (c) certification of the date of issuance of the certificate specified on the form; and   (d) notification to the individual of:   (i) the individual's conversion rights;   (ii) the availability of COBRA continuation coverage; and   (iii) other notification as determined necessary and in the form prescribed by rule by the commissioner.   (4) To the extent that medical care under a group health plan consists of group health insurance coverage, a group health plan satisfies the certification requirement of this section if the health insurance issuer offering the coverage provides the certification in accordance with this section.   (5) In the case of an election described in 33-22-141 by a group health plan or health insurance issuer, if the group health plan or health insurance issuer enrolls an individual for coverage under the group health plan and the individual provides a certification of coverage of the individual, the entity that issued the certification shall upon request of the group health plan or health insurance issuer promptly disclose information on coverage of classes and categories of health benefits available under the certified coverage. The entity may charge the requesting group health plan or health insurance issuer the reasonable cost of disclosing the information.   (6) At the time that an individual ceases to be covered by a group or individual health plan, the group health plan or health insurance issuer shall notify the individual that the individual may request the certification described in subsection (3) within the timeframes described in subsection (1).   History: En. Sec. 36, Ch. 416, L. 1997; amd. Sec. 5, Ch. 384, L. 2003; amd. Sec. 25, Ch. 271, L. 2009; amd. Sec. 20, Ch. 63, L. 2015; amd. Sec. 1, Ch. 225, L. 2015.