reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.1. Coverage for Treatment of Inherited Metabolic Disease › 27-8-24.1-3. "Inherited Metabolic Disease"

Sec. 3. As used in this chapter, "inherited metabolic disease" means a disease:
(1) caused by inborn errors of amino acid, organic acid, or urea cycle metabolism; and
(2) treatable by the dietary restriction of one (1) or more amino acids.
As added by P.L.166-2003, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.1. Coverage for Treatment of Inherited Metabolic Disease › 27-8-24.1-4. "Medical Food"

Sec. 4. As used in this chapter, "medical food" means a formula that is:
(1) intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation; and
(2) formulated to be consumed or administered enterally under the direction of a physician.
As added by P.L.166-2003, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.1. Coverage for Treatment of Inherited Metabolic Disease › 27-8-24.1-5. Coverage for Medical Food

Sec. 5. An accident and sickness insurance policy must provide coverage for medical food that is:
(1) medically necessary; and
(2) prescribed by a covered individual's treating physician for treatment of the covered individual's inherited metabolic disease.
As added by P.L.166-2003, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.1. Coverage for Treatment of Inherited Metabolic Disease › 27-8-24.1-6. Dollar Limits, Out-of-Pocket Expenses

Sec. 6. The coverage that must be provided under this chapter shall not be subject to dollar limits, coinsurance, or deductibles that are less favorable to a covered individual than the dollar limits, coinsurance, or deductibles that apply to coverage for:
(1) prescription drugs generally under the accident and sickness insurance policy, if prescription drugs are covered under the accident and sickness insurance policy; or
(2) physical illness generally under the accident and sickness insurance policy, if prescription drugs are not covered under the accident and sickness insurance policy.
As added by P.L.166-2003, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-0.1. Application of Chapter

Sec. 0.1. The addition of this chapter by P.L.109-2008 applies to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2008.
As added by P.L.220-2011, SEC.450.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-1. "Insured"

Sec. 1. As used in this chapter, "insured" means an individual who is entitled to coverage under a policy of accident and sickness insurance.
As added by P.L.109-2008, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-2. "Orthotic Device"

Sec. 2. As used in this chapter, "orthotic device" means a medically necessary custom fabricated brace or support that is designed as a component of a prosthetic device.
As added by P.L.109-2008, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-3. "Policy of Accident and Sickness Insurance"

Sec. 3. (a) As used in this chapter, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1.
(b) The term does not include the following:
(1) Accident only, credit, dental, vision, Medicare, Medicare supplement, long term care, or disability income insurance.
(2) Coverage issued as a supplement to liability insurance.
(3) Automobile medical payment insurance.
(4) A specified disease policy.
(5) A limited benefit health insurance 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 a stipulated daily, weekly, or monthly payment to an insured during hospital confinement, without regard to the actual expense of the confinement.
(8) Worker's compensation or similar insurance.
(9) A student health insurance policy.
As added by P.L.109-2008, SEC.2. Amended by P.L.288-2019, SEC.19.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-5. Coverage Required

Sec. 5. A policy of accident and sickness insurance must provide coverage for orthotic devices and prosthetic devices, including repairs or replacements, that:
(1) are provided or performed by a person that is:
(A) accredited as required under 42 U.S.C. 1395m(a)(20); or
(B) a qualified practitioner (as defined in 42 U.S.C. 1395m(h)(1)(F)(iii));
(2) are determined by the insured's physician to be medically necessary to restore or maintain the insured's ability to perform activities of daily living or essential job related activities; and
(3) are not solely for comfort or convenience.
As added by P.L.109-2008, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-6. Coverage and Reimbursement

Sec. 6. The:
(1) coverage required under section 5 of this chapter must be equal to the coverage that is provided for the same device, repair, or replacement under the federal Medicare program (42 U.S.C. 1395 et seq.); and
(2) reimbursement under the coverage required under section 5 of this chapter must be equal to the reimbursement that is provided for the same device, repair, or replacement under the federal Medicare reimbursement schedule, unless a different reimbursement rate is negotiated.
This section does not require a deductible under a policy of accident and sickness insurance to be equal to a deductible under the federal Medicare program.
As added by P.L.109-2008, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-7. Comparison to Other Benefits

Sec. 7. Except as provided in sections 8 and 9 of this chapter, the coverage required under section 5 of this chapter:
(1) may be subject to; and
(2) may not be more restrictive than;
the provisions that apply to other benefits under the policy of accident and sickness insurance.
As added by P.L.109-2008, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-8. Continued Medical Necessity Review

Sec. 8. The coverage required under section 5 of this chapter may be subject to utilization review, including periodic review, of the continued medical necessity of the benefit.
As added by P.L.109-2008, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-9. Lifetime Maximum Coverage Limitation

Sec. 9. Any lifetime maximum coverage limitation that applies to prosthetic devices and orthotic devices:
(1) must not be included in; and
(2) must be equal to;
the lifetime maximum coverage limitation that applies to all other items and services generally under the policy of accident and sickness insurance.
As added by P.L.109-2008, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.2. Coverage for Prosthetic Devices › 27-8-24.2-10. Deductible, Copayment, or Coinsurance Requirements

Sec. 10. For purposes of this section, "items and services" does not include preventive services for which coverage is provided under a high deductible health plan (as defined in 26 U.S.C. 220(c)(2) or 26 U.S.C. 223(c)(2)). The coverage required under section 5 of this chapter may not be subject to a deductible, copayment, or coinsurance provision that is less favorable to an insured than the deductible, copayment, or coinsurance provisions that apply to other items and services generally under the policy of accident and sickness insurance.
As added by P.L.109-2008, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-0.1. Application of Chapter

Sec. 0.1. The addition of this chapter by P.L.188-1996 applies only to an insurance policy or a health plan issued, renewed, or entered into after June 30, 1996.
As added by P.L.220-2011, SEC.451.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-1. Applicability of Chapter

Sec. 1. This chapter applies to every:
(1) policy of accident and sickness insurance (as described in IC 27-8-5-1), whether written on an individual basis, a group basis, a franchise basis, a blanket basis, or under a preferred provider plan (as defined in IC 27-8-11-1);
(2) group contract (as defined in IC 27-13-1-16) or individual contract (as defined in IC 27-13-1-21) through which a health maintenance organization furnishes health care services; and
(3) policy of life insurance or disability insurance described under Class 1 of IC 27-1-5-1.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-2. "Abuse" Defined

Sec. 2. As used in this chapter, "abuse" refers to the occurrence of one (1) or more of the following acts between family members or current or former household members:
(1) Attempting to cause or intentionally, knowingly, or recklessly causing bodily injury to, physical harm to, sexual assault on, involuntary sexual intercourse with, or rape of another individual.
(2) Knowingly engaging in a course of conduct or repeatedly committing acts, including stalking (as defined in IC 35-45-10-1) or impermissible contact (as defined in IC 35-45-10-3), under circumstances that place the individual toward whom such acts are directed in reasonable fear of bodily injury or physical harm.
(3) Subjecting another individual to false imprisonment.
(4) Attempting to cause or intentionally, knowingly, or recklessly causing damage to property in order to intimidate or attempt to control the behavior of another individual.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-4. "An Insurance Policy or a Health Plan" Defined

Sec. 4. As used in this chapter, "an insurance policy or a health plan" refers to an insurance policy or a health maintenance organization contract described in section 1 of this chapter.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-5. "Insurer" Defined

Sec. 5. As used in this chapter, "insurer" means a company, a firm, a partnership, an association, an order, a society, or a system:
(1) making any of the kinds of insurance; or
(2) entering into any of the kinds of contracts;
described in section 1 of this chapter.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-6. Prohibited Acts by Insurer

Sec. 6. Except as provided in sections 7 and 8 of this chapter, an insurer may not do any of the following:
(1) Deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on an individual under an insurance policy or a health plan because the individual:
(A) has been, is, or has the potential to be a victim of abuse; or
(B) seeks, has sought, or should have sought protection from abuse, shelter from abuse, or medical or psychological treatment for abuse.
(2) Add any surcharge or rating factor to a premium of an insurance policy or a health plan because an individual:
(A) has a history of being;
(B) is; or
(C) has the potential to be;
a victim of abuse.
(3) Exclude or limit coverage for losses or deny a claim incurred by a person covered by an insurance policy or a health plan as a result of abuse or the potential for abuse.
(4) Designate that if an individual:
(A) has a history of being a victim of abuse; or
(B) is a victim of abuse;
the abuse is a preexisting condition that causes coverage to be denied for a specified period.
(5) Ask an individual covered by or applying for an insurance policy or a health plan if the individual:
(A) is, has been, or may be a victim of abuse; or
(B) seeks, has sought, or should have sought protection from abuse, shelter from abuse, or medical or psychological treatment for abuse.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-7. Insurer May Adjust Premiums

Sec. 7. This chapter does not prohibit an insurer from adjusting premiums of an individual applying for or covered by an insurance policy described in Class 1(a) of IC 27-1-5-1 on the basis that the individual has a physical or mental condition or medical claims history.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-8. Underwriting or Rating Risk on Basis of Physical or Mental Condition Caused by Abuse

Sec. 8. This chapter does not prohibit an insurer from inquiring about, underwriting, or rating a risk on the basis of a physical or mental condition, even if that condition has been caused by abuse if:
(1) the insurer routinely underwrites or charges a different rate for that condition in the same manner with respect to all individuals who apply for or are covered by an insurance policy or a health plan regardless of whether the individual has been the victim of abuse;
(2) the individual's status as being, having been, or having the potential to be the subject of abuse is not considered to be a physical or mental condition;
(3) the insurer does not:
(A) refuse to insure or refuse to contract with;
(B) refuse to continue to insure or refuse to continue to contract with;
(C) limit the amount, extent, or coverage available; or
(D) charge a different rate for the same coverage;
solely because of a physical or mental condition, except where the refusal, limitation, or rate differential is based on sound actuarial principles or is related to actuarial or reasonably anticipated experience; and
(4) the underwriting or rating is not used to evade the intent of this chapter.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-9. Violations

Sec. 9. A violation of this chapter is an unfair and deceptive act and practice in the business of insurance under IC 27-4-1-4.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.3. Insurance and Health Plan Coverage for Victims of Abuse › 27-8-24.3-10. Immunity From Liability

Sec. 10. An insurer is immune from civil and criminal liability for any damages caused as a result of the insurer's compliance with this chapter.
As added by P.L.188-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.7. Referrals to Women's Health Care Providers › 27-8-24.7-1. "Health Insurance Policy" Defined

Sec. 1. As used in this chapter, "health insurance policy" means any individual or group accident and sickness policy, contract, subscriber agreement, rider, endorsement, or any contract providing for the delivery of health care benefits, delivered or issued for delivery in Indiana after June 30, 1996, by any of the following:
(1) An insurer.
(2) A fraternal benefit society.
(3) A nonprofit corporation.
(4) A health maintenance organization (as defined in IC 27-13-1-19).
(5) A preferred provider arrangement under IC 27-8-11.
As added by P.L.192-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.7. Referrals to Women's Health Care Providers › 27-8-24.7-2. "Health Insurer" Defined

Sec. 2. As used in this chapter, "health insurer" means an entity referred to in section 1 of this chapter that issues, delivers, or renews a health insurance policy.
As added by P.L.192-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.7. Referrals to Women's Health Care Providers › 27-8-24.7-3. "Insured" Defined

Sec. 3. As used in this chapter, "insured" means an individual who is entitled to the benefits provided by a health insurance policy. The term includes the following:
(1) A policyholder of an individual health insurance policy.
(2) A member of the group covered by a group health insurance policy.
(3) A female who is entitled to coverage under a health insurance policy as a spouse or dependent of an individual referred to in subdivision (1) or (2).
As added by P.L.192-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.7. Referrals to Women's Health Care Providers › 27-8-24.7-4. "Women's Health Care Provider" Defined

Sec. 4. As used in this chapter, "women's health care provider" means a physician licensed under IC 25-22.5 who specializes in the provision of obstetric or gynecological services.
As added by P.L.192-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 24.7. Referrals to Women's Health Care Providers › 27-8-24.7-5. Designation of Women's Health Care Provider as Primary Care Provider

Sec. 5. Under a health insurance policy that is issued, delivered, issued for delivery, or renewed in Indiana, an organization or arrangement described in section 1(1) through 1(5) of this chapter may not refuse to designate a women's health care provider as an insured's primary care provider if the women's health care provider meets the terms and conditions for participation established by an organization or arrangement described in section 1(1) through 1(5) of this chapter under an insurance policy as a primary care physician solely because the individual physician specializes in the provision of obstetric or gynecological services.
As added by P.L.192-1996, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 25. Coverage for Care Related to Clinical Trials › 27-8-25-2. "Clinical Trial"

Sec. 2. As used in this chapter, "clinical trial" means a Phase I, II, III, or IV research study:
(1) that is conducted:
(A) using a particular care method to prevent, diagnose, or treat a cancer for which:
(i) there is no clearly superior, noninvestigational alternative care method; and
(ii) available clinical or preclinical data provides a reasonable basis from which to believe that the care method used in the research study is at least as effective as any noninvestigational alternative care method;
(B) in a facility where personnel providing the care method to be followed in the research study have:
(i) received training in providing the care method;
(ii) expertise in providing the type of care required for the research study; and
(iii) experience providing the type of care required for the research study to a sufficient volume of patients to maintain expertise; and
(C) to scientifically determine the best care method to prevent, diagnose, or treat the cancer; and
(2) that is approved or funded by one (1) of the following:
(A) A National Institutes of Health institute.
(B) A cooperative group of research facilities that has an established peer review program that is approved by a National Institutes of Health institute or center.
(C) The federal Food and Drug Administration.
(D) The United States Department of Veterans Affairs.
(E) The United States Department of Defense.
(F) The institutional review board of an institution located in Indiana that has a multiple project assurance contract approved by the National Institutes of Health Office for Protection from Research Risks as provided in 45 CFR 46.103.
(G) A research entity that meets eligibility criteria for a support grant from a National Institutes of Health center.
As added by P.L.109-2009, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 25. Coverage for Care Related to Clinical Trials › 27-8-25-3. "Contracted Provider"

Sec. 3. As used in this chapter, "contracted provider" means a health care provider that has entered into an agreement under IC 27-8-11-3 with an insurer that issues a policy of accident and sickness insurance.
As added by P.L.109-2009, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 25. Coverage for Care Related to Clinical Trials › 27-8-25-4. "Covered Individual"

Sec. 4. As used in this chapter, "covered individual" means an individual entitled to coverage under a policy of accident and sickness insurance.
As added by P.L.109-2009, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 25. Coverage for Care Related to Clinical Trials › 27-8-25-5. "Noncontracted Provider"

Sec. 5. As used in this chapter, "noncontracted provider" means a health care provider that has not entered into an agreement to serve as a contracted provider.
As added by P.L.109-2009, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 25. Coverage for Care Related to Clinical Trials › 27-8-25-6. "Policy of Accident and Sickness Insurance"

Sec. 6. As used in this chapter, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1.
As added by P.L.109-2009, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 25. Coverage for Care Related to Clinical Trials › 27-8-25-7. "Routine Care Cost"

Sec. 7. As used in this chapter, "routine care cost" means the cost of medically necessary services related to the care method that is under evaluation in a clinical trial. The term does not include the following:
(1) The health care service, item, or investigational drug that is the subject of the clinical trial.
(2) Any treatment modality that is not part of the usual and customary standard of care required to administer or support the health care service, item, or investigational drug that is the subject of the clinical trial.
(3) Any health care service, item, or drug provided solely to satisfy data collection and analysis needs that are not used in the direct clinical management of the patient.
(4) An investigational drug or device that has not been approved for market by the federal Food and Drug Administration.
(5) Transportation, lodging, food, or other expenses for the patient or a family member or companion of the patient that are associated with travel to or from a facility where a clinical trial is conducted.
(6) A service, item, or drug that is provided by a clinical trial sponsor free of charge for any new patient.
(7) A service, item, or drug that is eligible for reimbursement from a source other than a covered individual's policy of accident and sickness insurance, including the sponsor of the clinical trial.
As added by P.L.109-2009, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 25. Coverage for Care Related to Clinical Trials › 27-8-25-8. Coverage for Routine Care Costs

Sec. 8. (a) A policy of accident and sickness insurance must provide coverage for routine care costs that are incurred in the course of a clinical trial if the policy of accident and sickness insurance would provide coverage for the same routine care costs not incurred in a clinical trial.
(b) The coverage that must be provided under this section is subject to the terms, conditions, restrictions, exclusions, and limitations that apply generally under the policy of accident and sickness insurance, including terms, conditions, restrictions, exclusions, or limitations that apply to health care services rendered by contracted providers and noncontracted providers.
(c) This section does not do any of the following:
(1) Require an insurer that issues a policy of accident and sickness insurance to provide coverage for clinical trial services rendered by a contracted provider.
(2) Prohibit an insurer that issues a policy of accident and sickness insurance from providing coverage for clinical trial services rendered by a contracted provider.
(3) Require reimbursement under a policy of accident and sickness insurance for services that are rendered in a clinical trial by a noncontracted provider at the same rate of reimbursement that would apply to the same services rendered by a contracted provider.
As added by P.L.109-2009, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 25. Coverage for Care Related to Clinical Trials › 27-8-25-9. No Cause of Action Created by Chapter

Sec. 9. This chapter does not create a cause of action against a person for any harm to a covered individual resulting from a clinical trial.
As added by P.L.109-2009, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-0.1. Application of Chapter

Sec. 0.1. The addition of this chapter by P.L.150-1997 applies to all applications and policies for accident and sickness insurance delivered, issued for delivery, renewed, or executed after December 31, 1997.
As added by P.L.220-2011, SEC.452.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-1. Applicability of Chapter

Sec. 1. (a) This chapter applies to the following:
(1) Every policy of accident and sickness insurance (as defined in IC 27-8-5-1), whether written on an individual basis, a group basis, a franchise basis, or a blanket basis that is issued, delivered, or renewed in Indiana.
(2) Every group contract (as defined in IC 27-13-1-16) or individual contract (as defined in IC 27-13-1-21) through which a health maintenance organization furnishes health care services that is delivered, executed, or renewed in Indiana.
(3) Every health care plan of a state or local governmental entity that provides coverage for health care services on a self-insurance basis in Indiana.
(4) Every employee welfare benefit plan (as defined in 29 U.S.C. 1002) that is self-funded.
(b) This chapter does not apply to the following:
(1) Accident-only insurance, credit insurance, 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) Life insurance.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-2. "Genetic Screening or Testing" Defined

Sec. 2. (a) As used in this chapter, "genetic screening or testing" means a laboratory test:
(1) of an individual's genes or chromosomes for abnormalities, defects, or deficiencies, including changes in the number, structure, or integrity of an individual's chromosomes or carrier status, that:
(A) are linked to physical or mental disorders or impairments;
(B) indicate a susceptibility to illness, disease, or other disorders, whether physical or mental; or
(C) demonstrate genetic or chromosomal damage due to environmental factors; and
(2) that is a direct test for abnormalities, defects, or deficiencies in an individual's genes or chromosomes.
(b) The term does not include the detection of a genetic disorder through the manifestation of the genetic disorder.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-3. "Health Care Services Coverage" Defined

Sec. 3. As used in this chapter, "health care services coverage" refers to an insurance policy, a health maintenance organization contract, or a governmental health care plan described in section 1 of this chapter.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-4. "Insurer" Defined

Sec. 4. As used in this chapter, "insurer" means a company, a firm, a partnership, an entity, an association, an order, a society, or a system:
(1) making any of the kinds of insurance;
(2) entering into any of the kinds of contracts; or
(3) providing any of the coverage;
described in section 1 of this chapter.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-5. Determination of Eligibility for Health Care Services Coverage by Insurer; Prohibitions

Sec. 5. In processing an application for health care services coverage or in determining insurability for health care services coverage, an insurer may not do any of the following:
(1) Require an individual or any member of an individual's family seeking health care services coverage to submit to genetic screening or testing.
(2) Consider any information obtained from genetic screening or testing in a manner adverse to:
(A) an applicant or a member of an applicant's family for; or
(B) an individual or a member of an individual's family covered by;
health care services coverage.
(3) Inquire, directly or indirectly, into the results of genetic screening or testing, or use such information to cancel, refuse to issue or renew, or limit benefits under health care services coverage.
(4) Make a decision adverse to an applicant or a member of an applicant's family based on entries related to the results of genetic testing or screening in medical records or other reports of genetic screening or testing.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-6. Questions by Insurer Regarding Genetic Screening or Testing Results Prohibited

Sec. 6. In developing and asking questions regarding the medical history of an applicant for health care services coverage, an insurer may not ask:
(1) for the results of; or
(2) questions designed to ascertain the results of;
genetic screening or testing.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-7. Refusal of Health Care Services Coverage Based on Genetic Screening or Testing Results Prohibited

Sec. 7. An insurer may not cancel, refuse to issue, refuse to renew, or refuse to enter into a contract for health care services coverage based on the results of genetic screening or testing.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-8. Limitation of Benefits or Establishment of Premiums Based on Genetic Screening or Testing Results Prohibited

Sec. 8. An insurer may not deliver, issue for delivery, renew, or execute a contract for health care services coverage in Indiana that:
(1) limits benefits; or
(2) establishes premiums;
based on the results of genetic screening or testing.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-9. Consideration of Genetic Screening or Testing Results by Insurer

Sec. 9. An insurer may consider the results of genetic screening or testing if:
(1) the results are voluntarily submitted by:
(A) an applicant for; or
(B) an individual seeking renewal of;
health care services coverage; and
(2) the results are favorable to the applicant or the individual.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-10. Enforcement of Chapter; Rules

Sec. 10. (a) The commissioner shall enforce this chapter.
(b) The commissioner may adopt rules under IC 4-22-2 to carry out this chapter.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 26. Genetic Screening or Testing › 27-8-26-11. Violation Unfair and Deceptive Act or Practice

Sec. 11. A violation of this chapter is an unfair and deceptive act or practice in the business of insurance under IC 27-4-1-4.
As added by P.L.150-1997, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities › 27-8-27-1. "Early Intervention Services" Defined

Sec. 1. For purposes of this chapter, "early intervention services" means services provided to a first steps child under IC 12-12.7-2 and 20 U.S.C. 1432(4).
As added by P.L.121-1999, SEC.13. Amended by P.L.93-2006, SEC.17.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities › 27-8-27-2. "First Steps Child" Defined

Sec. 2. For purposes of this chapter, "first steps child" means an infant or toddler from birth through two (2) years of age who is enrolled in the Indiana first steps program and is an insured.
As added by P.L.121-1999, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities › 27-8-27-3. "First Steps Program" Defined

Sec. 3. As used in this chapter, "first steps program" means the program established under IC 12-12.7-2 and 20 U.S.C. 1431 et seq. to meet the needs of:
(1) children who are eligible for early intervention services; and
(2) their families.
The term includes the coordination of all available federal, state, local, and private resources available to provide early intervention services within Indiana.
As added by P.L.121-1999, SEC.13. Amended by P.L.93-2006, SEC.18.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities › 27-8-27-4. "Health Insurance Plan"

Sec. 4. (a) For purposes of this chapter, "health insurance 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 an insured.
(b) The term does not include the following:
(1) Accident-only, credit, dental, 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 issued as an individual policy.
(6) A limited benefit health insurance plan issued as an individual policy.
(7) 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).
(8) A policy that provides a stipulated daily, weekly, or monthly payment to an insured during hospital confinement, without regard to the actual expense of the confinement.
As added by P.L.121-1999, SEC.13. Amended by P.L.288-2019, SEC.20.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities › 27-8-27-5. "Insured" Defined

Sec. 5. As used in this chapter, "insured" means an individual covered by a health insurance plan.
As added by P.L.121-1999, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities › 27-8-27-6. Reimbursement of First Steps Program for Early Intervention Services Payments

Sec. 6. (a) A health insurance plan that provides coverage for early intervention services shall reimburse the first steps program a monthly fee established by the division of disability and rehabilitative services. Except when the monthly fee is less than the product determined under IC 12-12.7-2-23(b), the monthly fee shall be provided instead of claims processing of individual claims.
(b) A health insurance plan may not require authorization for services specified in the covered individual's individualized family service plan, if those services are a covered benefit under the plan, once the individualized family service plan is signed by a physician, an advanced practice registered nurse, or a physician assistant.
(c) The department of insurance shall adopt rules under IC 4-22-2 to ensure compliance with this section.
As added by P.L.121-1999, SEC.13. Amended by P.L.229-2011, SEC.254; P.L.111-2020, SEC.13; P.L.133-2020, SEC.19; P.L.143-2022, SEC.75.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities › 27-8-27-8. Reimbursement Not to Be Applied to Lifetime Coverage Limit

Sec. 8. The reimbursement required under section 6 of this chapter may not be applied to any annual or aggregate lifetime limit on the first steps child's coverage under the health insurance plan.
As added by P.L.121-1999, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities › 27-8-27-9. Payment of Deductibles, Copayments, or Other Expenses

Sec. 9. The first steps program may pay required deductibles, copayments, or other out-of-pocket expenses for a first steps child directly to a provider. An insurer (as defined in IC 27-8-14.5-3) shall apply any payments made by the first steps program to the health insurance plan's deductibles, copayments, or other out-of-pocket expenses according to the terms and conditions of the health insurance plan.
As added by P.L.121-1999, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-1. "Accident and Sickness Insurance Policy"

Sec. 1. (a) As used in this chapter, "accident and sickness insurance policy" means an insurance policy that provides one (1) or more of the kinds of insurance described in Class 1(b) and 2(a) of IC 27-1-5-1.
(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) Automobile medical payment insurance.
(4) A specified disease policy issued as an individual policy.
(5) A limited benefit health insurance policy issued as an individual 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 a stipulated daily, weekly, or monthly payment to an insured during hospital confinement without regard to the actual expense of the confinement.
(8) Worker's compensation or similar insurance.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.288-2019, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-2. "Commissioner"

Sec. 2. As used in this chapter, "commissioner" refers to the insurance commissioner appointed under IC 27-1-1-2.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.1-2002, SEC.113.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-3. "Covered Individual"

Sec. 3. As used in this chapter, "covered individual" means an individual who is covered under an accident and sickness insurance policy.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-4. "Department"

Sec. 4. As used in this chapter, "department" refers to the department of insurance.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-5. "External Grievance"

Sec. 5. As used in this chapter, "external grievance" means the independent review under IC 27-8-29 of a grievance filed under this chapter.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-6. "Grievance"

Sec. 6. As used in this chapter, "grievance" means any dissatisfaction expressed by or on behalf of a covered individual regarding:
(1) a determination that a service or proposed service is not appropriate or medically necessary;
(2) a determination that a service or proposed service is experimental or investigational;
(3) the availability of participating providers;
(4) the handling or payment of claims for health care services;
(5) matters pertaining to the contractual relationship between:
(A) a covered individual and an insurer; or
(B) a group policyholder and an insurer;
(6) an insurer's decision to rescind an accident and sickness insurance policy; or
(7) a determination concerning a prior authorization request under IC 27-1-37.5;
and for which the covered individual has a reasonable expectation that action will be taken to resolve or reconsider the matter that is the subject of dissatisfaction.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.1-2002, SEC.114; P.L.160-2011, SEC.22; P.L.77-2018, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-7. "Grievance Procedure"

Sec. 7. As used in this chapter, "grievance procedure" means a written procedure established and maintained by an insurer for filing, investigating, and resolving grievances and appeals.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-8. "Insured"

Sec. 8. As used in this chapter, "insured" means:
(1) an individual whose employment status or other status except family dependency is the basis for coverage under a group accident and sickness insurance policy; or
(2) in the case of an individual accident and sickness insurance policy, the individual in whose name the policy is issued.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-9. "Insurer"

Sec. 9. As used in this chapter, "insurer" means any person who delivers or issues for delivery an accident and sickness insurance policy or certificate in Indiana.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-10. Grievance Procedure to Comply With Chapter Requirements

Sec. 10. An insurer shall establish and maintain a grievance procedure that complies with the requirements of this chapter for the resolution of grievances initiated by a covered individual.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-11. Commissioner May Examine Procedure

Sec. 11. The commissioner may examine the grievance procedure of any insurer.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-12. Grievance Records

Sec. 12. An insurer shall maintain all grievance records received by the insurer after the most recent examination of the insurer's grievance procedure by the commissioner.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-13. Notice of Grievance Related Information

Sec. 13. (a) An insurer shall provide, at the request of the insured, covered individual, or legal representative of the insured or covered individual, and upon policy issuance, at each policy renewal, and with any notice of denial of a claim, timely, adequate, and appropriate notice to each insured, covered individual, or legal representative, of:
(1) the grievance procedure required under this chapter;
(2) the external grievance procedure required under IC 27-8-29;
(3) information on how to file:
(A) a grievance under this chapter; and
(B) a request for an external grievance review under IC 27-8-29;
(4) a toll free telephone number through which a covered individual may contact the insurer at no cost to the covered individual to obtain information and to file grievances; and
(5) the address for the Internet web site established by the department under IC 27-1-3-33.
(b) An insurer shall prominently display on all notices to covered individuals the toll free telephone number and the address at which a grievance or request for external grievance review may be filed.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.18-2016, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-14. Filing Grievance; Toll Free Number

Sec. 14. (a) A covered individual may file a grievance orally or in writing.
(b) An insurer shall make available to covered individuals a toll free telephone number through which a grievance may be filed. The toll free telephone number must:
(1) be staffed by a qualified representative of the insurer;
(2) be available for at least forty (40) hours per week during normal business hours; and
(3) accept grievances in the languages of the major population groups served by the insurer.
(c) A grievance is considered to be filed on the first date it is received, either by telephone or in writing.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-15. Assistance in Filing Grievance; Designation of Representative

Sec. 15. (a) An insurer shall establish procedures to assist covered individuals in filing grievances.
(b) A covered individual may designate a representative to file a grievance for the covered individual and to represent the covered individual in a grievance under this chapter.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.