reglab/statecodes huggingface dataset:
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1355 - Legal actions

20-1355.
Legal actions
There shall be a provision as follows: " Legal actions: No action at law or in equity shall be brought to recover on this policy prior to the expiration of sixty days after written proof of loss has been furnished in accordance with the requirements of this policy. No such action shall be brought after the expiration of two years after the time written proof of loss is required to be furnished."
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1356 - Change of beneficiary

20-1356.
Change of beneficiary
A. There shall be a provision as follows: " Change of beneficiary: Unless the insured makes an irrevocable designation of beneficiary,  the right to change a beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries,  or to any other changes in this policy."
B. The first clause of the provision set forth in subsection A of this section relating to the irrevocable designation of beneficiary may be omitted at the insurer's option.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1357 - Optional policy provisions

20-1357.
Optional policy provisions
Except as provided in subsection B of section 20-1344,  no such policy delivered or issued for delivery to any person in this state shall contain provisions respecting the matters set forth in sections 20-1358 to 20-1368,  inclusive,  unless the provisions are in the words in which such provisions appear in the applicable section,  except that the insurer may,  at its option,  use in lieu of any such provision a corresponding provision of different wording approved by the director which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the appropriate caption or,  at the option of the insurer,  by such appropriate individual or group captions or subcaptions as the director may approve.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1358 - Change of occupation

20-1358.
Change of occupation
There may be a provision as follows: " Change of occupation: If the insured be injured or contract sickness after having changed his occupation to one classified by the insurer as more hazardous than that stated in this policy or while doing for compensation anything pertaining to an occupation so classified,  the insurer will pay only such portion of the indemnities provided in this policy as the premium paid would have purchased at the rates and within the limits fixed by the insurer for such more hazardous occupation. If the insured changes his occupation to one classified by the insurer as less hazardous than that stated in this policy,  the insurer,  upon receipt of proof of such change of occupation,  will reduce the premium rate accordingly,  and will return the excess pro rata unearned premium from the date of change of occupation or from the policy anniversary date immediately preceding receipt of such proof,  whichever is the more recent. In applying this provision,  the classification of occupational risk and the premium rates shall be such as have been last filed by the insurer prior to the occurrence of the loss for which the insurer is liable or prior to date of proof of change in occupation with the state official having supervision of insurance in the state where the insured resided at the time this policy was issued;  but if such filing was not required,  then the classification of occupational risk and the premium rates shall be those last made effective by the insurer in such state prior to the occurrence of the loss or prior to the date of proof of change in occupation."
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1360 - Other insurance in this insurer

20-1360.
Other insurance in this insurer
A. There may be a provision as follows:
" Other insurance in this insurer: If an accident or sickness or accident and sickness policy or policies previously issued by the insurer to the insured be in force concurrently herewith,  making the aggregate indemnity for _____________________ (insert type of coverage or coverages) in excess of $ _______________________ (insert maximum limit of indemnity or indemnities) the excess insurance shall be void and all premiums paid for such excess shall be returned to the insured or to his estate."
B. The following provision may be inserted in lieu of the provision set forth in subsection A of this section: " Insurance effective at any one time on the insured under a like policy or policies in this insurer is limited to the one such policy elected by the insured,  his beneficiary or his estate,  as the case may be,  and the insurer will return all premiums paid for all other such policies."
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1361 - Insurance with other insurers; provision of service or expense incurred basis

20-1361.
Insurance with other insurers;  provision of service or expense incurred basis
A. There may be a provision as follows:
" Insurance with other insurers: If there be other valid coverage,  not with this insurer,  providing benefits for the same loss on a provision of service basis or on an expense incurred basis and of which this insurer has not been given written notice prior to the occurrence or commencement of loss,  the only liability under any expense incurred coverage of this policy shall be for such proportion of the loss as the amount which would otherwise have been payable hereunder plus the total of the like amounts under all such other valid coverages for the same loss of which this insurer had notice bears to the total like amounts under all valid coverages for such loss,  and for the return of such portion of the premiums paid as shall exceed the pro rata portion for the amount so determined. For the purpose of applying this provision when other coverage is on a provision of service basis,  the 'like amount' of such other coverage shall be taken as the amount which the services rendered would have cost in the absence of such coverage."
B. If the policy provision set forth in subsection A of this section is included in a policy which also contains the policy provision set out in section 20-1362 there shall be added to the caption of the provision the phrase " --expense incurred benefits."  The insurer may,  at its option,  include in this provision a definition of " other valid coverage, "  approved as to form by the director which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada,  and by hospital or medical service organizations,  and to any other coverage the inclusion of which may be approved by the director. In the absence of such definition the term shall not include group insurance,  automobile medical payments insurance,  or coverage provided by hospital or medical service organizations or by union welfare plans or employer or employee benefit organizations. For the purpose of applying the policy provision with respect to any insured,  any amount of benefit provided for the insured pursuant to any compulsory benefit statute,  including any workers' compensation or employer's liability statute,  whether provided by a governmental agency or otherwise shall in all cases be deemed to be " other valid coverage"  of which the insurer has had notice. In applying the policy provision no third party liability coverage shall be included as " other valid coverage."
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1362 - Insurance with other insurers

20-1362.
Insurance with other insurers
A. There may be a provision as follows:
" Insurance with other insurers: If there be other valid coverage,  not with this insurer,  providing benefits for the same loss on other than an expense incurred basis and of which this insurer has not been given written notice prior to the occurrence or commencement of loss,  the only liability for such benefits under this policy shall be for such proportion of the indemnities otherwise provided hereunder for such loss as the like indemnities of which the insurer had notice (including the indemnities under this policy) bear to the total amount of all like indemnities for such loss,  and for the return of such portion of the premium paid as shall exceed the pro rata portion for the indemnities thus determined."
B. If the provision is included in a policy which also contains the policy provision set out in section 20-1361 there shall be added to the caption of the provision set forth in subsection A of this section the phrase " --other benefits."  The insurer may,  at its option,  include in this provision a definition of " other valid coverage, "  approved as to form by the director,  which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada,  and to any other coverage the inclusion of which may be approved by the director. In the absence of such definition the term shall not include group insurance,  or benefits provided by union welfare plans or by employer or employee benefit organizations. For the purpose of applying the policy provision with respect to any insured,  any amount of benefit provided for the insured pursuant to any compulsory benefit statute,  including any workers' compensation or employer's liability statute,  whether provided by a governmental agency or otherwise shall in all cases be deemed to be " other valid coverage"  of which the insurer has had notice. In applying the policy provision no third party liability coverage shall be included as " other valid coverage."
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1363 - Relation of earnings to insurance

20-1363.
Relation of earnings to insurance
A. There may be a provision as follows: " Relation of earnings to insurance: If the total monthly amount of loss of time benefits promised for the same loss under all valid loss of time coverage upon the insured,  whether payable on a weekly or monthly basis,  shall exceed the monthly earnings of the insured at the time disability commenced or his average monthly earnings for the period of two years immediately preceding a disability for which claim is made,  whichever is the greater,  the insurer will be liable only for such proportionate amount of such benefits under this policy as the amount of such monthly earnings or such average monthly earnings of the insured bears to the total amount of monthly benefits for the same loss under all such coverage upon the insured at the time such disability commences and for the return of such part of the premiums paid during such two years as shall exceed the pro rata amount of the premiums for the benefits actually paid hereunder;  but this shall not operate to reduce the total monthly amount of benefits payable under all such coverage upon the insured below the sum of two hundred dollars or the sum of the monthly benefits specified in such coverages,  whichever is the lesser,  nor shall it operate to reduce benefits other than those payable for loss of time."
B. The policy provision set forth in subsection A of this section may be inserted only in a policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums until at least age fifty or,  in the case of a policy issued after age forty-four for at least five years from its date of issue. The insurer may,  at its option,  include in this provision a definition of " valid loss of time coverage, "  approved as to form by the director,  which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada,  or to any other coverage the inclusion of which may be approved by the director or any combination of such coverages. In the absence of such definition the term shall not include any coverage provided for the insured pursuant to any compulsory benefit statute,  including any workers' compensation or employer's liability statute,  or benefits provided by union welfare plans or by employer or employee benefit organizations.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1365 - Cancellation

20-1365.
Cancellation
There may be a provision as follows: " Cancellation: The insurer may cancel this policy at any time by written notice delivered to the insured,  or mailed to his last address as shown by the records of the insurer,  stating when,  not less than thirty days thereafter,  such cancellation shall be effective;  and after the policy has been continued beyond its original term the insured may cancel this policy at any time by written notice delivered or mailed to the insurer,  effective upon receipt or on such later date as may be specified in such notice. In the event of cancellation,  the insurer will return promptly the unearned portion of any premium paid. If the insured cancels,  the earned premium shall be computed by the use of the short-rate table last filed with the state official having supervision of insurance in the state where the insured resided when the policy was issued. If the insurer cancels,  the earned premium shall be computed pro rata. Cancellation shall be without prejudice to any claim originating prior to the effective date of cancellation."
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1366 - Conformity with statutes

20-1366.
Conformity with statutes
There may be a provision as follows: " Conformity with statutes: Any provision of this policy which,  on its effective date,  is in conflict with the statutes of the state,  District of Columbia or territory in which the insured resides on such date is hereby amended to conform to the minimum requirements of such statutes."
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1368 - Intoxicants and narcotics

20-1368.
Intoxicants and narcotics
There may be a provision as follows: " Intoxicants and narcotics: The insurer shall not be liable for any loss sustained or contracted in consequence of the insured's being intoxicated or under the influence of any narcotic unless administered on the advice of a physician."
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1369 - Arrangement of provisions in policy

20-1369.
Arrangement of provisions in policy
The provisions which are the subject of sections 20-1345 to 20-1368,  inclusive,  or any corresponding provisions which are used in lieu thereof in accordance with such sections,  shall be printed in the consecutive order of the provisions in such sections or,  at the option of the insurer,  any such provision may appear as a unit in any part of the policy,  with other provisions to which it may be logically related,  provided that the resulting policy shall not be in whole or in part unintelligible,  uncertain,  ambiguous,  abstruse or likely to mislead a person to whom the policy is offered,  delivered or issued.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1370 - Third party ownership

20-1370.
Third party ownership
The word " insured, "  as used in this article shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities,  benefits and rights provided therein.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1371 - Policy provision requirements of other jurisdictions

20-1371.
Policy provision requirements of other jurisdictions
Any policy of a foreign or alien insurer,  when delivered or issued for delivery to any person in this state,  may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this article and which is prescribed or required by the law of the state or country under which the insurer is organized. Any policy of a domestic insurer may,  when issued for delivery in any other state or country,  contain any provision permitted or required by the laws of such other state or country.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1372 - Effect of policy containing nonconforming provisions

20-1372.
Effect of policy containing nonconforming provisions
No policy provision which is not subject to this article shall cause a policy,  or any portion thereof to be less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this article. A policy delivered or issued for delivery to any person in this state in violation of this article shall be held valid but shall be construed as provided in this article. When any provision in a policy subject to this article is in conflict with any provision of this article,  the rights,  duties and obligations of the insurer,  the insured and the beneficiary shall be governed by the provisions of this article.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1373 - Age limit

20-1373.
Age limit
If any policy contains a provision establishing,  as an age limit or otherwise,  a date after which the coverage provided by the policy will not be effective,  and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date,  the coverage provided by the policy will continue in force subject to any right of cancellation until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if,  according to the correct age of the insured,  the coverage provided by the policy would not have become effective,  or would have ceased prior to the acceptance of such premium or premiums,  then the liability of the insurer shall be limited to the refund,  upon request,  of all premiums paid for the period not covered by the policy.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1374 - Effective date of provisions; moratorium

20-1374.
Effective date of provisions;  moratorium
A policy,  rider or endorsement which could have been lawfully used or delivered or issued for delivery to any person in this state immediately prior to January 1,  1955,  may be used or delivered or issued for delivery to any such person until January 1,  1957,  without being subject to the provisions of sections 20-1341 to 20-1372,  inclusive.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1375 - Franchise disability insurance law

20-1375.
Franchise disability insurance law
Disability insurance on a franchise plan is declared to be that form of disability insurance issued to five or more employees of any corporation,  copartnership or individual employer or any governmental corporation,  agency or department thereof,  or to ten or more members,  employees or employees of members of any trade or professional association or of a labor union or of any other association having had an active existence for at least two years where such association or union has a constitution or bylaws and is formed in good faith for purposes other than that of obtaining insurance,  where such persons,  with or without their dependents,  are issued the same form of an individual policy varying only as to amounts and kinds of coverage applied for by such persons under an arrangement whereby the premiums on the policies may be paid to the insurer periodically by the employer,  with or without payroll deductions,  or by the association for its members,  or by some designated person acting on behalf of the employer or association. The term " employees"  as used herein may be deemed to include the officers,  managers and employees of the employer and the individual proprietor or partners if the employer is an individual proprietor or partnership.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376 - Prohibiting denial of certain contract benefits

20-1376.
Prohibiting denial of certain contract benefits
A. Notwithstanding any provision of any disability insurance contract,  benefits shall not be denied under the contract for any medical or surgical service performed by a holder of a license issued pursuant to title 32,  chapter 7 or 11,  or a registered nurse practitioner who is licensed pursuant to title 32,  chapter 15,  if the service performed is within the lawful scope of such person's license,  and if the service is surgical,  such person is a member of the staff of an accredited hospital,  and if such contract would have provided benefits if such service had been performed by a holder of a license issued pursuant to title 32,  chapter 13.
B. If any disability insurance contract provides for or offers eye care services,  the subscriber shall have freedom of choice to select either an optometrist or a physician and surgeon skilled in diseases of the eye to provide the examination,  care,  or treatment for which the subscriber is eligible and that falls within the scope of practice of the optometrist or physician and surgeon. Unless such disability insurance contract otherwise provides,  there shall be no reimbursement for ophthalmic materials,  lenses,  spectacles,  eyeglasses or appurtenances to these materials or items.
C. If any individual disability insurance contract is written to provide coverage for psychiatric,  drug abuse or alcoholism services,  reimbursement for such services shall be made in accordance with the terms of the contract without regard to whether the covered services are rendered in a psychiatric special hospital or general hospital. Reimbursement for the cost of the service may be made directly to the person licensed or certified pursuant to title 32,  chapter 13 or 19.1 or to the subscriber if the cost of the service has not been reimbursed to another provider or health care institution.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376.01 - Prohibiting denial of chiropractic contract benefits; direct reimbursement

20-1376.01.
Prohibiting denial of chiropractic contract benefits;  direct reimbursement
If a disability insurance contract provides for or offers reimbursement for any service which is within the lawful scope of the practice of a chiropractor holding a certificate or license issued by the state in which the services are rendered,  a subscriber covered under such contract may select either a physician or chiropractor to provide the examination,  care or treatment for which the subscriber is eligible and which falls within the scope of practice of the chiropractor or physician. Reimbursement for the cost of the service may be made directly to the person licensed or certified pursuant to title 32,  chapter 8 or 13 or to the subscriber if the cost of the service has not been reimbursed to another provider or health care institution.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376.02 - Prohibiting denial of psychologist contract benefits

20-1376.02.
Prohibiting denial of psychologist contract benefits
If a disability insurance contract provides for or offers reimbursement for any service which is within the lawful scope of the practice of a psychologist holding a certificate or license issued by the state in which the services are rendered,  a subscriber covered under such contract may select either a physician or psychologist to provide the examination,  care or treatment for which the subscriber is eligible and which falls within the scope of practice of the psychologist or physician.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376.03 - Prohibiting denial of contract benefits; nurses; reimbursement

20-1376.03.
Prohibiting denial of contract benefits;  nurses;  reimbursement
If a disability insurance contract provides or offers reimbursement for any service which is within the scope of the practice of a registered nurse practitioner or a certified registered nurse qualified under the rules adopted by the state board of nursing regarding extended nursing practice and licensed pursuant to title 32,  chapter 15,  the contract benefits shall not be denied to a subscriber who receives the services of the certified registered nurse or registered nurse practitioner. The cost of the service may be reimbursed directly to the certified registered nurse or registered nurse practitioner or to the subscriber if another provider or health care institution was not reimbursed for the cost of the service.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376.04 - Prohibiting denial of occupational or physical therapist contract benefits

20-1376.04.
Prohibiting denial of occupational or physical therapist contract benefits
If a disability insurance contract provides coverage for occupational or physical therapy services,  and provides both an in-network and out-of-network benefit,  an insurer shall not deny a claim for covered occupational or physical therapy services obtained out-of-network solely on the basis that a physician did not refer the insured to the occupational or physical therapist or prescribe specific occupational or physical therapy services. An insurer may impose coinsurance,  copayments,  deductibles,  dollar caps,  limitations on the number of visits,  provider network restrictions or other cost containment measures as a condition of coverage of occupational and physical therapy services for both in-network and out-of-network benefits.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376.06 - Cancer treatment medications; cost sharing; definition

20-1376.06.
Cancer treatment medications;  cost sharing;  definition
A. A disability insurance policy that is issued,  delivered or renewed by a disability insurer on or after January 1,  2016 and that provides coverage both for cancer treatment medications that are injected or intravenously administered by a health care provider and for patient-administered cancer treatment medications,  including medications that are orally administered or self-injected,  may not require a higher copayment,  deductible or coinsurance amount for patient-administered cancer treatment medications than is required for those cancer treatment medications that are injected or intravenously administered by a health care provider,  regardless of the formulation or benefit category.
B. A disability insurer may not increase copayment,  deductible or coinsurance amounts for covered cancer treatment medications that are injected or intravenously administered in order to avoid compliance with subsection A of this section,  but may increase copayment,  deductible or coinsurance amounts for cancer treatment medications if the increase is applied generally to other medical or pharmaceutical benefits under the policy and is not done to circumvent subsection A of this section.
C. A disability insurer may not reclassify benefits with respect to cancer treatment medications in a manner that is inconsistent with this section.
D. For the purposes of this section,  " cancer treatment medications"  means prescription drugs and biologics that are used to kill,  slow or prevent the growth of cancerous cells.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376.07 - Prescriptions; cost sharing; refills; dispensing fees; definition

20-1376.07.
Prescriptions;  cost sharing;  refills;  dispensing fees;  definition
A. A disability insurance policy that is issued or renewed on or after January 1,  2017 and that provides coverage for prescription drugs:
1. May not deny coverage and shall prorate the cost sharing rate for a prescription drug covered by the policy that is dispensed by a network pharmacy for less than the standard refill amount if the insured requests enrollment into a medication synchronization program and less than the standard refill amount for the purpose of synchronizing the insured's medications.
2. Shall accept early refill and short fill requests for prescription drugs using the submission clarification and message codes as adopted by the national council for prescription drug plans or alternative codes provided by the plan upon July 3,  2015.
B. For the purposes of this section,  " medication synchronization"  means the coordination of medication refills for a patient taking two or more medications for a chronic condition that are being dispensed by a single contracted pharmacy to facilitate the synchronization of the patient's medications for the purpose of improving medication adherence.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376.08 - Prescription eyedrops; refills

20-1376.08.
Prescription eyedrops;  refills
A. Beginning January 1,  2018,  any policy that is issued,  delivered or renewed by a disability insurer and that provides coverage for prescription eyedrops to treat glaucoma or ocular hypertension may not deny coverage for a refill of a prescription for eyedrops to treat glaucoma or ocular hypertension if all of the following apply:
1. The insured requests the refill:
(a) For a thirty-day supply,  at least twenty-three days and less than thirty days from the later of:
(i) The original date that the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
(b) For a sixty-day supply,  at least forty-five days and less than sixty days from the later of:
(i) The original date that the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
(c) For a ninety-day supply,  at least sixty-eight days and less than ninety days from the later of:
(i) The original date that the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
2. The prescription eyedrops to treat glaucoma or ocular hypertension prescribed by the health care provider are a covered benefit under the insured's policy.
3. The prescribing health care provider indicates on the original prescription that additional quantities of the prescription eyedrops to treat glaucoma or ocular hypertension are needed.
4. The refill requested by the insured does not exceed the number of additional quantities prescribed.
B. To the extent practicable,  the requirements of this section are limited in quantity to the remaining dosage initially approved for coverage,  except that any limited refilling may not limit or restrict coverage to any previously or subsequently approved prescription eyedrops to treat glaucoma or ocular hypertension and is subject to the terms and conditions of the policy that are applicable to this coverage.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1376.09 - Coverage of health care services

20-1376.09.
Coverage of health care services
All policies issued,  delivered or renewed on or after July 1,  2017 by a disability insurer in this state must provide coverage for lawful health care services that are provided by a health care provider to an insured regardless of the familial relationship of the health care provider to the insured if the health care service would be covered were it provided to an insured who was not related to the health care provider. The policy may limit the coverage to those health care providers who are members of the disability insurer's provider network. This section does not apply to disability income.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1378 - Eligibility; prohibiting cancellation because of eligibility for certain benefits

20-1378.
Eligibility;  prohibiting cancellation because of eligibility for certain benefits
A. Except as specifically provided in sections 20-1379 and 20-1380,  with respect to the determination of whether a person is an eligible individual,  an insurer issuing disability insurance contracts shall not consider the availability of or a person's eligibility for medical assistance pursuant to title XIX of the social security act (P.L. 89-97;  79 Stat. 344;  42 United States Code section 1396a (1980)) when considering eligibility for coverage or calculating payments under its plans for eligible policyholders.
B. To the extent that payment for covered expenses has been made under the state program pursuant to title XIX of the social security act for health care items or services furnished to an individual,  the state is considered to have acquired the rights of the individual to payment by any other party for those health care items or services. On presentation of proof that the state program pursuant to title XIX of the social security act has paid for covered items or services,  the insurer shall make payments to the state program pursuant to title XIX of the social security act according to the coverage provided in the disability insurance policy.
C. An insurer issuing disability insurance contracts may not impose on a state agency that has been assigned the rights of an individual who is eligible for medical assistance and who is covered for health benefits from the insurer any requirements that are different from the requirements applicable to an agent or assignee of any other covered individual.
D. An insurer issuing disability insurance contracts shall not cancel or fail to renew the contract of any person based on that person's eligibility for or enrollment in a program funded under title XIX of the social security act or title 36,  chapter 29 or 34. Nothing in this section prohibits cancellation or failure to renew for nonpayment of monies due under the contract.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1381 - Suspension of health care insurer obligation to issue coverage on a guaranteed issuance basis to eligible individuals

20-1381.
Suspension of health care insurer obligation to issue coverage on a guaranteed issuance basis to eligible individuals
A. A health care insurer may apply to the director to suspend its obligation to issue coverage to eligible individuals pursuant to section 20-1379 for a specified period if all of the following conditions are met:
1. The health care insurer can demonstrate to the director that its financial or administrative capacity to serve eligible individuals would impair the ability of the health care insurer to serve previously enrolled individuals in the individual market.
2. The health care insurer requests that its obligation to issue coverage to eligible individuals pursuant to section 20-1379 be suspended for a specified period,  of not more than one year,  and provides a rationale for suspending its obligation to issue coverage to eligible individuals for that period of time.
3. The health care insurer provides sufficient information for the director to determine that the health care insurer has met the requirements of this subsection.
B. A health care insurer that refuses to enroll an eligible individual shall not enroll any eligible individuals until the earlier of:
1. The date on which the director determines that the health care insurer has the capacity to enroll eligible individuals.
2. The date on which the health care insurer enrolls an eligible individual. The health care insurer shall notify the director within ten days after that enrollment.
C. The director shall approve or disapprove an application submitted by a health care insurer within sixty days after the filing. The director may extend the period for good cause for up to an additional sixty days. The director may suspend a health care insurer's obligation to issue coverage to eligible individuals for a period of less time than requested in the application.
D. In calculating the period of creditable coverage to determine if a person is an eligible individual,  if the person was an eligible individual when the person submitted an application for coverage to a health care insurer and the health care insurer has received an order pursuant to this section,  the person continues to be an eligible individual until the later of the expiration of the original sixty-three day period or an additional thirty days after the individual receives a written notice from the health care insurer pursuant to an order of the director that the health care insurer will not issue coverage to the individual pursuant to section 20-1379.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1382 - Health care insurers; reporting requirements

20-1382.
Health care insurers;  reporting requirements
A. On or before March 1 of each year,  each health care insurer shall submit to the director a written report that contains the following information:
1. The number of eligible individuals covered by policies that were written by that health care insurer in the individual market during the previous calendar year.
2. The number of individuals covered by policies that were issued other than to eligible individuals during the previous calendar year.
3. The earned premium for each category of individual policy for the previous calendar year.
4. The total number of eligible individuals covered by policies that were issued by the health care insurer as of the end of the previous calendar year.
B. Each health care insurer shall submit the following information to the department,  if applicable,  to demonstrate compliance with sections 20-1379,  20-1380 and 20-1381:
1. The health care insurer's name and address.
2. The identification,  form number and summary of all products that the health care insurer offers in the individual market.
3. If the health care insurer elects the option prescribed in section 20-1379,  subsection C,  paragraph 2,  subdivision (a) the data on premium volumes of all policy forms that the health care insurer offers in the individual market and the number of individuals who are covered under each form during the preceding calendar year.
4. If the health care insurer elects the option prescribed in section 20-1379,  subsection C,  paragraph 2,  subdivision (b) the data,  assumptions and methods used to calculate the actuarial values of the two representative policy forms.
5. An explanation of how the health care insurer is complying with sections 20-1379,  20-1380 and 20-1381.
6. A list of all products,  including all marketing material,  that the health care insurer is making or will make available to eligible individuals and an explanation of how the health care insurer will inform individuals of these policy forms.
7. A description of the risk spreading and financial subsidization mechanism.
C. The health care insurer shall submit the information described in subsection B of this section to the department by March 1 of each year.
D. If all or part of the information required by subsection B,  paragraph 5,  6 or 7 of this section has not changed since the health care insurer's last previous submission,  instead of refiling the information the health care insurer may indicate the information that has not changed.
E. Notwithstanding any other law,  an insurer is not required to comply with the reporting requirements of this section if the federal laws that require providing a certificate of creditable coverage are superseded by the prohibition on preexisting condition exclusions.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1383 - Individual health insurance policies; mandatory coverage exemption; definitions

20-1383.
Individual health insurance policies;  mandatory coverage exemption;  definitions
A. A disability insurer may issue a policy to an uninsured individual that is not subject to the requirements of any of the following:
1. Section 20-461,  subsection A,  paragraph 17 and subsection B.
2. Section 20-1342,  subsection A,  paragraphs 11 and 12.
3. Section 20-1342,  subsections H,  I,  J and K.
4. Section 20-1376,  subsections A and C.
5. Sections 20-1342.01,  20-1376.01,  20-1376.02,  20-1376.03 and 20-1376.04.
B. For the purposes of this section:
1. " Health insurance coverage" :
(a) Means a health care plan or arrangement that pays for or furnishes medical or health services and that is issued by a disability insurer,  group disability insurer,  blanket disability insurer,  health care services organization,  hospital service corporation,  medical service corporation or medical,  hospital,  dental and optometric service corporation or a similar entity in another state.
(b) Includes a self-insured or self-funded employee benefit plan or multiemployer employee benefit plan created pursuant to 29 United States Code section 186(c) if the regulation of that plan is preempted by section 514(b) of the employee retirement insurance security act of 1974 (29 United States Code section 1144(b)).
(c) Does not include limited benefit coverage as defined in section 20-1137.
2. " Uninsured individual"  means a person who has either:
(a) Not had health insurance coverage for the ninety days immediately before the effective date of coverage issued pursuant to this section,  except that this requirement does not apply at the renewal of coverage pursuant to this section.
(b) Lost health insurance coverage in one of the following ways within ninety days immediately before the effective date of coverage issued pursuant to this section:
(i) The individual left a job that provided health insurance coverage.
(ii) The individual's employer discontinued offering health insurance coverage.
(iii) The individual exhausted continuation coverage under a COBRA continuation provision as defined in section 20-2301.
(iv) The individual's family health insurance coverage was discontinued due to the death of a spouse or a divorce.
(v) The individual attained the maximum age for dependent coverage under a health insurance policy.
(vi) The individual's participation in a public health care program was discontinued.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1384 - Short-term limited duration insurance; notice; definitions

20-1384.
Short-term limited duration insurance;  notice;  definitions
A. All policies or certificates issued,  delivered or renewed in this state for short-term limited duration insurance shall display on the policy's fact page and in any application materials provided in connection with enrollment in such coverage the following federal disclosure in at least fourteen-point type:
Notice
This coverage is not required to comply with certain federal market requirements for health insurance,  principally those contained in the affordable care act. Be sure to check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization,  emergency services,  maternity care,  preventive care,  prescription drugs and mental health and substance use disorder services). Your policy might also have lifetime or annual dollar limits on health benefits,  or both. If this coverage expires or you lose eligibility for this coverage,  you might have to wait until an open enrollment period to get other health insurance coverage.
B. A health care insurer shall provide notice to the insured before expiration that the policy needs to be renewed or is expiring.
C. For the purposes of this section:
1. " Health care insurer"  has the same meaning prescribed in section 20-1379.
2. " Short-term limited duration insurance"  means health insurance coverage that is offered by a health care insurer,  that is not subject to state health coverage mandates in this title,  that has an expiration date specified in the contract that is less than twelve months after the original effective date of the contract and,  taking into account renewals or extensions,  that has a duration of not longer than thirty-six months.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1401.01 - Group disability insurers; notice; copies

20-1401.01.
Group disability insurers;  notice;  copies
A. No person or insurer may deliver or issue for delivery to an employer in this state a certificate of insurance or other evidence of coverage of a group disability policy issued outside this state unless the certificate or other evidence of coverage contains the following notice,  prominently displayed: " Notice: This certificate of insurance may not provide all benefits and protections provided by law in Arizona. Please read this certificate carefully."
B. At least thirty days before offering coverage under a group disability policy issued outside this state to an employer in this state,  any person or insurer offering this coverage shall make available to the director copies of the policies and certificates of insurance or other evidences of coverage issued under such policies.
C. The director may adopt rules prescribing disclosure standards for advertising,  solicitation and similar representations. Such standards shall apply to all representations made prior to sale or at the point of sale.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1402.02 - Eosinophilic gastrointestinal disorder; formula

20-1402.02.
Eosinophilic gastrointestinal disorder;  formula
A. Any group disability policy that is offered by a group disability insurer and that contains a prescription drug benefit shall cover amino acid-based formula that is ordered by a physician or a registered nurse practitioner if:
1. The insured has been diagnosed with an eosinophilic gastrointestinal disorder.
2. The insured is under the continuous supervision of a physician who is licensed pursuant to title 32,  chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to title 32,  chapter 15.
3. There is risk of a mental or physical impairment without the use of the formula.
B. A group disability insurer shall cover at least seventy-five per cent of the cost of the formula. The group disability insurer may limit the maximum annual benefit for formula under this section to twenty thousand dollars.
C. This section does not apply to limited benefit coverage as defined in section 20-1137.
2023 Arizona Revised Statutes › Title 20 - Insurance › § 20-1402.03 - Group disability insurers; autism spectrum disorder; coverage; exceptions; definitions

20-1402.03.
Group disability insurers;  autism spectrum disorder;  coverage;  exceptions;  definitions
A. A group disability insurer shall not:
1. Exclude or deny coverage for a treatment or impose dollar limits,  deductibles and coinsurance provisions based solely on the diagnosis of autism spectrum disorder. For the purposes of this paragraph,  " treatment"  includes diagnosis,  assessment and services.
2. Exclude or deny coverage for medically necessary behavioral therapy services. To be eligible for coverage,  behavioral therapy services shall be provided or supervised by a licensed or certified provider.
B. This section does not:
1. Apply to a policy that is issued to an individual or a small employer.
2. Apply to long term care insurance,  life insurance,  annuities and limited benefit coverage as defined in section 20-1137.
3. Require coverage for services provided outside of this state.
C. The coverage required by this section is subject to all the terms and conditions of the group disability contract. Nothing in this section prevents a group disability insurer from imposing deductibles,  coinsurance or other cost sharing in relation to the coverage required by this section.
D. Coverage for behavioral therapy is subject to:
1. A fifty thousand dollar maximum benefit per year for an eligible person up to the age of nine.
2. A twenty-five thousand dollar maximum benefit per year for an eligible person who is between the ages of nine and sixteen.
E. For the purposes of this section:
1. " Autism spectrum disorder"  means one of the three following disorders as defined in the most recent edition of the diagnostic and statistical manual of mental disorders of the American psychiatric association:
(a) Autistic disorder.
(b) Asperger's syndrome.
(c) Pervasive developmental disorder not otherwise specified.
2. " Behavioral therapy"  means interactive therapies derived from evidence based research,  including applied behavior analysis,  which includes discrete trial training,  pivotal response training,  intensive intervention programs and early intensive behavioral intervention.
3. " Small employer"  has the same meaning prescribed in section 20-2301.