reglab/housing_qa huggingface dataset:
IN Code § 27-1-23-12 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23. Regulation of Insurance Holding Company Systems|27-1-23-12. Review of Actions of Commissioner; Stay; Mandamus

Sec. 12. (a) Any person aggrieved by any agency action of the commissioner pursuant to this chapter may petition for judicial review thereof in accordance, so far as practical, with IC 4-21.5-5.(b) Notwithstanding IC 4-21.5-5, the filing of a petition for review of the commissioner's determination approving an acquisition of control under section 2 of this chapter shall stay the application of any such determination or other action of the commissioner unless the court to which the petition is directed, after giving the petitioner notice and an opportunity to be heard, determines that such a stay would be detrimental to the interests of policyholders or the public.(c) Any person aggrieved by any failure of the commissioner to act or make a determination required by this chapter may bring an action for mandate in the circuit court of Marion County to compel the commissioner to act or make such determination forthwith.Formerly: Acts 1971, P.L.387, SEC.1. As amended by Acts 1981, P.L.244, SEC.10; P.L.7-1987, SEC.141.
IN Code § 27-1-23-13 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23. Regulation of Insurance Holding Company Systems|27-1-23-13. Application of Chapter

Sec. 13. This chapter, while independent in its enactment of any other law, shall be supplemental to the Indiana Insurance Law (IC 27-1-2 through IC 27-1-20). All provisions of IC 27-1-2 through IC 27-1-20 shall be fully and completely applicable to this chapter in the same manner as if the provisions of this chapter had been an original part of IC 27-1-2 through IC 27-1-20. This chapter shall be controlling in the event there exists any conflict between this chapter and IC 27-1-2 through IC 27-1-20.Formerly: Acts 1971, P.L.387, SEC.1. As amended by Acts 1981, P.L.244, SEC.11.
IN Code § 27-1-23.5-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-1. Application of Chapter

Sec. 1. This chapter applies beginning January 1, 2015.As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-2. Definitions

Sec. 2. Except as otherwise provided in this chapter, the definitions in IC 27-1-23 apply throughout this chapter.As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-3. "Insurance Group"

Sec. 3. As used in this chapter, "insurance group", for purposes of conducting an ORSA, means insurers and affiliates of an insurance holding company system (as defined in IC 27-1-23-1).As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-4. "Insurer"

Sec. 4. As used in this chapter, "insurer" has the same meaning as set forth in IC 27-1-2-3, except that the term:(1) refers only to domestic insurers (as defined in IC 27-1-36-8); and(2) does not include agencies, authorities, or instrumentalities of the United States, possessions and territories of the United States, the Commonwealth of Puerto Rico, the District of Columbia, or a state or political subdivision of a state.As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-5. "Orsa"

Sec. 5. As used in this chapter, "ORSA" or "own risk and solvency assessment" means a confidential internal assessment:(1) that is:(A) appropriate to the nature, scale, and complexity of; and(B) conducted by;an insurer or insurance group; and(2) of the:(A) material and relevant risks associated with the insurer or insurance group's current business plan; and(B) sufficiency of capital resources to support the risks described in clause (A).As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-7. "Orsa Summary Report"

Sec. 7. As used in this chapter, "ORSA summary report" means a confidential, high level summary of an insurer or insurance group's ORSA.As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-8 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-8. Risk Management Framework

Sec. 8. (a) An insurer shall maintain a risk management framework to assist the insurer with identifying, assessing, monitoring, managing, and reporting concerning the insurer's material and relevant risks.(b) If an insurance group of which an insurer is a member maintains a risk management framework described in subsection (a) that applies to the operations of the insurer, the insurer is considered to be in compliance with subsection (a).As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-9 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-9. Conducting an Orsa

Sec. 9. Subject to section 11 of this chapter, an:(1) insurer; or(2) insurance group of which an insurer is a member;shall, at any time when significant changes occur to the risk profile of the insurer or insurance group and at least one (1) time per year, conduct an ORSA in a manner consistent with the ORSA guidance manual.As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-10 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-10. Orsa Reports; Requirements

Sec. 10. (a) Upon the request of the commissioner, and not more than one (1) time per year, an insurer shall submit to the commissioner:(1) an ORSA summary report; or(2) a combination of reports that together contain the information described in the ORSA Manual;applicable to the insurer or insurance group of which the insurer is a member.(b) Regardless of a request from the commissioner, if the commissioner is the lead state commissioner of an insurance group of which an insurer is a member (as determined by the procedures in the Financial Analysis Handbook), the insurer shall submit a report described in subsection (a) at least one (1) time per year.(c) A report required by this section must include a signature of the insurer's or insurance group's chief risk officer, or another executive who has responsibility for the oversight of the insurer's enterprise risk management process, attesting that:(1) to the best of the officer's or executive's belief and knowledge the insurer applies the enterprise risk management process described in the ORSA summary report; and(2) a copy of the report has been provided to the insurer's board of directors or the appropriate committee of the insurer's board of directors.(d) If an insurer or another member of an insurance group of which the insurer is a member submits to the commissioner the most recent report that:(1) was provided to the:(A) commissioner of another state; or(B) regulatory authority of an alien jurisdiction;(2) is substantially similar to an ORSA summary report; and(3) contains information that is comparable to the information described in the ORSA Manual;the insurer is considered to have satisfied the requirements of this section.(e) If a report described in subsection (d) is completed in a language other than English, a translation of the report into the English language must be submitted with the report.As added by P.L.129-2014, SEC.8. Amended by P.L.124-2018, SEC.44.
IN Code § 27-1-23.5-12 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-12. Orsa Summary Report Preparation, Review

Sec. 12. (a) Except as provided in subsection (b), an ORSA summary report must be prepared in a manner consistent with the ORSA guidance manual. Documentation and supporting information must be maintained and made available upon examination or request of the commissioner.(b) The commissioner's review of an ORSA summary report, and any requests for additional information, must be made in a manner similar to the procedures used by the commissioner in the analysis and examination of multistate or global insurers and insurance groups.As added by P.L.129-2014, SEC.8.
IN Code § 27-1-23.5-14 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 23.5. Risk Management and Own Risk and Solvency Assessment|27-1-23.5-14. Civil Penalties

Sec. 14. (a) An insurer that fails, without just cause (as determined by the commissioner), to timely file an ORSA summary report as required by this chapter shall, after notice and hearing under IC 4-21.5, pay a civil penalty of one hundred dollars ($100) for each day of noncompliance, not to exceed ten thousand dollars ($10,000).(b) The commissioner may reduce a penalty imposed under subsection (a) if the insurer demonstrates to the commissioner that the imposition of the penalty would constitute a financial hardship to the insurer.(c) A civil penalty collected under this section shall be deposited in the department of insurance fund established by IC 27-1-3-28.As added by P.L.129-2014, SEC.8.
IN Code § 27-1-24.5-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-1. "Covered Individual"

Sec. 1. As used in this chapter, "covered individual" means an individual who is entitled to coverage under a health plan.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-2. "Effective Rate of Reimbursement"

Sec. 2. As used in this chapter, "effective rate of reimbursement" includes the following:(1) Generic effective rates.(2) Brand effective rates.(3) Direct and indirect remuneration fees.(4) Any other reduction or aggregate reduction of payment.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-3. "Equal Access and Incentives"

Sec. 3. As used in this chapter, "equal access and incentives" means that a pharmacy benefit manager allows any willing pharmacy provider to participate as part of any of the pharmacy benefit manager's networks as long as the pharmacy provider agrees to the terms and conditions of the relevant contract applicable to any other pharmacy provider within that network.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-4. "Generic Drug"

Sec. 4. As used in this chapter, "generic drug" means a drug product that is identified by the drug's chemical name and that is:(1) accepted by the federal Food and Drug Administration;(2) available from at least three (3) sources; and(3) therapeutically equivalent to an originating brand name drug.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-5. "Health Plan"

Sec. 5. As used in this chapter, "health plan" means the following:(1) A state employee health plan (as defined in IC 5-10-8-6.7).(2) A policy of accident and sickness insurance (as defined in IC 27-8-5-1). However, the term does not include the coverages described in IC 27-8-5-2.5(a).(3) An individual contract (as defined in IC 27-13-1-21) or a group contract (as defined in IC 27-13-1-16) that provides coverage for basic health care services (as defined in IC 27-13-1-4).(4) Any other plan or program that provides payment, reimbursement, or indemnification to a covered individual for the cost of prescription drugs.As added by P.L.68-2020, SEC.1. Amended by P.L.207-2021, SEC.52.
IN Code § 27-1-24.5-6 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-6. "Independent Pharmacies"

Sec. 6. As used in this chapter, "independent pharmacies" means pharmacies that are not a pharmacy benefit manager affiliate.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-7. "Maximum Allowable Cost"

Sec. 7. As used in this chapter, "maximum allowable cost" means the maximum amount that a pharmacy benefit manager will reimburse a pharmacy for the cost of a generic drug. The term does not include a dispensing fee or professional fee.As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.76.
IN Code § 27-1-24.5-8 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-8. "Maximum Allowable Cost List"

Sec. 8. As used in this chapter, "maximum allowable cost list" means a list of drugs that is used:(1) by a pharmacy benefit manager; and(2) to set the maximum amount that may be reimbursed to a pharmacy or pharmacist for a drug.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-9 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-9. "Pharmacist"

Sec. 9. As used in this chapter, "pharmacist" means an individual licensed as a pharmacist under IC 25-26.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-10 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-10. "Pharmacist Services"

Sec. 10. As used in this chapter, "pharmacist services" means products, goods, and services provided as part of the practice of pharmacy.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-11 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-11. "Pharmacy"

Sec. 11. As used in this chapter, "pharmacy" means the physical location:(1) that is licensed under IC 25-26; and(2) at which drugs, chemicals, medicines, prescriptions, and poisons are compounded, dispensed, or sold at retail.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-12 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-12. "Pharmacy Benefit Manager"

Sec. 12. (a) As used in this chapter, "pharmacy benefit manager" means an entity that, on behalf of a health plan, state agency, insurer, managed care organization, or other third party payor:(1) contracts directly or indirectly with pharmacies to provide prescription drugs to individuals;(2) administers a prescription drug benefit;(3) processes or pays pharmacy claims;(4) creates or updates prescription drug formularies;(5) makes or assists in making prior authorization determinations on prescription drugs;(6) administers rebates on prescription drugs; or(7) establishes a pharmacy network.(b) The term does not include the following:(1) A person licensed under IC 16.(2) A health provider who is:(A) described in IC 25-0.5-1; and(B) licensed or registered under IC 25.(3) A consultant who only provides advice concerning the selection or performance of a pharmacy benefit manager.As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.77.
IN Code § 27-1-24.5-13 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-13. "Pharmacy Benefit Manager Affiliate"

Sec. 13. As used in this chapter, "pharmacy benefit manager affiliate" means a pharmacy or pharmacist that directly or indirectly, through one (1) or more intermediaries:(1) owns or controls;(2) is owned or controlled by; or(3) is under common ownership or control with;a pharmacy benefit manager.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-14 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-14. "Pharmacy Benefit Manager Network"

Sec. 14. As used in this chapter, "pharmacy benefit manager network" means a group of pharmacies or pharmacists that is offered:(1) through an agreement or health plan contract; and(2) to provide pharmacist services for health plans.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-15 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-15. "Pharmacy Services Administrative Organization"

Sec. 15. As used in this chapter, "pharmacy services administrative organization" means an organization that assists independent pharmacies and pharmacy benefit managers or health plans to achieve administrative efficiencies, including contracting and payment efficiencies.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-16 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-16. "Rebate"

Sec. 16. (a) As used in this chapter, "rebate" means a discount or other price concession that is:(1) based on use of a prescription drug; and(2) paid by a manufacturer or third party to a pharmacy benefit manager, pharmacy services administrative organization, or pharmacy after a claim has been processed and paid at a pharmacy.(b) The term includes an incentive and a disbursement.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-17 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-17. "Third Party"

Sec. 17. As used in this chapter, "third party" means a person other than a:(1) pharmacy benefit manager; or(2) covered individual.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-18 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-18. Licensure

Sec. 18. A person shall, before establishing or operating as a pharmacy benefit manager, apply to and obtain a license from the commissioner under this chapter.As added by P.L.68-2020, SEC.1.
IN Code § 27-1-24.5-19 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-19. Equal Access and Incentives; Prohibited Acts

Sec. 19. (a) A pharmacy benefit manager shall provide equal access and incentives to all pharmacies within the pharmacy benefit manager's network.(b) A pharmacy benefit manager may not do any of the following:(1) Condition participation in any network on accreditation, credentialing, or licensing of a pharmacy, other than a license or permit required by the Indiana board of pharmacy or other state or federal regulatory authority for the services provided by the pharmacy. However, nothing in this subdivision precludes the department from providing credentialing or accreditation standards for pharmacies.(2) Discriminate against any pharmacy.(3) Directly or indirectly retroactively deny a claim or aggregate of claims after the claim or aggregate of claims has been adjudicated, unless any of the following apply:(A) The original claim was submitted fraudulently.(B) The original claim payment was incorrect because the pharmacy or pharmacist had already been paid for the drug.(C) The pharmacist services were not properly rendered by the pharmacy or pharmacist.(4) Reduce, directly or indirectly, payment to a pharmacy for pharmacist services to an effective rate of reimbursement, including permitting an insurer or plan sponsor to make such a reduction.(5) Reimburse a pharmacy that is affiliated with the pharmacy benefit manager, other than solely being included in the pharmacy benefit manager's network, at a greater reimbursement rate than other pharmacies in the same network.(6) Impose limits, including quantity limits or refill frequency limits, on a pharmacy's access to medication that differ from those existing for a pharmacy benefit manager affiliate.(7) Share any covered individual's information, including de-identified covered individual information, received from a pharmacy or pharmacy benefit manager affiliate, except as permitted by the federal Health Insurance Portability and Accountability Act (HIPAA) (P.L.104-191).A violation of this subsection by a pharmacy benefit manager constitutes an unfair or deceptive act or practice in the business of insurance under IC 27-4-1-4.As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.78; P.L.196-2021, SEC.22.
IN Code § 27-1-24.5-19.5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 24.5. Pharmacy Benefit Managers|27-1-24.5-19.5. Federal Drug Pricing Program

Sec. 19.5. (a) This section:(1) applies to a Medicaid managed care organization (as defined in 42 U.S.C. 1396b(m)); and(2) does not apply to the state Medicaid program when Medicaid provides reimbursement for covered outpatient drugs (as defined in 42 U.S.C. 1396r-8(k)) on a fee for service basis.(b) As used in this section, "340B covered entity" means an entity authorized to participate in the federal 340B Drug Pricing Program under Section 340B(a)(4) of the federal Public Health Service Act (42 U.S.C. 256b(a)(4)) and includes any pharmacy under contract with the entity to dispense drugs on behalf of the entity.(c) The following provisions may not be contained in a contract between a pharmacy benefit manager and a 340B covered entity:(1) A reimbursement rate for a prescription drug that would diminish the 340B benefit to a 340B covered entity.(2) A fee or adjustment that is not imposed on a pharmacy that is not a 340B covered entity.(3) A fee or adjustment amount that exceeds the fee or adjustment amount imposed on a pharmacy that is not a 340B covered entity.(4) Any provision that prevents or interferes with an individual's choice to receive a prescription drug from a 340B covered entity, including the administration of the drug.(5) Any provision that excludes a 340B covered entity from pharmacy benefit manager networks based on the 340B covered entity's participation in the federal 340B Drug Pricing Program.(6) Any provision that discriminates against a 340B covered entity.A violation of this subsection by a pharmacy benefit manager constitutes an unfair or deceptive act or practice in the business of insurance under IC 27-4-1-4.(d) For contracts between a pharmacy benefit manager and a 340B covered entity that are entered into, amended, or renewed after June 30, 2021, a provision that violates subsection (c) is considered void and unenforceable.As added by P.L.196-2021, SEC.23.