reglab/statecodes huggingface dataset:
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2125 Same; loans to finance plan commencement, repayment.

40-2125.
Same; loans to finance plan commencement, repayment.
Upon request of the commissioner to provide for amounts that may be required to assist in financing the commencement of operations of the plan, the pooled money investment board shall loan to the uninsurable health insurance plan fund not to exceed $500,000 on July 15, 1992, July 15, 1993, July 15, 1994, and July 15, 1995. The total of the amounts so loaned shall be repaid from the uninsurable health insurance plan fund over the period of 10 fiscal years after fiscal year 1994 in accordance with appropriation acts. Amounts loaned under this section shall not bear interest.
History:
L. 1992, ch. 209, § 9; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2126 Same; uninsurable health insurance plan fund; transfers to fund plan losses; transfer of plan surplus to fund.

40-2126.
Same; uninsurable health insurance plan fund; transfers to fund plan losses; transfer of plan surplus to fund.
There is hereby created in the state treasury a fund to be known and designated as the uninsurable health insurance plan fund. Periodically, the plan shall compare the premiums earned to the losses and expenses sustained by the plan. If there is any excess of losses and expenses over premiums earned, an amount determined by the commissioner to be necessary to fund such excess losses and expenses shall be transferred from the uninsurable health insurance plan fund to the plan to pay claims and expenses resulting from its operation. If there is any surplus of premiums earned over losses and expenses, such surplus shall be transferred to the uninsurable health insurance plan fund from the plan. All expenditures from the uninsurable health insurance plan fund shall be made in accordance with appropriation acts upon warrants of the director of accounts and reports issued pursuant to vouchers approved by the commissioner or a person or persons designated by the commissioner.
History:
L. 1992, ch. 209, § 10; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2127 Same; annual financial report to commissioner; financial examination by commissioner.

40-2127. Same; annual financial report to commissioner; financial examination by commissioner.
(a) Not later than July 1, 1993, and July 1 of each succeeding year, the board shall submit an audited financial report for the plan for the preceding calendar year to the commissioner in a form provided or prescribed by the commissioner.
(b) The financial status of the plan shall be subject to examination by the commissioner or the commissioner's designee. Such examination shall be conducted at least once every five years. The commissioner shall transmit a copy of the results of such examination to the legislature by February 1 of the year following the year in which the examination is conducted.
History:
L. 1992, ch. 209, § 11; L. 2015, ch. 83, § 4; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2128 Same; submission of financial report to joint committee on health care decisions for the 90's; information required.

40-2128.
Same; submission of financial report to joint committee on health care decisions for the 90's; information required.
The commissioner shall submit annually to the joint committee on health care decisions for the 90's the financial report of the plan, the number of individuals covered and the specific coverage of the plan. The report shall compare the provider reimbursement rates to those of medicaid and medicare, and include the number of participating providers and their locations and other information as the joint committee shall request.
History:
L. 1992, ch. 209, § 12; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2129 Same; commissioner's recommendations for plan improvements to joint committee, when.

40-2129.
Same; commissioner's recommendations for plan improvements to joint committee, when.
If, by July 1, 1995, operation of the Kansas uninsurable health insurance plan has inadequate participation; or activity in the health insurance marketplace materially impairs affordability or marketability of the plan; or the commissioner deems other factors jeopardize the operation of the plan, the commissioner shall develop and submit to the joint committee on health care decisions for the 90's recommendations the commissioner deems necessary to ensure the successful operation of the plan.
History:
L. 1992, ch. 209, § 13; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2130 Same; form directing withholding or withdrawal of life-sustaining procedures to be provided applicants for coverage; retention upon execution.

40-2130.
Same; form directing withholding or withdrawal of life-sustaining procedures to be provided applicants for coverage; retention upon execution.
The association or a member insurer thereof shall provide every applicant for health coverage under the provisions of this act with a form for making a declaration directing the withholding or withdrawal of life-sustaining procedures in a terminal condition in substantial conformance with subsection (c) of K.S.A. 65-28,103, and amendments thereto. If such applicant elects to execute such declaration the applicant shall submit a copy of such declaration to the association or member insurer thereof, and such copy shall be retained and made a part of the applicant's permanent records.
History:
L. 1992, ch. 209, § 14; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2131 Same; health service provider agreements; charge to insured not permitted, when.

40-2131.
Same; health service provider agreements; charge to insured not permitted, when.
Unless otherwise specified by the plan, as a prerequisite for payment from the plan, each provider of health services to persons covered under the plan shall enter into a provider agreement with the association under which reimbursement for services provided shall be at rates established by the board. Providers shall not charge persons covered under the plan with the exception of authorized deductible and co-pay requirements and noncovered services if the recipient has been informed in advance of the noncoverage.
History:
L. 1992, ch. 209, § 15; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2132 Long-term care partnership act; citation of act.

40-2132.
Long-term care partnership act; citation of act.
K.S.A. 40-2132 through 40-2137, and amendments thereto, shall be known and may be cited as the "long-term care partnership program act."
History:
L. 2008, ch. 51, § 1; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2133 Same; definitions.

40-2133.
Same; definitions.
As used in K.S.A. 40-2132 through 40-2137, and amendments thereto: (a) "Asset disregard" means, with regard to the state's medical assistance program, disregarding any assets or resources in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under a qualified long-term care insurance partnership policy.
(b) "Long-term care insurance policy" means a policy as defined in K.S.A. 40-2227, and amendments thereto.
(c) "Long-term care partnership program" means a qualified state long-term care insurance partnership as defined in section 1917(b) of the social security act, 42 U.S.C. § 1396p.
(d) "Long-term care partnership program policy" means a qualified long-term care insurance policy that the commissioner of insurance certifies as meeting the requirements of section 1917(b) of the social security act, 42 U.S.C. § 1396p, section 6021 of the federal deficit reduction act of 2005, public law 109-171, and any applicable federal regulations or guidelines.
(e) "Medicaid" means the program of medical assistance operated by the state under title XIX of the federal social security act, 42 U.S.C. §§ 1396 et seq., and amendments thereto.
(f) "State plan amendment" means the amendment to the state's medicaid state plan implementing the state qualified long-term care insurance partnership program authorized in section 6020 of the federal deficit reduction act of 2005, public law 109-171, and any applicable federal regulations or guidelines.
History:
L. 2008, ch. 51, § 2; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2135 Same; duties of commissioner.

40-2135.
Same; duties of commissioner.
The commissioner of insurance shall: (a) Determine the level of inflation protection reasonably necessary to protect individuals who purchase a Kansas long-term care partnership program policy.
(b) Not impose any requirement affecting the terms or benefits of qualified long-term partnership program policies other than the requirements of section 1917 (b) of the social security act, 42 U.S.C. § 1396p, section 6021 of the federal deficit reduction act of 2005, public law 109-171, or any applicable federal regulation or guidelines unless the commissioner imposes such a requirement on all long-term care insurance policies sold in this state without regard to whether the policy is covered under the partnership or is offered in connection with such partnership.
History:
L. 2008, ch. 51, § 4; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2138 Payment of claims by property insurer; requirements; dual endorsement not required.

40-2138.
Payment of claims by property insurer; requirements; dual endorsement not required.
(a) For insurance policies issued or renewed on or after July 1, 2010, a property insurer shall transmit claims payments directly to the primary policyholder by check or other allowable payment method, payable to the primary policyholder only, without requiring dual endorsement from any mortgageholder or lienholder for amounts payable under the insurance policy for personal property and contents, additional living expenses and other covered items that are not subject to a recorded security interest.
(b) This section shall be a part of and supplemental to the insurance code of the state of Kansas.
History:
L. 2010, ch. 103, § 2; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2139 Commissions not administrative expenses for purposes of medical loss ratio.

40-2139. Commissions not administrative expenses for purposes of medical loss ratio.
(a) Any portion of the health insurance premiums paid by consumers that are in fact passed through as commissions shall not be considered a part of administrative expenses and shall be excluded from all determinations of the medical loss ratio calculations when totaling the ratio of premiums paid by a consumer used for claims versus administrative expenses for a policy. Any portion of premiums identified as commissions must be paid to a nonemployee in order to be excluded. Any portion of the premiums retained by the insurance company or its employees must be considered as a part of the calculation of the medical loss ratio as administrative related income.
(b) For the purposes of this section, "commission" means commissions to agents, consultation fees, counseling fees, consultant fees, and similar advising or sales compensation to a nonemployee licensed agent.
History:
L. 2013, ch. 97, § 13; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2140 Law enforcement officer health insurance; continuation.

40-2140. Law enforcement officer health insurance; continuation.
(a) (1) Except as provided in paragraph (2), whenever a state agency or municipality provides for the payment of premiums for any health benefit plan for law enforcement officers employed by such state agency or such municipality, the state agency or municipality shall pay premiums for the continuation of coverage under COBRA for the surviving spouse and eligible dependent children under the age of 26 years of a law enforcement officer who dies in the line of duty. Premiums for continuation of coverage under COBRA shall be paid for 18 months.
(2) Neither the state agency nor the municipality may be required to pay the premiums described in paragraph (1) for a surviving spouse:
(A) On or after the end of the 18th calendar month after the date of death of the deceased law enforcement officer;
(B) upon the remarriage of the deceased law enforcement officer's surviving spouse; or
(C) upon the deceased law enforcement officer's surviving spouse reaching the age of 65.
(b) For the purposes of this section:
(1) "Health benefit plan" shall have the meaning ascribed to such term in K.S.A. 40-4602, and amendments thereto.
(2) "Law enforcement officer" means an employee employed by:
(A) A law enforcement agency whose principal duties are engagement in the enforcement of law and maintenance of order within this state and its political subdivisions and who is certified pursuant to the provisions of the Kansas law enforcement training act, K.S.A. 74-5601 et seq., and amendments thereto; or
(B) the Kansas department of corrections.
(3) "Municipality" means a city, county or township.
(4) "State agency" shall have the meaning ascribed to such term in K.S.A. 75-3701, and amendments thereto.
History:
L. 2013, ch. 109, § 2; L. 2014, ch. 101, § 4; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2141 Emergency personnel health insurance; continuation.

40-2141. Emergency personnel health insurance; continuation.
(a) (1) Except as provided in paragraph (2), whenever a municipality provides for the payment of premiums for any health benefit plan for its emergency personnel, it shall pay premiums for the continuation of coverage under COBRA for the surviving spouse and eligible dependent children under the age of 26 years of any emergency personnel who dies in the line of duty. Premiums for continuation of coverage under COBRA shall be paid for 18 months.
(2) A municipality may not be required to pay the premiums described in paragraph (1) for a surviving spouse:
(A) On or after the end of the 18th calendar month after the date of death of the deceased emergency personnel;
(B) upon the remarriage of the deceased emergency personnel's surviving spouse; or
(C) upon the deceased emergency personnel's surviving spouse reaching the age of 65.
(b) For the purposes of this section:
(1) "Emergency personnel" means an emergency medical service provider as such term is defined in K.S.A. 65-6112, and amendments thereto.
(2) "Health benefit plan" shall have the meaning ascribed to it in K.S.A. 40-4602, and amendments thereto.
(3) "Municipality" means a city or county.
History:
L. 2014, ch. 101, § 3; L. 2019, ch. 64, § 6; June 6.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 21 - Miscellaneous Provisions › 40-2142 Fair plan act; requirements.

40-2142. Fair plan act; requirements.
(a) This act shall be known and may be cited as the fair access to insurance requirements plan act, or the FAIR plan act.
(b) The purpose of this act is to make available basic property and casualty insurance to persons having property interests in this state who are in good faith entitled to, but who are unable to, procure such coverage through the voluntary market. The FAIR plan shall provide for the equitable distribution and placement of risks among all member insurers who have voluntarily elected to participate and shall operate subject to the provisions and conditions of this act. This act supersedes the prior authority of the FAIR plan to act under K.S.A. 40-2101, and amendments thereto.
(c) All policies shall be issued on the forms and in accordance with the reasonable rates and rating procedures approved by the commissioner of insurance.
(d) All policies shall be issued for a term of one year.
(e) Within 60 days of the filing of the proposed rates, the commissioner of insurance shall enter an order either approving or disapproving, in whole or in part, the rate plan filed. The commissioner of insurance may, upon notice to the facility, extend the period for entering an order for an additional 30 days. No policies or endorsements shall be issued applying the proposed rates until such time as the commissioner of insurance approves such rates. An order disapproving a rate shall state the grounds for the disapproval and the findings in support thereof.
(f) The commissioner of insurance may adopt rules and regulations to administer the provisions of this act. Any such rules and regulations deemed necessary shall be promulgated no later than January 1, 2018.
History:
L. 2017, ch. 6, § 1; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2201 Accident and sickness policy; definition.

40-2201.
Accident and sickness policy; definition.
(a) The term "policy of accident and sickness insurance" as used herein includes any policy or contract insuring against loss resulting from sickness or bodily injury or death by accident, or both, issued by a stock, or mutual company or association or any other insurer.
(b) The term "policy of stop loss or excess loss insurance coverage" means a policy, contract, endorsement, attachments, amendments or other modifications that insure against losses of the policyholder issued by a stock, or mutual company or association or any other insurer.
History:
L. 1951, ch. 296, § 1; L. 1997, ch. 190, § 24; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2204 Conforming to statute; construction of policies in conflict.

40-2204.
Conforming to statute; construction of policies in conflict.
(A) Other policy provisions: No policy provision which is not subject to K.S.A. 40-2203 shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this act.
(B) Policy conflicting with this act. A policy delivered or issued for delivery to any person in this state in violation of this act shall be held valid but shall be construed as provided in this act. When any provision in a policy subject to this act is in conflict with any provision of this act, the rights, duties and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this act.
History:
L. 1951, ch. 296, § 4; June 30.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2205 Statements made in application for policy; effect.

40-2205.
Statements made in application for policy; effect.
(A) The insured shall not be bound by any statement made in an application for a policy unless a copy of such application is attached to or endorsed on the policy when issued as a part thereof. If any such policy delivered or issued for delivery to any person in this state shall be reinstated or renewed, and the insured or the beneficiary or assignee of such policy shall make written request to the insurer for a copy of the application, if any, for such reinstatement or renewal, the insurer shall within fifteen (15) days after the receipt of such request at its home office or any branch office of the insurer, deliver or mail to the person making such request, a copy of such application. If such copy shall not be so delivered or mailed, the insurer shall be precluded from introducing such application as evidence in any action or proceeding based upon or involving such policy or its reinstatement or renewal.
(B) No alteration of any written application for any such policy shall be made by any person other than the applicant without his written consent, except that insertions may be made by the insurer, for administrative purposes only, in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant.
(C) The falsity of any material statement in the application for any policy covered by this act may not bar the right to recovery thereunder unless the false statement has actually contributed to the contingency or event on which the policy is to become due and payable: Provided, however, That any recovery resulting from the operation of this section shall not bar the right to render the policy void in accordance with its provisions.
History:
L. 1951, ch. 296, § 5; L. 1963, ch. 264, § 1; L. 1965, ch. 305, § 1; June 30.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2206 Notice acknowledged by insurer not waiver of rights.

40-2206.
Notice acknowledged by insurer not waiver of rights.
The acknowledgment by any insurer of the receipt of notice given under any policy covered by this act, or the furnishing of forms for filing proofs of loss, or the acceptance of such proofs, or the investigation of any claim thereunder shall not operate as a waiver of any of the rights of the insurer in defense of any claim arising under such policy.
History:
L. 1951, ch. 296, § 6; June 30.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2207 Age; limit; misstatement by insured.

40-2207.
Age; limit; misstatement by insured.
If any such 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.
History:
L. 1951, ch. 296, § 7; June 30.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2208 Nonapplication to certain policies.

40-2208.
Nonapplication to certain policies.
Nothing in this act shall apply to or affect: (1) Any policy or contract of reinsurance; (2) life insurance, endowment or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to accident and sickness insurance as (a) provide additional benefits in case of death or dismemberment or loss of sight by accident, or by as (b) operate to safeguard such contracts against lapse; or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant shall become totally and permanently disabled, as defined by the contract or supplemental contract; (3) fraternal benefit societies; or (4) endorsements or supplemental coverages, as authorized by K.S.A. 40-1110; (5) except as to K.S.A. 40-2209 and 40-2210, or any amendments thereto, any blanket or group policies of sickness and accident insurance; and (6) except as to K.S.A. 40-2211 and 40-2212, or any amendments thereto, any policy or workmen's compensation insurance or liability insurance with or without supplementary expense coverage therein.
History:
L. 1951, ch. 296, § 8; L. 1957, ch. 284, § 2; June 29.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2209a Applicability of 1978 amendments to K.S.A. 40-1805, 40-1905 and 40-2209.

40-2209a.
Applicability of 1978 amendments to K.S.A. 40-1805, 40-1905 and 40-2209.
The amendments in this act to K.S.A. 40-1805, 40-1905 and 40-2209 shall be applicable only to policy contracts delivered or issued for delivery in this state on or after the effective date of this act.
History: L. 1978, ch. 181, § 4; November 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2209b Small employer healthcare plans; citation; purpose of act.

40-2209b. Small employer healthcare plans; citation; purpose of act.
(a) The provisions of K.S.A. 40-2209b through 40-2209j and 40-2209m through 40-2209o, and amendments thereto, shall be known and may be cited as the small employer health insurance availability act.
(b) The purpose and intent of the small employer health insurance availability act are to promote the availability of health insurance coverage to small employers regardless of their health status or claims experience, to prevent abusive rating practices, to require disclosure of rating practices to purchasers, to establish rules regarding renewability of coverage, to establish limitations on the use of pre-existing condition exclusions, to provide for development of "basic" and "standard" health benefit plans to be offered to all small employers, to provide for establishment of a reinsurance program, and to improve the overall fairness and efficiency of the small group health insurance market.
History:
L. 1992, ch. 200, § 1; L. 2019, ch. 54, § 9; May 9.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2209c Same; application of act; construction of K.S.A. 40-2209.

40-2209c.
Same; application of act; construction of K.S.A. 40-2209.
The provisions of this act shall apply to health benefit plans covering small employers as defined herein. Where the provisions of K.S.A. 40-2209, and amendments thereto, are not inconsistent with these provisions, they shall be construed as supplemental to and not in derogation or limitation of any requirements, prohibitions or restrictions contained herein.
History:
L. 1992, ch. 200, § 2; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2209e Same; plans subject to act; certain laws inapplicable to plans; individual policies not subject to act.

40-2209e. Same; plans subject to act; certain laws inapplicable to plans; individual policies not subject to act.
(a) Any individual or group health benefit plan issued to a group authorized by K.S.A. 40-2209(a), and amendments thereto, shall be subject to the provisions of this act if it provides health care benefits covering employees of a small employer and if it meets any one of the following conditions:
(1) Any portion of the premium is paid by a small employer, or any covered individual, whether through wage adjustments, reimbursement, withholding or otherwise;
(2) the health benefit plan is treated by the employer or any of the covered individuals as part of a plan or program for the purposes of section 106 or section 162 of the United States internal revenue code; or
(3) with the permission of the board, the carrier elects to renew or continue a health benefit plan covering employees of an employer who no longer meets the definition of a "small employer."
(b) Except as expressly provided in this act, no health benefit plan offered to a small employer shall be subject to:
(1) Any law that would inhibit any carrier from contracting with providers or groups of providers with respect to health care services or benefits;
(2) any law that would impose any restriction on the ability to negotiate with providers regarding the level or method of reimbursing care or services provided under the health benefit plan.
(c) Individual policies of accident and sickness insurance issued to individuals and their dependents totally independent of any group, association or trust arrangement permitted under K.S.A. 40-2209, and amendments thereto, shall not be subject to the provisions of this act.
History:
L. 1992, ch. 200, § 4; L. 1994, ch. 355, § 5; L. 1998, ch. 174, § 7; L. 2019, ch. 54, § 11; May 9.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2209g Same; establishment of business classes by carrier; limitation.

40-2209g.
Same; establishment of business classes by carrier; limitation.
From and after January 1, 1993: (a) A small employer carrier may establish a class of business only to reflect substantial differences in expected claims experience or administrative costs related to the following reasons:
(1) The small employer carrier uses more than one type of system for the marketing and sale of health benefit plans to small employers;
(2) the small employer carrier has acquired a class of business from another small employer carrier; or
(3) the small employer carrier provides coverage to one or more association groups that meet the requirements of subsection (f)(5) of K.S.A. 40-2209, and amendments thereto.
(b) A small employer carrier may establish up to nine separate classes of business under subsection (a).
(c) The commissioner may adopt rules and regulations to provide for a period of transition in order for a small employer carrier to come into compliance with subsection (b) in the instance of acquisition of an additional class of business from another small employer carrier.
(d) The commissioner may approve the establishment of additional classes of business upon application to the commissioner and a finding by the commissioner that such action would enhance the efficiency and fairness of the small employer marketplace.
History:
L. 1992, ch. 200, § 6; L. 1998, ch. 174, § 9; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2209i Same; carrier sales solicitations, disclosures required.

40-2209i.
Same; carrier sales solicitations, disclosures required.
From and after January 1, 1993: In connection with the offering for sale of any health benefit plan to a small employer, each carrier shall make a reasonable disclosure as part of its solicitation and sales materials, of:
(a) The extent to which premium rates for a specific small employer are established or adjusted in part based upon the actual or expected variation in claims costs or actual or expected variation in health condition of the employees and dependents of such small employer;
(b) the provisions concerning such carrier's right to change premium rates and the factors other than claims experience which affect changes in premium rates; and
(c) provisions relating to renewability of policies and contracts; and
(d) the provision relating to any pre-existing condition provision.
History:
L. 1992, ch. 200, § 8; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2209j Same; actuarial certification of underwriting and rating compliance.

40-2209j.
Same; actuarial certification of underwriting and rating compliance.
From and after January 1, 1993: Compliance with the underwriting and rating requirements contained in this act shall be demonstrated through actuarial certification. Carriers offering health benefit plans to small employers shall on or before March 15 file annually with the commissioner an actuarial certification stating that the underwriting and rating methods of the carrier:
(a) Comply with accepted actuarial practices;
(b) are uniformly applied to health benefit plans covering small employers; and
(c) comply with the provisions of this act.
History:
L. 1992, ch. 200, § 9; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2209o Same; violations, penalties.

40-2209o.
Same; violations, penalties.
Violations of this act shall be treated as violations of the unfair trade practices act and subject to the penalties prescribed by K.S.A. 40-2407 and 40-2411 and amendments thereto.
History:
L. 1992, ch. 200, § 14; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2211 Workmen's compensation; insolvency of insured.

40-2211.
Workmen's compensation; insolvency of insured.
Every policy issued by any insurance corporation, association or organization to assure the payment of compensation under the workmen's compensation act, shall contain a provision to the effect that the insurance carrier shall not be relieved from the payment of compensation for injuries, or death sustained by injuries, if the insured becomes insolvent or is discharged in bankruptcy during the period that the policy is in operation, and the compensation, or any part of it, is due and unpaid.
History:
L. 1951, ch. 296, § 11; June 30.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2212 Same; notice of injury or death; jurisdiction; lien of employee; payment to employee, agent or dependents.

40-2212.
Same; notice of injury or death; jurisdiction; lien of employee; payment to employee, agent or dependents.
Every policy issued by any insurance corporation, association or organization to assure the payment of compensation, under the workmen's compensation act, shall contain a clause providing that between any employer and the insurer, notice to and knowledge of the occurrence of injury or death on the part of the insured shall be notice and knowledge on the part of the insurer; and jurisdiction of the insured shall be jurisdiction of the insurer and the insurer shall be bound by every agreement, adjudgment, award, or judgment rendered against the insured. Every such policy shall provide that the employee shall have first lien upon any amount becoming due on account of such policy to the insured from the insurer and that in case of the legal incapacity, inability, or disability of the insured to receive the amount due and pay it over to the insured employee, or his dependents, said insurer shall pay the same direct to such employee, his agent, or to a trustee for him or his dependents to the extent of discharging any obligation of the insured to said employee or his dependents.
History:
L. 1951, ch. 296, § 12; June 30.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2213 Prior policy, rider or endorsement.

40-2213.
Prior policy, rider or endorsement.
A policy, rider or endorsement, which could have been lawfully used or delivered or issued for delivery to any person in this state immediately before the effective date of this act may be used or delivered or issued for delivery to any such person during five (5) years after the effective date of this act without being subject to the provisions of K.S.A. 40-2202, 40-2203 or 40-2204.
History:
L. 1951, ch. 296, § 13; June 30.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2216 Purpose of act.

40-2216.
Purpose of act.
The purpose of this act shall be to provide reasonable standardization and simplification of terms and coverages of individual accident and sickness insurance policies and subscriber contracts of non-profit hospital, medical and dental service corporations to facilitate public understanding and comparison, to eliminate provisions contained in individual accident and sickness insurance policies and subscriber contracts of non-profit hospital, medical, and dental service corporations which may be misleading or unreasonably confusing in connection either with the purchase of such coverages or with the settlement of claims, and to provide for full disclosure in the sale of accident and sickness coverages.
History:
L. 1976, ch. 218, § 1; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2217 Definitions.

40-2217.
Definitions.
For the purposes of this act:
(a) The term "form" means policies, riders, endorsements, applications, subscriber contracts, or other documents required to be filed pursuant to K.S.A. 40-216 or 40-19a07, and amendments thereto.
(b) The term "accident and sickness insurance" means insurance written under K.S.A. 40-401, K.S.A. 40-1102(1)(a), other than credit insurance, and coverages written under K.S.A. 40-19a02, and amendments thereto. For purposes of this act nonprofit dental service corporations shall be deemed to be engaged in the business of insurance.
(c) The term "policy" means the entire contract between the insurer and the insured, including the policy, riders, endorsements, and the application if attached, and such term includes subscriber agreements issued by nonprofit dental service corporations.
History:
L. 1976, ch. 218, § 2; L. 1997, ch. 8, § 8; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2218 Establishment of benefit standards for accident and sickness policies or subscriber contracts; delivery or issuance of policy or contract not meeting standards prohibited, exceptions; identification of policies and contracts.

40-2218.
Establishment of benefit standards for accident and sickness policies or subscriber contracts; delivery or issuance of policy or contract not meeting standards prohibited, exceptions; identification of policies and contracts.
(a) The commissioner of insurance shall issue rules and regulations to establish standards for benefits under each of the following categories of coverage in individual policies, other than conversion policies issued pursuant to a contractual conversion privilege under a group policy, of accident and sickness insurance or subscriber contracts:
(1) Basic hospital expense coverage;
(2) basic medical-surgical expense coverage;
(3) hospital confinement indemnity coverage;
(4) major medical expense coverage;
(5) disability income protection coverage;
(6) accident only coverage; and
(7) specified disease or specified accident coverage.
(b) Nothing in this section shall preclude the issuance of any policy or contract which combines two (2) or more of the categories of coverage enumerated in paragraphs (1) through (6) of subsection (a).
(c) No policy or contract shall be delivered or issued for delivery in this state which does not meet the prescribed standards for the categories of coverage listed in paragraphs (1) through (7) of subsection (a) which are contained within the policy or contract unless the commissioner finds such policy or contract, including those affording supplemental coverage, will fulfill a reasonable public need and such policy or contract meets the requirements set forth in K.S.A. 40-2215 or unless the outline of coverage required by K.S.A. 40-2219 clearly sets forth wherein such policy does not provide the standards for benefits promulgated by the commissioner.
(d) The commissioner shall prescribe the method of identification of policies and contracts based upon coverages provided.
History:
L. 1976, ch. 218, § 3; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2219 Outline of coverage to accompany policy at issuance or to be delivered at time of application; format and contents of outline.

40-2219.
Outline of coverage to accompany policy at issuance or to be delivered at time of application; format and contents of outline.
(a) In order to provide for full and fair disclosure in the sale of individual accident and sickness insurance policies or subscriber contracts of a non-profit hospital, medical or dental service corporation, no such policy or contract shall be delivered or issued for delivery in this state unless: (1) The outline of coverage described in subsection (b) either accompanies the policy; or (2) in all other cases, the outline of coverage described in subsection (b) is delivered to the applicant at the time application is made and an acknowledgment of receipt or certificate of delivery of such outline is provided the insurer with the application. In the event the policy is issued on a basis other than that applied for, the outline of coverage properly describing the policy or contract must accompany the policy or contract when it is delivered and clearly state that it is not the policy or contract for which application was made.
(b) The commissioner shall prescribe the format and content of the outline of coverage required by subsection (a). "Format" means style, arrangement and overall appearance, including such items as the size, color, and prominence of type and the arrangement of text and captions. Such outline of coverage shall include:
(1) A statement identifying the applicable category or categories of coverage provided by the policy or contract as prescribed in K.S.A. 40-2218;
(2) a description of the principal benefits and coverage provided in the policy or contract;
(3) a statement of the exceptions, reductions and limitations contained in the policy or contract;
(4) a statement of the renewal provisions including any reservation by the insurer or non-profit hospital, medical, or dental service corporation of a right to change premiums;
(5) a statement that the outline is a summary of the policy or contract issued or applied for and that the policy or contract should be consulted to determine governing contractual provisions.
History:
L. 1976, ch. 218, § 4; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2220 Coverage of loss from pre-existing conditions required, when.

40-2220.
Coverage of loss from pre-existing conditions required, when.
Notwithstanding the provisions of K.S.A. 40-2203 (A) (2) (b), if an insurer or a non-profit hospital, medical, or dental service corporation elects to use a simplified application form, with or without a question as to the applicant's health at the time of application, but without any questions concerning the insured's health history or medical treatment history, the policy must cover any loss occurring after twelve (12) months from any pre-existing condition not specifically excluded from coverage by terms of the policy, and, except as so provided, the policy or contract shall not include wording that would permit a defense based upon pre-existing conditions.
History:
L. 1976, ch. 218, § 5; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2221 Medicare supplement policies; rules and regulations to establish standards; denial of coverage prohibited, when.

40-2221.
Medicare supplement policies; rules and regulations to establish standards; denial of coverage prohibited, when.
In addition to any other statutory authority not inconsistent herewith, the commissioner shall adopt rules and regulations establishing specific standards for medicare supplement policies delivered or issued for delivery in this state. The standards so established shall equal, or may exceed, the minimum standards and requirements permitted by section 1395SS(b)(B) of the federal social security act (42 U.S.C. § 1395 et seq.). In addition, an issuer of a medicare supplement policy: (a) Shall not deny coverage to an applicant under 65 years of age who becomes eligible for a medicare by reason of disability if such person makes application for medicare supplement policy within six months of the first day on which such person enrolls for benefits under medicare part B;
(b) may not condition the issuance or effectiveness of a medicare supplement policy issued to a person eligible for medicare by reason of disability because of the health status, claims experience, receipt of health care, or medical condition of such applicant if such applicant makes application for a medicare supplement policy during the six month period beginning with the first day of the month in which such applicant enrolls for benefits under medicare part B;
(c) shall make available to persons eligible for medicare by reason of disability each type of medicare supplement policy such issuer makes available to person eligible for medicare by reason of age; and
(d) shall not charge individuals who become eligible for medicare by reason of disability and who are under the age of 65 premium rates for any medical supplemental insurance benefit plan offered by the issuer that exceeds the issuer's premium rates charged for such plan to individuals who are age 65.
History: L. 1981, ch. 194, § 1; L. 1992, ch. 58, § 1; L. 1996, ch. 24, § 1; L. 1999, ch. 106, § 4; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2221a Same; notice required prior to termination; reinstatement.

40-2221a.
Same; notice required prior to termination; reinstatement.
(a) Except as otherwise provided in K.S.A. 40-2221b, no medicare supplement policy of insurance, as defined by the commissioner of insurance by rules and regulations, issued or delivered in this state shall be terminated for failure to pay premiums when due unless the insurer sends to the insured a notice, addressed to the insured's last address of record with such insurer, indicating the policy terminated due to failure to pay the required premium as of the premium due date. Such notice shall be enclosed in an envelope on the front of which the following language appears in bold-faced type in a conspicuous place: IMPORTANT—-PREMIUM RENEWAL NOTICE ENCLOSED. Such notice shall be sent no later than 45 days following the date on which premium was due, and shall inform the insured of the amount of premium that would be required to reinstate the policy and of the time within which such premium must be remitted to the insurer to effect such reinstatement. Except as provided in subsection (b), upon payment of the required premium by the insured to the insurer within 45 days of the insurer's having mailed such notice, the policy shall be automatically reinstated as continuous coverage without lapse by the insurer without imposing upon the insured any new exclusions, reductions or waiting periods and without requiring of the insured proof of insurability.
(b) Medicare supplement policies of insurance, as defined by the commissioner of insurance by rules and regulations, shall be reinstated in the event of lapse if the insurer is provided proof of cognitive impairment or the loss of functional capacity within five months after termination and the insured requests such reinstatement. Collection of past due premium will be allowed, where appropriate. The standard of proof of cognitive impairment or loss of functional capacity shall be established by clinical diagnosis by a person licensed to practice medicine and surgery and qualified to make such diagnosis.
History:
L. 1988, ch. 159, § 1; L. 1996, ch. 182, § 8; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2221b Same; when provisions of K.S.A. 40-2221a not applicable.

40-2221b.
Same; when provisions of K.S.A. 40-2221a not applicable.
The provisions of K.S.A. 40-2221a shall not apply to: (a) An insurance contract which is billed for by the insurer to other than the insured or a guardian, conservator or trustee of the insured;
(b) an insurance contract billed for by the insurer to the insured on a preauthorized check or bank draft basis; and
(c) an insurance contract for which the insurer has sent the proper notice as provided under this act more than twice in the preceding 12 months.
History:
L. 1988, ch. 159, § 2; July 1.
2023 Kansas Statutes › Chapter 40 - Insurance › Article 22 - Uniform Policy Provisions › 40-2222a Same; associations not subject to jurisdiction of commissioner to provide applicants with written notice of nature of coverage.

40-2222a. Same; associations not subject to jurisdiction of commissioner to provide applicants with written notice of nature of coverage.
At the time the initial application for coverage is taken with respect to new applicants and upon the first renewal, reinstatement or extension of coverage following the effective date of this act with respect to persons previously covered, each person or entity described in K.S.A. 40-2222, and amendments thereto, shall provide a written notice stating that:
(a) The coverage is not provided by an insurance company;
(b) the plan is not subject to the laws and regulations relating to insurance companies;
(c) the plan is not under the jurisdiction of the commissioner of insurance; and
(d) if the plan does not pay medical expenses that are eligible for payment under the plan for any reason, the individuals covered by the plan may be liable for such expenses.
History:
L. 1991, ch. 135, § 2; L. 2014, ch. 44, § 2; L. 2019, ch. 54, § 14; L. 2019, ch. 54, § 15; July 1.