reglab/housing_qa huggingface dataset:
HI Rev Stat § 431:10A-301 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-301 Definitions.

Attorney General Opinions Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in §431:10A-103. Att. Gen. Op. 97-10.   §431:10A-301 Definitions. For the purposes of this part:  "Applicant" means:  (1) In the case of an individual medicare supplement policy, the person who seeks to contract for insurance benefits, and  (2) In the case of a group medicare supplement policy, the proposed certificate holder.  "Certificate" means any certificate delivered or issued for delivery in this State under a group medicare supplement policy.  "Certificate form" means the form on which the certificate is delivered or issued for delivery by the issuer.  "Issuer" includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this State medicare supplement policies or certificates.  "Medicare" means the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.  "Medicare supplement policy" means a group or individual policy of accident and health or sickness insurance or a subscriber contract of hospital and medical service associations or health maintenance organizations, other than a policy issued pursuant to a contract under section 1876 of the federal Social Security Act (42 U.S.C. section 1395 et seq.), or an issued policy under a demonstration project specified in 42 U.S.C. section 1395ss(g)(1), which is advertised, marketed, or designed primarily as a supplement to reimbursements under medicare for the hospital, medical, or surgical expenses of persons eligible for medicare.  "Policy form" means the form on which the policy is delivered or issued for delivery by the issuer. [L 1987, c 347, pt of §2; am L 1989, c 195, §25; am L 1990, c 84, §1; am L 1992, c 195, §1; am L 1996, c 28, §1; am L 2003, c 212, §78]
HI Rev Stat § 431:10A-302 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-302 Applicability and scope.

  §431:10A-302 Applicability and scope. (a) Notwithstanding any provision in this part to the contrary, this part shall apply to:  (1) All medicare supplement policies delivered or issued for delivery in this State; and  (2) All certificates issued under group medicare supplement policies, which certificates have been delivered or issued for delivery in this State.  (b) This part shall not apply to a policy of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees, or combination thereof, or for members or former members, or combination thereof, of the labor organizations.  (c) The commissioner shall have all rights and powers with respect to the group or master policy and certificate issued pursuant to the medicare supplement policy as if the group or master policy was issued and delivered to a person domiciled in this State.  (d) Except as otherwise specifically provided in section 431:10A-307(d), this part is not intended to prohibit or apply to insurance policies or health care benefit plans including group conversion policies, issued to medicare eligible persons that are not marketed or held to be medicare supplement policies or benefit plans. [L 1987, c 347, pt of §2; am L 1989, c 207, §11; am L 1990, c 84, §2; am L 1992, c 195, §2; am L 1996, c 28, §2; am L 2004, c 122, §34]
HI Rev Stat § 431:10A-303 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-303 REPEALED.

  §431:10A-303 REPEALED. L 1990, c 84, §10.
HI Rev Stat § 431:10A-304 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-304 Standards for policy provisions.

  §431:10A-304 Standards for policy provisions. (a) No medicare supplement policy or certificate in force in the State shall contain benefits that duplicate benefits provided by medicare.  (b) The commissioner shall adopt reasonable rules to establish specific standards for the provisions of medicare supplement policies and certificates. The standards shall be in addition to and in accordance with applicable laws of this State, including the provisions of part I of this article. No requirement of this chapter relating to minimum required policy benefits, other than the minimum standards contained in this part, shall apply to medicare supplement policies and certificates. The standards may cover, but shall not be limited to:  (1) Terms of renewability;  (2) Initial and subsequent conditions of eligibility;  (3) Nonduplication of coverage;  (4) Probationary periods;  (5) Benefit limitations, exceptions, and reductions;  (6) Elimination periods;  (7) Requirements for replacement;  (8) Recurrent conditions; and  (9) Definition of terms.  (c) The commissioner may adopt reasonable rules that specify prohibited policy provisions not otherwise specifically authorized by law, which, in the opinion of the commissioner, are unjust, unfair, or unfairly discriminatory to any person insured or proposed to be insured under any medicare supplement policy or certificate.  (d) A medicare supplement policy or certificate shall not exclude or limit benefits for losses incurred more than six months after the effective date of coverage because it involved a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage. [L 1987, c 347, pt of §2; am L 1989, c 195, §26; am L 1990, c 84, §3; am L 1992, c 195, §3]
HI Rev Stat § 431:10A-305 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-305 Rules.

  §431:10A-305 Rules. (a) The commissioner shall adopt reasonable rules to establish minimum standards for benefits and claims payment, marketing practices, compensation arrangements, and reporting practices for medicare supplement policies and certificates.  (b) The commissioner may adopt from time to time, reasonable rules as are necessary to conform medicare supplement policies and certificates to the requirements of federal law and regulations adopted thereunder, including but not limited to:  (1) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements;  (2) Establishing a uniform methodology for calculating and reporting loss ratios;  (3) Assuring public access to policies, premiums, and loss ratio information of issuers of medicare supplement insurance;  (4) Establishing a process for approving or disapproving policy forms and certificate forms and proposed premium increases;  (5) Establishing a policy for holding public hearings prior to approval of premium increases; and  (6) Establishing standards for medicare select policies and certificates. [L 1987, c 347, pt of §2; am L 1989, c 195, §27; am L 1990, c 84, §4; am L 1992, c 195, §4; am L 1993, c 205, §23; am L 1996, c 28, §3]
HI Rev Stat § 431:10A-306 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-306 Loss ratio standards.

  §431:10A-306 Loss ratio standards. Medicare supplement policies shall return to policyholders benefits which are reasonable in relation to the premium charged. The commissioner shall adopt reasonable rules to establish minimum standards for loss ratios of medicare supplement policies on the basis of incurred claims experience or incurred health care expenses where coverage is provided by a health maintenance organization on a service rather than reimbursement basis, and earned premiums in accordance with accepted actuarial principles and practices. For the purposes of rules adopted under this section, group medicare supplement policies and certificates issued as a result of solicitations of individuals through the mail or mass media advertising, including both print and broadcast advertising, shall be regarded as group policies. [L 1987, c 347, pt of §2; am L 1989, c 195, §28; am L 1990, c 84, §5; am L 1992, c 195, §5; am L 1996, c 28, §4]
HI Rev Stat § 431:10A-307 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-307 Disclosure standards.

  §431:10A-307 Disclosure standards. (a) In order to provide for full and fair disclosure in the sale of medicare supplement policies, no medicare supplement policy or certificate shall be delivered or issued for delivery in this State unless an outline of coverage is delivered to the applicant at or prior to the time application is made.  (b) The commissioner shall prescribe the format and content of the outline of coverage required by subsection (a). For the purposes of this section, format means style, arrangement and overall appearance, including such items as the size, color, prominence of type, and the arrangement of text and captions. The outline of coverage shall include:  (1) A description of the principal benefits and coverage provided in the policy;  (2) A statement of the renewal provisions including any reservation by the issuer of a right to change premiums; and disclosure of the existence of any automatic renewal premium increases based on the policyholder's age; and  (3) A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.  (c) The commissioner may prescribe by rule a standard form and contents of an informational brochure for persons eligible for medicare which is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of medicare. Except in the case of direct response insurance policies, the commissioner may require by rule that the informational brochure be provided to any prospective insureds eligible for medicare concurrently with delivery of the outline of coverage. With respect to direct response insurance policies, the commissioner may require by rule that the prescribed brochure be provided upon request to any prospective insureds eligible for medicare, but in no event later than the time of policy delivery.  (d) The commissioner may adopt reasonable rules for captions or notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not medicare supplement coverages, for all accident and health or sickness insurance policies sold to persons eligible for medicare, other than:  (1) Medicare supplement policies; or  (2) Disability income policies.  (e) The commissioner may adopt reasonable rules to govern the full and fair disclosure of information in connection with the replacement of accident and health or sickness insurance policies, subscriber contracts, or certificates by persons eligible for medicare. [L 1987, c 347, pt of §2; am L 1990, c 84, §6; am L 1992, c 195, §6; am L 1996, c 28, §5; am L 2002, c 155, §64]
HI Rev Stat § 431:10A-308 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-308 Notice of free examination.

  §431:10A-308 Notice of free examination. Medicare supplement policies and certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Any refund made pursuant to this section shall be paid directly to the applicant by the issuer in a timely manner. [L 1987, c 347, pt of §2; am L 1989, c 195, §29; am L 1990, c 84, §7; am L 1992, c 195, §7]
HI Rev Stat § 431:10A-309 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-309 Filings; approval of forms.

  §431:10A-309 Filings; approval of forms. (a) No medicare supplement policy or certificate shall be delivered or issued for delivery in this State after the date specified in rules adopted by the commissioner unless the form of the policy or certificate is approved in accordance with this section.  (b) Every issuer providing medicare supplement insurance benefits to a resident of this State shall file with the commissioner a copy of the policy and any certificate used in this State, including copies of any riders or endorsements of applications which may be attached to or made a part of the policy. The commissioner may require a certification from the issuer that, to the best of the certifier's knowledge and belief, the filing complies with the minimum standards established in the rules and all applicable Hawaii laws and rules.  (c) Every issuer providing medicare supplement policies or certificates in this State shall file annually its rates, rating schedule, and supporting documentation demonstrating that it is in compliance with the applicable loss ratio standards of this State. The commissioner may require the issuer to submit a certification by a qualified actuary that the premium rates, to the best of the actuary's knowledge and belief, are in accordance with the loss ratio standards adopted by rule.  (d) The commissioner may disapprove any policy or certificate or withdraw approval of a previously approved policy or certificate if the commissioner finds that:  (1) It is not in accordance with applicable laws and rules in any respect;  (2) It is or it contains provisions which are misleading, deceptive, inconsistent, or ambiguous; or  (3) The benefits are unreasonable in relation to the premium charge.  (e) A policy or certificate shall be deemed approved if:  (1) It is in accordance with all applicable laws and rules;  (2) It has not been disapproved earlier than sixty-one days after the date of filing;  (3) It fully meets all filing requirements; and  (4) It is received by the commissioner.  (f) The commissioner shall promptly give written notice to the issuer of the commissioner's approval of a policy or certificate or, if a policy or certificate is disapproved or approval is withdrawn, of such disapproval or withdrawal together with the reasons for it and of the procedure by which the issuer may request and be granted a hearing on the merits of such action.  (g) The commissioner by rule may establish requirements and procedures for medicare supplement filings. [L 1987, c 347, pt of §2; am L 1990, c 84, §8; am L 1992, c 195, §8; am L 2004, c 122, §35]
HI Rev Stat § 431:10A-310 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-310 Filing requirements for advertising.

  §431:10A-310 Filing requirements for advertising. (a) Every issuer of medicare supplement insurance policies or certificates in this State shall file a copy of any medicare supplement advertisement intended for use in this State whether through written, radio, or television medium to the commissioner for review. The commissioner may require a certification from the entity that to the best of the certifier's knowledge and belief the advertisement complies with the provisions of this chapter and all applicable rules.  (b) If the commissioner finds the advertisement to be in violation of any provision of this chapter or any rule, the commissioner shall order the issuer to cease and desist use of the advertisement pursuant to section 431:2-203.  (c) In conjunction with a cease and desist order issued pursuant to subsection (b), the commissioner may order the issuer to refund to the insured the premium paid for the medicare supplement policy. Any refund of an amount paid by the insured for the medicare supplement insurance shall be paid within fifteen days to the person entitled thereto; provided that by rule the commissioner may prescribe an amount below which no refund need be made. [L 1989, c 195, §3; am L 1990, c 84, §9; am L 1992, c 195, §9; am L 2004, c 122, §36]
HI Rev Stat § 431:10A-311 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-311 Penalties.

  §431:10A-311 Penalties. In addition to any other applicable penalties for violations of this chapter, pursuant to section 431:2-203, the commissioner may require issuers violating any provision of this part or rules adopted pursuant to this part to cease marketing or selling any medicare supplement policy in this State which is related directly or indirectly to a violation or may require the issuer to take actions necessary to comply with the provisions of this part, or both. [L 1989, c 195, §4; am L 1992, c 195, §10]
HI Rev Stat § 431:10A-312 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-312 Severability.

  §431:10A-312 Severability. If any provision of this part or the application thereof to any person or circumstances is for any reason held to be invalid, the remainder of the part and the application of such provision to other persons or circumstances shall not be affected thereby. [L 1989, c 195, §5]
HI Rev Stat § 431:10A-401 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-401 Purpose.

Attorney General Opinions Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in §431:10A-103. Att. Gen. Op. 97-10.   §431:10A-401 Purpose. It is the purpose of this part to provide a means of more adequately meeting the needs of persons who are sixty-five years of age or older and their spouses for insurance coverage against financial loss from accident or disease through the combined resources and experience of a number of insurers; to make possible the fullest extension of such coverage by encouraging insurers to combine their resources and experience and to exercise their collective efforts in the development and offering of policies of such insurance to all such applicants at costs lower than those generally available through individual insurers; and to regulate the joint activities herein authorized in accordance with the intent of Congress as expressed in the Act of Congress of March 9, 1945 (Public Law 15, 79th Congress), as amended. [L 1987, c 347, pt of §2]
HI Rev Stat § 431:10A-402 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-402 Definitions.

  §431:10A-402 Definitions.  Unless the context otherwise requires, for the purposes of this part:  (1) Association means a voluntary unincorporated association formed for the purpose of enabling cooperative action to provide accident and health or sickness insurance as defined in section 431:1-205, in accordance with this part in this or any other state having legislation enabling the issuance of insurance of the type provided in this part.  (2) Insurer means any insurance company authorized to transact accident and health or sickness insurance in this State.  (3) Extended health insurance means hospital, surgical, and medical expense insurance provided by a policy issued as provided by this part. [L 1987, c 347, pt of §2; am L 2002, c 155, §65]
HI Rev Stat § 431:10A-403 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-403 Association of insurers; policyholder; policy.

  §431:10A-403 Association of insurers; policyholder; policy. (a) Any insurer may join with one or more other insurers to plan, develop, underwrite, offer and provide to any person who is sixty-five years of age or older and to the spouse of such person, extended health insurance against financial loss from accident or disease, or both. The insurance may be offered, issued and administered jointly by two or more insurers by a group policy issued to a policyholder through an association formed for the purpose of offering, selling, issuing and administering such insurance.  (b) The policyholder may be an association, a trustee, or any other person. A master group policy issued to an association or to a trustee or any person appointed by an association for the purpose of providing the insurances described in this part shall be another form of group disability insurance.  Any form of policy approved by the commissioner for an association shall be offered throughout the State to all persons sixty-five and older and their spouses, and the coverage of any person insured under such a form of policy shall not be cancellable except for nonpayment of premiums unless the coverage of all persons insured under such form of policy is also cancelled.  (c) Any such policy may provide, among other things, that the benefits payable under the policy are subject to reduction if the individual insured has any other coverage providing hospital, surgical or medical benefits whether on an indemnity basis or a provision of service basis resulting in such insured being eligible for more than one hundred per cent of covered expenses which the insured is required to pay. Any insurer issuing individual policies providing extended hospital, surgical or medical benefits to persons sixty-five years of age and older and their spouses may also use such a policy provision. [L 1987, c 347, pt of §2]
HI Rev Stat § 431:10A-404 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-404 Persons authorized to transact insurance.

  §431:10A-404 Persons authorized to transact insurance. Notwithstanding the provisions of article 9A, any person licensed to transact accident and health or sickness insurance as a producer may transact extended health insurance and may be paid a commission in accordance with commission schedules filed with the commissioner as required by section 431:10A-406. [L 1987, c 347, pt of §2; am L 2001, c 216, §16; am L 2002, c 155, §66; am L 2003, c 212, §79]
HI Rev Stat § 431:10A-404.5 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10A-404.5 Genetic information nondiscrimination in extended health insurance coverage.

  §431:10A-404.5 Genetic information nondiscrimination in extended health insurance coverage. (a) No insurer may:  (1) Use an individual's or a family member's genetic information, or request for genetic services, to deny or limit any coverage or establish eligibility, continuation, enrollment, or premium payments;  (2) Request or require collection or disclosure of an individual's or a family member's genetic information; or  (3) Disclose an individual's or a family member's genetic information without the written consent of the person affected, the person's legal guardian, or a person with power of attorney for health care for the person affected. This consent shall be required for each disclosure and shall include the name of each person or organization to whom the disclosure will be made.  (b) As used in this section:  "Family member" means, with respect to the individual, another individual related by blood to that individual.  "Genetic information" means information about genes, gene products, hereditary susceptibility to disease, or inherited characteristics that may derive from the individual or family member.  "Genetic services" means health services to obtain, assess, or interpret genetic information for diagnosis, therapy, or genetic counseling.  (c) This section shall not apply to any action taken in connection with policies of life insurance, disability income insurance, and long-term care insurance delivered or issued for delivery in this State. [L 2002, c 217, §2] Law Journals and Reviews  Privacy and Genetics: Protecting Genetic Test Results in Hawai €˜i. 25 UH L. Rev. 449 (2003).