reglab/housing_qa huggingface dataset:
NC Gen Stat § 58-3-247 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-247 - Insurance identification card.

 58-3-247. Insurance identification card.(a) Every insurer offering a health benefit plan as defined under G.S. 58-3-167 shall provide the health benefit plan subscriber or members with an insurance identification card. The card shall contain, at a minimum, all of the following information:(1) The subscriber's name and identification number.(2) The member's name and identification number, if applicable and different from the subscriber's name and identification number.(3) The group number.(4) The name of the organization issuing the policy, the name of the organization administering the policy, and the name of the network, whichever applies.(5) The effective date of health benefits plan coverage or the date the card is issued if it is after the effective date.(6) The address where claims are to be filed and, if applicable, the electronic claims filing payor identification number.(7) The policyholder's obligations with regard to copayments, if applicable, for at least all of the following:a. Primary care office visit.b. Specialty care office visit.c. Urgent care visit.d. Emergency room visit.(8) The phone number or website address whereby the subscriber, member, or service provider, in compliance with privacy rules under the Health Insurance Portability and Accountability Act may readily obtain the following:a. Confirmation of eligibility.b. Benefits verification in order to estimate patient financial responsibility.c. Prior authorization for services and procedures.d. The list of participating providers in the network.e. The employer group number.f. Special mental health medical benefits under the health plan, if applicable.(9) An indication of whether the health benefit plan is a fully insured or self-funded plan. Plans that are fully insured shall be noted by using the phrase "fully insured" to indicate to the consumer that the Department is able to provide assistance regarding the regulation of the plan.(b) The insurance identification card must be designed such that if the card is photocopied or electronically scanned, the resulting image is clearly legible. The identification card must present the information in a readily identifiable manner or, alternatively, the information may be embedded on the card and available through magnetic stripe or smart card. The information may also be provided through other electronic technology.  (2007-362, s. 2; 2021-30, s. 1(a).)
NC Gen Stat § 58-3-250 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-250 - Payment obligations for covered services.

 58-3-250. Payment obligations for covered services.(a) If an insurer calculates a benefit amount for a covered service under a health benefit plan through a method other than a fixed dollar co-payment, the insurer shall clearly explain in its evidence of coverage and plan summaries how it determines its payment obligations and the payment obligations of the insured. The explanation shall include:(1) An example of the steps the insurer would take in calculating the benefit amount and the payment obligations of each party.(2) Whether the insurer has obtained the agreement of health care providers not to bill an insured for any amounts by which a provider's charge exceeds the insurer's recognized charge for a covered service and whether the insured may be liable for paying any excess amount.(3) Which party is responsible for filing a claim or bill with the insurer.(b) If an insured is liable for an amount that differs from a stated fixed dollar co-payment or may differ from a stated coinsurance percentage because the coinsurance amount is based on a plan allowance or other such amount rather than the actual charges and providers are permitted to balance bill the insured, the evidence of coverage, plan summaries, and marketing and advertising materials that include information on benefit levels shall contain the following statement: "NOTICE: Your actual expenses for covered services may exceed the stated [coinsurance percentage or co-payment amount] because actual provider charges may not be used to determine [plan/insurer or similar term] and [insured/member/enrollee or similar term] payment obligations." (2001-446, s. 2.3.)
NC Gen Stat § 58-3-256 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-256 - Coverage related to organ transplants.

 58-3-256. Coverage related to organ transplants.(a) For the purposes of this section, the following definitions apply:(1) Anatomical gift. - The donation of all or part of a human body to take effect after the donor's death for the purpose of a transplant.(2) Disability. - As defined in the Americans with Disabilities Act of 1990, 42 U.S.C. 12102 et seq., as amended.(3) Health benefit plan. - As defined in G.S. 58-3-167.(4) Insurer. - As defined in G.S. 58-3-167.(5) Transplant. - The transplantation or transfusion of a part of a human body into the body of another human for the purpose of treating or curing a medical condition.(b) No insurer offering a health benefit plan in this State that provides coverage for anatomical gifts, organ transplants, or treatment and services related to anatomical gifts or transplants shall do any of the following:(1) Deny coverage to an insured solely on the basis of that individual's disability.(2) Deny to an individual eligibility, or continued eligibility, to enroll or to renew coverage under the terms of a health benefit plan solely for the purpose of avoiding the requirements of this section.(3) Attempt to induce a health care provider to provide care to an insured in a manner inconsistent with this section by doing either of the following:a. Penalizing, or otherwise reducing or limiting the reimbursement of, a health care provider.b. Providing monetary or nonmonetary incentives to a health care provider.(4) Reduce or limit health benefit plan coverage benefits to an insured for any services related to organ transplantation performed determined to be necessary in consultation with the attending physician and the insured.(c) When a person or that person's health care provider or representative requests that person's insurer to determine whether a transplant is eligible for benefits under that person's health benefit coverage, the insurer shall, within 10 business days after receipt of the request and medical documentation necessary to determine if there is coverage, inform the requesting person as to whether there is coverage; provided coverage exists at the time of the transplant.(d) In the case of a health benefit plan maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers, any amendment to the health benefit plan made pursuant to a collective bargaining agreement solely to conform to this section shall not be treated as a termination of the collective bargaining agreement.(e) Nothing in this section shall be deemed to require an insurer to provide coverage for a medically inappropriate organ transplant.  (2021-64, s. 3(a); 2021-64, s. 3(b).)
NC Gen Stat § 58-3-260 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-260 - Insurance coverage for newborn hearing screening mandated.

 58-3-260. Insurance coverage for newborn hearing screening mandated.(a) As used in this section, the terms "health benefit plan" and "insurer" have the meanings applied under G.S. 58-3-167.(b) Each health benefit plan shall provide coverage for newborn hearing screening ordered by the attending physician pursuant to G.S. 130A-125. The same deductibles, coinsurance, reimbursement methodologies, and other limitations and administrative procedures as apply to similar services covered under the health benefit plan shall apply to coverage for newborn hearing screening. (2001-446, s. 3.2.)
NC Gen Stat § 58-3-265 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-265 - Prohibition on managed care provider incentives.

 58-3-265. Prohibition on managed care provider incentives.An insurer offering a health benefit plan may not offer or pay any type of material inducement, bonus, or other financial incentive to a participating provider to deny, reduce, withhold, limit, or delay specific medically necessary and appropriate health care services covered under the health benefit plan to a specific insured or enrollee. This section does not prohibit insurers from paying a provider on a capitated basis or withholding payment or paying a bonus based on the aggregate services rendered by the provider or the insurer's financial performance. (2001-446, s. 1.8.)
NC Gen Stat § 58-3-270 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-270 - Coverage for surveillance tests for women at risk for ovarian cancer.

 58-3-270. Coverage for surveillance tests for women at risk for ovarian cancer.(a) Every health benefit plan, as defined in G.S. 58-3-167, shall provide coverage for surveillance tests for women age 25 and older at risk for ovarian cancer. As used in this section:(1) "At risk for ovarian cancer" means either:a. Having a family history:1. With at least one first-degree relative with ovarian cancer; and2. A second relative, either first-degree or second-degree, with breast, ovarian, or nonpolyposis colorectal cancer; orb. Testing positive for a hereditary ovarian cancer syndrome.(2) "Surveillance tests" mean annual screening using:a. Transvaginal ultrasound; andb. Rectovaginal pelvic examination.(b) The same deductibles, coinsurance, and other limitations as apply to similar services covered under the plan apply to coverage for transvaginal ultrasound and rectovaginal pelvic examinations required to be covered under this section. (2003-223, s. 1.)
NC Gen Stat § 58-3-280 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-280 - Coverage for the diagnosis and treatment of lymphedema.

 58-3-280. Coverage for the diagnosis and treatment of lymphedema.(a) Every health benefit plan, as defined in G.S. 58-3-167, shall provide coverage for the diagnosis, evaluation, and treatment of lymphedema. The coverage required by this section shall include benefits for equipment, supplies, complex decongestive therapy, gradient compression garments, and self-management training and education, if the treatment is determined to be medically necessary and is provided by a licensed occupational or physical therapist or licensed nurse that has experience providing this treatment, or other licensed health care professional whose treatment of lymphedema is within the professional's scope of practice.(b) The same deductibles, coinsurance, and other limitations as apply to similar services covered under the health benefit plan apply to coverage for the diagnosis, evaluation, and treatment of lymphedema required to be covered under this section. Nothing in this section requires a health benefit plan to provide a separate set of benefit limitations or maximums for the diagnosis, evaluation, or treatment of lymphedema.(c) As used in this section, gradient compression garments:(1) Require a prescription;(2) Are custom-fit for the covered individual; and(3) Do not include disposable medical supplies such as over-the-counter compression or elastic knee-high or other stocking products.  (2009-313, s. 1.)
NC Gen Stat § 58-3-285 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-285 - Coverage for hearing aids.

 58-3-285. Coverage for hearing aids.(a) Every health benefit plan, including the State Health Plan for Teachers and State Employees, shall provide coverage for one hearing aid per hearing-impaired ear up to two thousand five hundred dollars ($2,500) per hearing aid every 36 months for covered individuals under the age of 22 years subject to subsection (b) of this section. The coverage shall include all medically necessary hearing aids and services that are ordered by a physician or an audiologist licensed in this State. Only those persons authorized by law to fit hearing aids, including individuals licensed under Chapter 93D of the General Statutes, are eligible to fit a hearing aid under this section. Coverage shall be as follows:(1) Initial hearing aids and replacement hearing aids not more frequently than every 36 months.(2) A new hearing aid when alterations to the existing hearing aid cannot adequately meet the needs of the covered individual.(3) Services, including the initial hearing aid evaluation, fitting, and adjustments, and supplies, including ear molds.(b) The same deductibles, coinsurance, and other limitations as apply to similar services covered under the health benefit plan apply to hearing aids and related services and supplies required to be covered under this section.(c) Nothing in this section prevents an insurer from applying utilization review criteria to determine medical necessity as defined by G.S. 58-50-61 as long as it does so in accordance with all requirements for utilization review programs and medical necessity determinations specified in that section, including the offering of an insurer appeal process and where applicable, health benefit plans external review as provided in Part 4 of Article 50 of Chapter 58 of the General Statutes.  (2010-2, s. 1; 2010-97, s. 7.)
NC Gen Stat § 58-3-290 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-290 - Nondependent child coverage defined; open enrollment.

 58-3-290. Nondependent child coverage defined; open enrollment.(a) As used in this section, the following definitions apply:(1) "Health benefit plan" has the same meaning as G.S. 58-3-167(a)(1).(2) "Individual market" has the same meaning as G.S. 58-68-25(a)(9).(3) "Insurer" has the same meaning as G.S. 58-3-167(a)(2).(4) "Nondependent child coverage" or "nondependent child policy" means an individual health benefit plan which provides coverage to an individual under age 19. This shall not include health benefit plans that cover children under age 19 as dependents.(5) "Open enrollment" means, with respect to "nondependent child coverage," the period of time during which any individual under age 19 has the opportunity to apply for coverage under a health benefit plan offered by an insurer and shall not be denied eligibility for coverage under the plan due to factors relating to the individual's health status.(b) An insurer who offers nondependent child coverage shall offer open enrollment either continuously throughout the year or for the months of January and July of each year. Coverage issued under this section shall be issued without any riders based on the health status of the child. Nothing in this section shall require an insurer to offer nondependent child coverage or maternity coverage within an offer of nondependent child coverage.(c) The Commissioner shall adopt rules as necessary or proper to implement the provisions of this section.(d) Nothing in this section shall prohibit an insurer from adjusting the initial premium charged an individual afforded coverage under this section based upon medical underwriting to the extent that such an adjustment is in compliance with the applicable product's current rate filing approved by the Commissioner.  (2011-196, s. 5.)
NC Gen Stat § 58-3-300 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 3 - General Regulations for Insurance.|§ 58-3-300 - Health insurance issuers subject to certain requirements of federal law.

 58-3-300. Health insurance issuers subject to certain requirements of federal law.Pursuant to the authority granted to the states under 42 U.S.C. 300gg-22(a)(1), health insurance issuers that issue, sell, renew, or offer health benefit plans, as defined in G.S. 58-3-167(a)(1), in the State in the individual or group market shall meet the requirements of Part A of Subchapter XXV of Chapter 6A of Title 42 of the United States Code and regulations issued thereunder.  (2013-199, s. 24.)
NC Gen Stat § 58-4-1 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 4 - NAIC Filing Requirements.|§ 58-4-1 - Scope.

 58-4-1. Scope.The provisions of this Article shall apply to all domestic, foreign, and alien insurers who are authorized to transact business in this State. (1985, c. 305, s. 1.)
NC Gen Stat § 58-4-5 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 4 - NAIC Filing Requirements.|§ 58-4-5 - Filing requirements.

 58-4-5. Filing requirements.(a) Each domestic, foreign, and alien insurer that is authorized to transact insurance in this State shall file with the NAIC a copy of its financial statements required by G.S. 58-2-165, applicable rules, and legal directives and bulletins issued by the Department. The statements shall, in the Commissioner's discretion, be filed annually, semiannually, quarterly, or monthly and shall be filed in a form or format prescribed or permitted by the Commissioner. The Commissioner may require the statements to be filed in a format that can be read by electronic data processing equipment. Any amendments and addenda to the financial statement that are subsequently filed with the Commissioner shall also be filed with the NAIC.(b) Foreign insurers that are domiciled in a state that has a law or regulation substantially similar to this Article shall be deemed to be in compliance with this section. (1985, c. 305, s. 1; 1991, c. 681, s. 11; 1993, c. 504, s. 2.)
NC Gen Stat § 58-4-10 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 4 - NAIC Filing Requirements.|§ 58-4-10 - Immunity.

 58-4-10. Immunity.In the absence of actual malice, or gross negligence, members of the NAIC, their duly authorized committees, subcommittees, and task forces, their delegates, NAIC employees, and all others charged with the responsibility of collecting, reviewing, analyzing, and disseminating the information developed from the filings made pursuant to G.S. 58-4-10 shall be acting as agents of the Commissioner under the authority of this Article and shall not be subject to civil liability for libel, slander, or any other cause of action by virtue of their collection, review, and analysis or dissemination of the data and information collected from the filings required under this Article. (1985, c. 305, s. 1.)
NC Gen Stat § 58-4-15 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 4 - NAIC Filing Requirements.|§ 58-4-15 - Revocation or suspension of license.

 58-4-15. Revocation or suspension of license.The Commissioner may suspend or revoke the license of any insurer failing to file its financial statement when due or within any extension of time that the Commissioner, for good cause, may have granted. (1985, c. 305, s. 1; 1991, c. 681, s. 12; 1999-132, s. 9.1; 2003-212, s. 26(b).)
NC Gen Stat § 58-4-20 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 4 - NAIC Filing Requirements.|§ 58-4-20 - Recodified as § 58-2-220 pursuant to Session Laws 1989 (Regular Session, 1990), c. 0121, s. 7.

 58-4-20: Recodified as 58-2-220 pursuant to Session Laws 1989 (Regular Session, 1990), c. 0121, s. 7.
NC Gen Stat § 58-4-25 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 4 - NAIC Filing Requirements.|§ 58-4-25 - Insurance Regulatory Information System and similar program test data records.

 58-4-25. Insurance Regulatory Information System and similar program test data records.Financial test ratios, data, or information generated by the NAIC Insurance Regulatory Information System, any successor program, or any similar program shall be disseminated by the Commissioner consistent with procedures established by the NAIC. (1991, c. 681, s. 13.)
NC Gen Stat § 58-5-1 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 5 - Deposits and Bonds by Insurance Companies.|§ 58-5-1 - Deposits; use of master trust.

 58-5-1. Deposits; use of master trust.Notwithstanding any other provision of law, the Commissioner is authorized to select a bank or trust company as master trustee to hold cash or securities to be pledged to the State when deposited with him pursuant to statute. Securities may be held by the master trustee in any form which, in fact, perfects the security interest of the State in the securities. The Commissioner shall by rule establish the manner in which the master trust shall operate. The master trustee may charge the person making the deposit reasonable fees for services rendered in connection with the operation of the trust. (1985, c. 666, s. 55; 1987, c. 864, s. 23.)
NC Gen Stat § 58-5-5 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 5 - Deposits and Bonds by Insurance Companies.|§ 58-5-5 - Amount of deposits required of foreign or alien fire and/or marine insurance companies.

 58-5-5. Amount of deposits required of foreign or alien fire and/or marine insurance companies.Unless otherwise provided in this Article, every fire, marine, or fire and marine insurance company chartered by any other state or foreign government shall make and maintain deposits of securities with the Commissioner in the amount of one hundred thousand dollars ($100,000) market value. (1909, c. 923, s. 1; 1911, c. 164, s. 1; Ex. Sess. 1913, c. 62, ss. 1, 2, 3; 1915, c. 166, s. 6; C.S., s. 6442; 1933, c. 60; 1945, c. 384; 1991, c. 681, s. 15; 2003-212, s. 1.)
NC Gen Stat § 58-5-10 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 5 - Deposits and Bonds by Insurance Companies.|§ 58-5-10 - Amount of deposits required of foreign or alien fidelity, surety and casualty insurance companies.

 58-5-10. Amount of deposits required of foreign or alien fidelity, surety and casualty insurance companies.Unless otherwise provided in this Article, every fidelity, surety or casualty insurance company chartered by any other state or foreign government shall make and maintain deposits of securities with the Commissioner in the amount of two hundred thousand dollars ($200,000) market value. (1945, c. 384; 1991, c. 681, s. 16; 2003-212, s. 2.)
NC Gen Stat § 58-5-15 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 5 - Deposits and Bonds by Insurance Companies.|§ 58-5-15 - Minimum deposit required upon admission.

 58-5-15. Minimum deposit required upon admission.Upon admission to do business in the State of North Carolina every foreign or alien fire, marine, or fire and marine, fidelity, surety or casualty company shall deposit with the Commissioner securities in the amounts required under G.S. 58-5-5 and G.S. 58-5-10. (1945, c. 384; 1991, c. 681, s. 17; 2001-487, s. 18.)
NC Gen Stat § 58-5-20 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 5 - Deposits and Bonds by Insurance Companies.|§ 58-5-20 - Type of deposits.

 58-5-20. Type of deposits.The deposits required to be made under G.S. 58-5-5, 58-5-10, and 58-5-50 shall be composed of:(a) Interest-bearing bonds of the United States of America;(b) Interest-bearing bonds of the State of North Carolina, or of its cities or counties; or(c) Certificates of deposit issued by any solvent bank domesticated in the State of North Carolina. (1945, c. 384; 1989, c. 485, s. 34; 1991, c. 681, s. 18.)
NC Gen Stat § 58-5-25 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 5 - Deposits and Bonds by Insurance Companies.|§ 58-5-25 - Replacements upon depreciation of securities.

 58-5-25. Replacements upon depreciation of securities.Whenever any of the securities deposited by companies under the provisions of G.S. 58-5-5, 58-5-10, and 58-5-50 shall be depreciated or reduced in value, such company shall forthwith increase the deposit in order to maintain the required deposit in accordance with the amounts required by the said sections. (1945, c. 384; 1989, c. 485, s. 34.)