reglab/housing_qa huggingface dataset:
IN Code § 27-13-41-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 13. Health Maintenance Organizations|Chapter 41. Claims|27-13-41-1. Use of Diagnostic or Procedure Codes

Sec. 1. Not more than ninety (90) days after the date of the version specified in IC 27-1-1.5 of a diagnostic or procedure code described in this section:(1) a health maintenance organization and a limited service health maintenance organization shall begin using the version specified in IC 27-1-1.5 of the:(A) Current Procedural Terminology (CPT);(B) International Classification of Diseases (ICD);(C) American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM);(D) Current Dental Terminology (CDT);(E) Healthcare Common Procedure Coding System (HCPCS); and(F) third party administrator (TPA);codes under which the health maintenance organization and limited service health maintenance organization pay claims for health care services covered under an individual contract or a group contract; and(2) a provider shall begin using the version specified in IC 27-1-1.5 of the:(A) Current Procedural Terminology (CPT);(B) International Classification of Diseases (ICD);(C) American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM);(D) Current Dental Terminology (CDT);(E) Healthcare Common Procedure Coding System (HCPCS); and(F) third party administrator (TPA);codes under which the provider submits claims for payment for health care services covered under an individual contract or a group contract.As added by P.L.161-2001, SEC.5. Amended by P.L.66-2002, SEC.18; P.L.124-2018, SEC.101.
IN Code § 27-13-41-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 13. Health Maintenance Organizations|Chapter 41. Claims|27-13-41-2. Reimbursement

Sec. 2. If a provider provides health care services that are covered under an individual contract or a group contract:(1) after the date of the version specified in IC 27-1-1.5 of a diagnostic or procedure code described in section 1 of this chapter; and(2) before the health maintenance organization or limited service health maintenance organization begins using the version of the diagnostic or procedure code;the health maintenance organization or limited service health maintenance organization shall reimburse the provider under the version of the diagnostic or procedure code that was specified in IC 27-1-1.5 on the date that the health care services were provided.As added by P.L.161-2001, SEC.5. Amended by P.L.124-2018, SEC.102.
IN Code § 27-13-42-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 13. Health Maintenance Organizations|Chapter 42. Specific Reporting Requirements|27-13-42-1. Allowing a Health Maintenance Organization to Report the Number of Children Enrollees Who Are Prescribed Stimulant Medication for the Treatment of Certain Disorders

Sec. 1. A health maintenance organization that enters into an individual contract or a group contract that provides a prescription drug benefit may report to the drug utilization review board established by IC 12-15-35-19, not later than October 1 of each calendar year, the number of enrollees who are:(1) less than eighteen (18) years of age; and(2) prescribed a stimulant medication approved by the federal Food and Drug Administration for the treatment of attention deficit disorder or attention deficit hyperactivity disorder.As added by P.L.107-2002, SEC.30.
IN Code § 27-13-43-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 13. Health Maintenance Organizations|Chapter 43. Credentialing|27-13-43-1. Application of Chapter

Sec. 1. (a) Except as provided in subsection (b), this chapter applies to a health maintenance organization that provides basic health care services.(b) This chapter does not apply to the credentialing of a provider by a health maintenance organization if the provider's application for credentialing is only for purposes of providing health care services to the following:(1) A Medicaid recipient under a Medicaid risk based managed care program described in IC 12-15-12.(2) An individual who is covered under the children's health insurance program established under IC 12-17.6-2.As added by P.L.26-2005, SEC.4.
IN Code § 27-13-43-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 13. Health Maintenance Organizations|Chapter 43. Credentialing|27-13-43-2. Provider Credentialing

Sec. 2. (a) The department shall prescribe the credentialing application form used by the Council for Affordable Quality Healthcare (CAQH) in electronic or paper format. The form must be used by:(1) a provider who applies for credentialing by a health maintenance organization; and(2) a health maintenance organization that performs credentialing activities.(b) A health maintenance organization shall notify a provider concerning a deficiency on a completed credentialing application form submitted by the provider not later than thirty (30) business days after the health maintenance organization receives the completed credentialing application form.(c) A health maintenance organization shall notify a provider concerning the status of the provider's completed credentialing application not later than:(1) sixty (60) days after the health maintenance organization receives the completed credentialing application form; and(2) every thirty (30) days after the notice is provided under subdivision (1), until the health maintenance organization makes a final credentialing determination concerning the provider.As added by P.L.26-2005, SEC.4. Amended by P.L.1-2006, SEC.489.
IN Code § 27-13-43-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 13. Health Maintenance Organizations|Chapter 43. Credentialing|27-13-43-3. Provisional Credentialing; Criteria; Reimbursement; Termination

Sec. 3. (a) Notwithstanding section 2 of this chapter, if a health maintenance organization fails to issue a credentialing determination within thirty (30) days after receiving a completed credentialing application form from a provider, the health maintenance organization shall provisionally credential the provider if the provider meets the following criteria:(1) The provider has submitted a completed and signed credentialing application form and any required supporting material to the health maintenance organization.(2) The provider was previously credentialed by the health maintenance organization in Indiana and in the same scope of practice for which the provider has applied for provisional credentialing.(3) The provider is a member of a provider group that is credentialed and a participating provider with the health maintenance organization.(4) The provider is a network provider with the health maintenance organization.(b) The criteria for issuing provisional credentialing under subsection (a) may not be less stringent than the standards and guidelines governing provisional credentialing from the National Committee for Quality Assurance or its successor organization.(c) Once a health maintenance organization fully credentials a provider that holds provisional credentialing, reimbursement payments under the contract shall be retroactive to the date of the provisional credentialing. The health maintenance organization shall reimburse the provider at the rates determined by the contract between the provider and the health maintenance organization.(d) If a health maintenance organization does not fully credential a provider that is provisionally credentialed under subsection (a), the provisional credentialing is terminated on the date the health maintenance organization notifies the provider of the adverse credentialing determination. The health maintenance organization is not required to reimburse for services rendered while the provider was provisionally credentialed.As added by P.L.195-2018, SEC.19.
IN Code § 27-13-43-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 13. Health Maintenance Organizations|Chapter 43. Credentialing|27-13-43-4. Fully Credentialed Provider Reimbursement; Requirements

Sec. 4. (a) A fully credentialed provider shall be reimbursed for eligible services provided at any in-network hospital if the following conditions are met:(1) The provider submits the documentation required by the health maintenance organization to be loaded under the provider group or hospital.(2) The provider, provider group, or hospital is a network provider with the health maintenance organization.(3) The services are provided in accordance with all terms and conditions of the provider's, group provider's, or hospital's agreement or contract with the health maintenance organization.(4) Prior authorization is obtained in accordance with IC 27-1-37.5 when required by the health maintenance organization for an eligible service.(b) The health maintenance organization shall reimburse the provider or hospital for services described in subsection (a) at the rates determined by the contract between the provider and the health maintenance organization.(c) A health maintenance organization is not required to credential a provider. However, if:(1) a provider is employed by a hospital that is part of the hospital's network that is covered by the health maintenance organization; and(2) the provider meets the health maintenance organization's credentialing requirements;the health maintenance organization shall reimburse the provider for any reimbursable services from the date that the provider was employed by the hospital.As added by P.L.50-2020, SEC.9.
IN Code § 27-14-1-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-1. Short Title

Sec. 1. This article may be referred to as the Indiana mutual insurance holding company law.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-1.1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-1.1. Intent of Article; Alternative Organizational Structure

Sec. 1.1. (a) This article is intended to enable mutual insurance companies to seek additional capital more effectively to:(1) enhance their financial strength and flexibility;(2) support long term growth internally and through mergers and acquisitions; and(3) expand and enhance the domestic insurance companies of this state.(b) This article provides an alternative organizational structure to help strengthen the Indiana mutual insurance industry by permitting mutual insurance companies to:(1) reorganize into a mutual insurance holding company structure; and(2) raise capital through the sale of capital stock.As added by P.L.220-2011, SEC.463.
IN Code § 27-14-1-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-2. "Members' Surplus Protection Principle"

Sec. 2. (a) The requirements of this section constitute the "members' surplus protection principle" for purposes of this article.(b) The MIHC must at all times have the voting power and economic interests required by IC 27-14-5-1.(c) The aggregate value of the members' interests in an MIHC shall be protected from dilution as a result of sales of stock of a reorganized insurer or stock holding company to persons other than the MIHC through compliance with the requirements of IC 27-14-5-6, IC 27-14-5-7, IC 27-14-5-8, and IC 27-14-6-5.(d) Dividends paid on participating policies shall be protected as provided by IC 27-14-3-11.(e) An MIHC, stock holding company, and reorganized insurer must have outside directors as required by IC 27-14-3-5.(f) The officers and directors of the MIHC and any subsidiary of the MIHC are subject to the restrictions on stock ownership set forth in IC 27-14-5-2, IC 27-14-5-3, and IC 27-14-5-9.(g) Dividends paid on the equity securities of a stock holding company or reorganized insurer may be paid only in accordance with IC 27-14-3-11.(h) Compensation payable to directors and executive officers of an MIHC, stock holding company, or reorganized insurer may be paid only in accordance with IC 27-14-3-12.(i) Operations outside the ordinary course of the insurance business may be conducted only as provided in IC 27-14-3-13.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-3. Applicability of Definitions

Sec. 3. The definitions set forth in this chapter apply throughout this article.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-4. "Acting in Concert"

Sec. 4. (a) Subject to subsection (b), "acting in concert" means:(1) a knowing participation in a joint activity whether or not under an express agreement;(2) interdependent conscious parallel action toward a common goal under an express agreement or otherwise; or(3) a combination or pooling of voting interests or other interests in the securities of any person for a common purpose under any contract, understanding, relationship, agreement, or other arrangement, written or otherwise.(b) An employee benefit plan is acting in concert with:(1) its trustee; or(2) a person who serves in a capacity similar to a trustee;solely for the purpose of determining whether capital stock held by the trustee or the person in a similar capacity and capital stock held by the plan will be aggregated.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-5. "Adoption Date"

Sec. 5. "Adoption date" means, with respect to a plan, the date on which the board of directors approves a plan of reorganization or a plan to issue stock.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-6 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-6. "Affiliate"

Sec. 6. "Affiliate" means a person who, directly or indirectly:(1) controls;(2) is controlled by; or(3) is under common control with;another person.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-7. "Applicant"

Sec. 7. "Applicant" means, with respect to a plan, a person that has submitted a plan to the commissioner under this article.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-8 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-8. "Associate"

Sec. 8. (a) Subject to subsection (b), "associate" means any of the following:(1) With respect to a particular person, corporation, business entity, or other organization (other than the applicant or an affiliate of the applicant) for which the person is:(A) an officer;(B) a partner; or(C) directly or indirectly the beneficial owner of at least ten percent (10%) of any class of equity securities.(2) With respect to an individual who is a director or an officer of the applicant or of any of the applicant's affiliates, a:(A) spouse; or(B) member of the immediate family sharing the same household.(3) With respect to a particular person, a trust or other estate in which the person has a substantial beneficial interest or for which the person serves as trustee or in a similar fiduciary capacity.(b) The term does not apply to a person that:(1) has a beneficial interest in; or(2) serves as a trustee or in a similar fiduciary capacity for;an employee benefit plan.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-9 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-9. "Board"

Sec. 9. "Board" means:(1) the board of directors of an MIHC, an MIC, a stock holding company, or a reorganized insurer; or(2) another board or committee that is responsible under the articles or bylaws of the company for decisions involving the structure or management of an MIHC, MIC, stock holding company, or reorganized insurer.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-10 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-10. "Commissioner"

Sec. 10. "Commissioner" refers to the insurance commissioner appointed under IC 27-1-1-2.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-11 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-11. "Company"

Sec. 11. "Company" means any of the following:(1) An MIC.(2) An MIHC.(3) A stock holding company.(4) A reorganized insurer.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-12 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-12. "Disinterested Director"

Sec. 12. "Disinterested director" means a director of an MIHC who does not hold, directly or indirectly, a material ownership interest in any subsidiary.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-13 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-13. "Effective Date"

Sec. 13. "Effective date" means, with respect to a plan, the date on which the plan becomes effective under this article.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-14 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-14. "Eligible Member"

Sec. 14. "Eligible member" means, with respect to a plan, a person who is a member of an MIC or MIHC, as applicable, on the adoption date of a plan and:(1) solely for purposes of receipt of notice of and voting at a meeting of members on a plan of reorganization, continues to be a member of the MIC on the record date for the meeting of members; or(2) solely for purposes of eligibility to receive stock subscription rights under a plan to issue stock, continues to be a member of the MIC or MIHC, as applicable, on the date the commissioner approves the plan to issue stock.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-15 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-15. "Employee Benefit Plan"

Sec. 15. "Employee benefit plan" means an employee benefit plan established by an MIHC or by one (1) or more of the subsidiaries of an MIHC for the sole benefit of its:(1) employees; or(2) sales agents.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-16 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-16. "Financial Services Businesses"

Sec. 16. "Financial services businesses" includes investment banking, commercial banking, industrial banking, savings and loan associations, credit unions, trust companies, other lending and loan brokerage services, services related to the extension of credit (including but not limited to real estate and personal property appraisal; arranging equity financing; check-guaranty services; collection agency services; asset management, servicing, and collection activities; real estate settlement services; and lease financing transactions), securities broker-dealer and trading services, private placement services, acting as a futures commission merchant, securities underwriting, transactions in bullion, precious metals, and foreign currency, investment advisory services, financial planning services, third party administration of insurance policy claims and accounts receivable, the advance or loan of funds using accounts receivable as collateral, organization and operation of investment companies and mutual funds, employee benefit planning and consultation services, actuarial services, issuance of money orders, savings bonds, and traveler's checks, and other operations and services either closely related to or a proper incident to the foregoing.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-17 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-17. "Immediate Family"

Sec. 17. "Immediate family" means any child, stepchild, grandchild, parent, stepparent, grandparent, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law, and includes adoptive relationships.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-18 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-18. "Internal Revenue Code"

Sec. 18. "Internal Revenue Code" refers to the Internal Revenue Code of 1986, (26 U.S.C. 1 et seq.).As added by P.L.5-2000, SEC.4. Amended by P.L.124-2018, SEC.103.
IN Code § 27-14-1-19 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-19. "Material Ownership Interest"

Sec. 19. "Material ownership interest" means an ownership interest equal to more than one-half of one percent (0.5%) of the voting securities of the issuer, or a larger percentage as the commissioner may approve.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-20 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-20. "Member"

Sec. 20. "Member" means a person that, according to the:(1) records; and(2) articles of incorporation and bylaws;of an MIC or MIHC, as applicable, is a member of the MIC or MIHC, as applicable.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-21 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-21. "Member's Interest"

Sec. 21. "Member's interest" means:(1) the voting rights of a member provided by law and by the MIC's or MIHC's articles of incorporation and bylaws; and(2) the right to receive cash, stock, or other consideration in the event of a conversion to a stock company under IC 27-1 through IC 27-13 or a dissolution under IC 27-1-10, as provided by those laws and by the MIC's or MIHC's articles of incorporation or bylaws.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-22 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-22. "Mic"

Sec. 22. "MIC" refers to a mutual insurance company.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-23 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-23. "Mihc"

Sec. 23. "MIHC" refers to a mutual insurance holding company.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-24 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-24. "Mutual Insurance Company" or "Mic"

Sec. 24. "Mutual insurance company" or "MIC" means a mutual insurer that is:(1) submitting; or(2) subject to;a plan of reorganization or plan to issue stock under this article.As added by P.L.5-2000, SEC.4.
IN Code § 27-14-1-25 (2021)
2021 Indiana Code|Title 27. Insurance|Article 14. Mutual Insurance Holding Company Law|Chapter 1. General Provisions and Definitions|27-14-1-25. "Mutual Insurance Holding Company" or "Mihc"

Sec. 25. "Mutual insurance holding company" or "MIHC" means a mutual insurance holding company established under IC 27-14-2.As added by P.L.5-2000, SEC.4.