reglab/housing_qa huggingface dataset:
IN Code § 27-8-14.5-5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.5. Coverage for Services Related to Diabetes|27-8-14.5-5. Deductible, Copayment, and Coinsurance Provisions

Sec. 5. (a) An insured may not be required to pay an annual deductible or copayment that is greater than an annual deductible or copayment established for similar benefits under the health insurance plan. If the plan does not cover a similar benefit, the copayment or deductible may not be set at a level that materially diminishes the value of the diabetes benefit required by this chapter.(b) An insured may be subject to coinsurance that is not greater than coinsurance established for similar benefits under the health insurance plan. If the plan does not cover a similar benefit, the coinsurance may not be set at a level that materially diminishes the value of the diabetes benefit required by this chapter.As added by P.L.190-1997, SEC.1.
IN Code § 27-8-14.5-6 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.5. Coverage for Services Related to Diabetes|27-8-14.5-6. Coverage for Diabetes Self-Management Training

Sec. 6. (a) A health insurance plan issued by an insurer must provide coverage for diabetes self-management training that is:(1) medically necessary;(2) ordered in writing by a physician licensed under IC 25-22.5 or a podiatrist licensed under IC 25-29; and(3) provided by a health care professional who:(A) is licensed, registered, or certified under IC 25; and(B) has specialized training in the management of diabetes.(b) Coverage for diabetes self-management training may be limited to the following:(1) One (1) or more visits after receiving a diagnosis of diabetes.(2) One (1) or more visits after receiving a diagnosis by a physician licensed under IC 25-22.5 or a podiatrist licensed under IC 25-29 that:(A) represents a significant change in the insured's symptoms or condition; and(B) makes changes in the insured's self-management medically necessary.(3) One (1) or more visits for reeducation or refresher training.(c) Coverage for diabetes self-management training is subject to the requirements of the health insurance plan regarding the use of participating providers.As added by P.L.190-1997, SEC.1.
IN Code § 27-8-14.5-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.5. Coverage for Services Related to Diabetes|27-8-14.5-7. Adoption of Rules

Sec. 7. The department may adopt rules under IC 4-22-2 to carry out this chapter.As added by P.L.190-1997, SEC.1.
IN Code § 27-8-14.7-0.1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.7. Coverage for Services Related to Prostate Cancer Screening|27-8-14.7-0.1. Application of Chapter

Sec. 0.1. The addition of this chapter by P.L.170-1999 applies to accident and sickness insurance policies that are issued, delivered, or renewed after June 30, 1999.As added by P.L.220-2011, SEC.446.
IN Code § 27-8-14.7-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.7. Coverage for Services Related to Prostate Cancer Screening|27-8-14.7-1. "Accident and Sickness Insurance Policy"

Sec. 1. (a) As used in this chapter, "accident and sickness insurance policy" means an insurance policy that:(1) provides at least one (1) of the types of insurance described in IC 27-1-5-1, Classes 1(b) and 2(a); and(2) is issued on a group basis.(b) "Accident and sickness insurance policy" does not include the following:(1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.(2) Coverage issued as a supplement to liability insurance.(3) Worker's compensation or similar insurance.(4) Automobile medical payment insurance.(5) A specified disease policy.(6) A short term insurance plan that:(A) may be renewed for the greater of:(i) thirty-six (36) months; or(ii) the maximum period permitted under federal law;(B) has a term of not more than three hundred sixty-four (364) days; and(C) has an annual limit of at least two million dollars ($2,000,000).(7) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:(A) hospital confinement, critical illness, or intensive care; or(B) gaps for deductibles or copayments.(8) A supplemental plan that always pays in addition to other coverage.(9) A student health plan.(10) An employer sponsored health benefit plan that is:(A) provided to individuals who are eligible for Medicare; and(B) not marketed as, or held out to be, a Medicare supplement policy.As added by P.L.170-1999, SEC.4. Amended by P.L.173-2007, SEC.34; P.L.288-2019, SEC.15.
IN Code § 27-8-14.7-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.7. Coverage for Services Related to Prostate Cancer Screening|27-8-14.7-2. "Insured" Defined

Sec. 2. As used in this chapter, "insured" means a male individual who is entitled to coverage under a policy of accident and sickness insurance.As added by P.L.170-1999, SEC.4.
IN Code § 27-8-14.7-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.7. Coverage for Services Related to Prostate Cancer Screening|27-8-14.7-3. "Prostate Specific Antigen Test" Defined

Sec. 3. As used in this chapter, "prostate specific antigen test" means a standard blood test performed to determine the level of prostate specific antigen in the blood.As added by P.L.170-1999, SEC.4.
IN Code § 27-8-14.7-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.7. Coverage for Services Related to Prostate Cancer Screening|27-8-14.7-4. Coverage Required

Sec. 4. (a) Except as provided in subsection (f), an insurer shall provide coverage for prostate specific antigen testing in any accident and sickness insurance policy that the insurer issues in Indiana.(b) Except as provided in subsection (f), the coverage required under subsection (a) must include the following:(1) At least one (1) prostate specific antigen test annually for an insured who is at least fifty (50) years of age.(2) At least one (1) prostate specific antigen test annually for an insured who is less than fifty (50) years of age and who is at high risk for prostate cancer according to the American Cancer Society guidelines.(c) An insured may not be required to pay an annual deductible or coinsurance that is greater than an annual deductible or coinsurance established for similar benefits under the accident and sickness insurance policy. If the policy does not cover a similar benefit, the deductible or coinsurance may not be set at a level that materially diminishes the value of the prostate specific antigen testing benefit required by this chapter.(d) Except as provided in subsection (f), the coverage that an insurer must provide under this chapter may not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to the insured than the dollar limits, deductibles, or coinsurance provisions applying to physical illness generally under the accident and sickness insurance policy.(e) Except as provided in subsection (f), the coverage that an insurer must provide is in addition to any benefits specifically provided for x-rays, laboratory testing, or wellness examinations.(f) In the case of insurance policies that are not employer based, the insurer must offer to provide the coverage described in subsections (a) through (e).As added by P.L.170-1999, SEC.4. Amended by P.L.124-2018, SEC.81.
IN Code § 27-8-14.8-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.8. Coverage for Services Related to Colorectal Cancer Screening|27-8-14.8-1. "Accident and Sickness Insurance Policy"

Sec. 1. (a) As used in this chapter, "accident and sickness insurance policy" means an insurance policy that:(1) provides at least one (1) of the types of insurance described in IC 27-1-5-1, Classes 1(b) and 2(a); and(2) is issued on a group basis.(b) "Accident and sickness insurance policy" does not include the following:(1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.(2) Coverage issued as a supplement to liability insurance.(3) Worker's compensation or similar insurance.(4) Automobile medical payment insurance.(5) A specified disease policy.(6) A short term insurance plan that:(A) may be renewed for the greater of:(i) thirty-six (36) months; or(ii) the maximum period permitted under federal law;(B) has a term of not more than three hundred sixty-four (364) days; and(C) has an annual limit of at least two million dollars ($2,000,000).(7) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:(A) hospital confinement, critical illness, or intensive care; or(B) gaps for deductibles or copayments.(8) A supplemental plan that always pays in addition to other coverage.(9) A student health plan.(10) An employer sponsored health benefit plan that is:(A) provided to individuals who are eligible for Medicare; and(B) not marketed as, or held out to be, a Medicare supplement policy.As added by P.L.54-2000, SEC.2. Amended by P.L.173-2007, SEC.35; P.L.288-2019, SEC.16.
IN Code § 27-8-14.8-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.8. Coverage for Services Related to Colorectal Cancer Screening|27-8-14.8-2. "Insured" Defined

Sec. 2. As used in this chapter, "insured" means an individual who is entitled to coverage under an accident and sickness insurance policy.As added by P.L.54-2000, SEC.2.
IN Code § 27-8-14.8-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 14.8. Coverage for Services Related to Colorectal Cancer Screening|27-8-14.8-3. Colorectal Cancer Testing Coverage; Exception for High Deductible Health Plans

Sec. 3. (a) Except as provided in subsection (d), an insurer shall provide coverage for colorectal cancer examinations and laboratory tests for cancer for any nonsymptomatic insured in any accident and sickness insurance policy that the insurer issues in Indiana or issues for delivery in Indiana.(b) For an insured who is:(1) at least forty-five (45) years of age; or(2) less than forty-five (45) years of age and at high risk for colorectal cancer;the coverage required under this section must meet the requirements set forth in subsection (c), except as provided in subsection (e).(c) An insured may not be required to pay an additional annual deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit required by this section that is greater than an annual deductible or coinsurance established for similar benefits under the accident and sickness insurance policy under which the insured is covered. If the accident and sickness insurance policy does not cover a similar benefit, a deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit may not be set at a level that materially diminishes the value of the colorectal cancer examination and laboratory testing benefit.(d) In the case of an accident and sickness insurance policy that is not employer based, the insurer shall offer to provide the coverage described in this section.(e) The requirements imposed under this section do not apply to a high deductible health plan, as defined by Section 223 of the Internal Revenue Code. High deductible health plans described in this subsection may not excuse a deductible requirement with respect to colorectal cancer screening in a manner inconsistent with Section 223(c)(2)(C) of the Internal Revenue Code.As added by P.L.54-2000, SEC.2. Amended by P.L.124-2018, SEC.82; P.L.36-2020, SEC.2.
IN Code § 27-8-15-0.1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-0.1. Application of Certain Amendments to Chapter

Sec. 0.1. The following amendments to this chapter apply as follows:(1) The addition of sections 8.5, 10.5, 27, 28, 29, 30, 31, 32, 33, and 34 (before its repeal) of this chapter by P.L.93-1995 applies to all small employer health insurance plans issued or renewed under this chapter, as amended by P.L.93-1995, after December 31, 1995.(2) The amendments made to sections 9, 14, and 19 of this chapter by P.L.93-1995 apply to all small employer health insurance plans issued or renewed under this chapter, as amended by P.L.93-1995, after December 31, 1995.(3) Subject to section 31.1(a) of this chapter, as added by P.L.93-1995, section 16 of this chapter, as amended by P.L.93-1995, and section 31.1 of this chapter, as added by P.L.93-1995, apply to all small employer health insurance plans issued or renewed under this chapter, as amended by P.L.93-1995, after December 31, 1997.(4) The addition of section 34.1 of this chapter by P.L.91-1998 applies to all small employer health insurance plans in force under this chapter on April 1, 1998.(5) The amendments made to sections 10.5, 14, 19, 27, and 28 of this chapter by P.L.91-1998 apply to all small employer health insurance plans in force under this chapter on April 1, 1998.As added by P.L.220-2011, SEC.447.
IN Code § 27-8-15-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-1. Application of Chapter

Sec. 1. This chapter applies to any group health insurance plan that is issued for delivery in Indiana to at least two (2) employees of a small employer located in Indiana if one (1) of the following conditions is met:(1) Any part of the premium or benefits is paid by a small employer or any covered individual is reimbursed, whether through wage adjustments or otherwise, by a small employer for any part of the premium not including the administrative expenses of administering a payroll deduction plan where the employee contributes one hundred percent (100%) of the premium without reimbursement.(2) The health benefit plan is treated by the employer or any of the covered individuals as part of a plan or program for purposes of Section 106 or 162 of the United States Internal Revenue Code.As added by P.L.127-1992, SEC.1. Amended by P.L.11-2011, SEC.32.
IN Code § 27-8-15-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-3. "Actuarial Certification"

Sec. 3. As used in this chapter, "actuarial certification" means a written statement by a member of the American Academy of Actuaries that a small employer insurer is in compliance with section 16 of this chapter, based upon the person's examination, including a review of the appropriate records and of the actuarial assumptions and methods utilized by the insurer in establishing premium rates for applicable health insurance plans.As added by P.L.127-1992, SEC.1.
IN Code § 27-8-15-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-4. "Base Premium Rate"

Sec. 4. As used in this chapter, "base premium rate" means the lowest premium rate charged or that could have been charged under a rating system by the small employer insurer to small employers with similar case characteristics and benefit design characteristics.As added by P.L.127-1992, SEC.1.
IN Code § 27-8-15-5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-5. "Benefit Design Characteristics"

Sec. 5. As used in this chapter, "benefit design characteristics" means the following:(1) Covered services.(2) Cost sharing.(3) Utilization management.(4) Managed care networks.(5) Any other features differentiating plan or benefit design.As added by P.L.127-1992, SEC.1.
IN Code § 27-8-15-6 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-6. "Case Characteristics"

Sec. 6. As used in this chapter, "case characteristics" means demographic or other relevant characteristics of a small employer, as determined by a small employer insurer, that are considered by the insurer in the determination of premium rates for the small employer. Claim experience, health status, and duration of coverage since issue are not case characteristics.As added by P.L.127-1992, SEC.1.
IN Code § 27-8-15-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-7. "Commissioner"

Sec. 7. As used in this chapter, "commissioner" refers to the commissioner of the department of insurance.As added by P.L.127-1992, SEC.1.
IN Code § 27-8-15-8 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-8. "Department"

Sec. 8. As used in this chapter, "department" refers to the department of insurance.As added by P.L.127-1992, SEC.1.
IN Code § 27-8-15-8.5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-8.5. "Eligible Employee"

Sec. 8.5. (a) As used in this chapter, "eligible employee" means an employee:(1) who is employed to work at least thirty (30) hours each week; and(2) who meets an applicable waiting period required by a small employer before gaining coverage under a health insurance policy.(b) The term includes:(1) a sole proprietor;(2) a partner in a partnership; and(3) an owner of an S corporation;regardless of whether the sole proprietor, partner, or owner is included as an employee for purposes of taxation of a small employer.(c) The term does not include:(1) an employee who works on a temporary or substitute basis; or(2) a seasonal employee.As added by P.L.93-1995, SEC.10. Amended by P.L.11-2011, SEC.33.
IN Code § 27-8-15-9 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-9. "Health Insurance Plan"

Sec. 9. (a) Except as provided in section 28 of this chapter, as used in this chapter, "health insurance plan" or "plan" means any:(1) hospital or medical expense incurred policy or certificate;(2) hospital or medical service plan contract; or(3) health maintenance organization subscriber contract;provided to the employees of a small employer.(b) The term does not include the following:(1) Accident-only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.(2) Coverage issued as a supplement to liability insurance.(3) Worker's compensation or similar insurance.(4) Automobile medical payment insurance.(5) A specified disease policy.(6) A short term insurance plan that:(A) may be renewed for the greater of:(i) thirty-six (36) months; or(ii) the maximum period permitted under federal law;(B) has a term of not more than three hundred sixty-four (364) days; and(C) has an annual limit of at least two million dollars ($2,000,000).(7) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:(A) hospital confinement, critical illness, or intensive care; or(B) gaps for deductibles or copayments.(8) A supplemental plan that always pays in addition to other coverage.(9) A student health plan.(10) An employer sponsored health benefit plan that is:(A) provided to individuals who are eligible for Medicare; and(B) not marketed as, or held out to be, a Medicare supplement policy.As added by P.L.127-1992, SEC.1. Amended by P.L.93-1995, SEC.11; P.L.11-2011, SEC.34; P.L.288-2019, SEC.17.
IN Code § 27-8-15-10 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-10. "Insurer"

Sec. 10. As used in this chapter, "insurer" means any person who provides health insurance in Indiana. The term includes the following:(1) A licensed insurance company.(2) A prepaid hospital or medical service plan.(3) A health maintenance organization.(4) A multiple employer welfare arrangement.(5) Any person providing a plan of health insurance subject to state insurance law.As added by P.L.127-1992, SEC.1.
IN Code § 27-8-15-10.5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-10.5. "Late Enrollee"

Sec. 10.5. (a) As used in this chapter, "late enrollee" means an eligible employee or a dependent of an eligible employee who did not request enrollment in a health insurance plan of a small employer during the initial enrollment period during which the individual was entitled to enroll under the health insurance plan.(b) The term "late enrollee" does not include an eligible employee or the dependent of an eligible employee:(1) who was covered under a health insurance plan or had health insurance coverage at the time coverage was previously offered to the employee or to the dependent of the employee;(2) who stated in writing at the time coverage was offered that coverage under another health insurance plan was the reason for declining the enrollment, but only if the insurer required such a statement at the time and provided the employee with notice of the requirement (and the consequences of the requirement) at the time;(3) whose coverage under this subsection:(A) was under a COBRA continuation provision and the coverage under the provision was exhausted; or(B) was not under a COBRA continuation provision and either the coverage was terminated as a result of loss of eligibility for the coverage (including as a result of legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment) or employer contributions toward the coverage were terminated; and(4) who requests enrollment under the terms of the plan not later than thirty (30) days after the date of exhaustion of coverage as described in subdivision (3)(A) or the termination of coverage or employer contributions as described in subdivision (3)(B).(c) The term "late enrollee" does not include an eligible employee who is employed by a small employer that offers multiple health insurance plans and who elects a different plan during an open enrollment period.(d) The term "late enrollee" does not include an eligible employee or the eligible employee's spouse or minor or dependent child where:(1) a court has ordered that health insurance coverage be provided for the spouse or minor or dependent child of an eligible employee under the eligible employee's insurance plan; and(2) the request for enrollment is made not more than thirty (30) days after the issuance of the court order.As added by P.L.93-1995, SEC.12. Amended by P.L.190-1996, SEC.3; P.L.91-1998, SEC.15.
IN Code § 27-8-15-11 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-11. "Midpoint Rate"

Sec. 11. As used in this chapter, "midpoint rate" means for small employers with similar case and benefit design characteristics the arithmetic average of the applicable base premium rate and the corresponding highest premium rate.As added by P.L.127-1992, SEC.1.
IN Code § 27-8-15-12 (2021)
2021 Indiana Code|Title 27. Insurance|Article 8. Life, Accident, and Health|Chapter 15. Small Employer Group Health Insurance|27-8-15-12. "New Business Premium Rate"

Sec. 12. As used in this chapter, "new business premium rate" means the premium rate charged or offered by the small employer insurer to small employers with similar case characteristics and benefit design characteristics for newly issued health insurance plans.As added by P.L.127-1992, SEC.1.