reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 46. Provider Facility Good Faith Estimates › 27-1-46-13. Provision of Good Faith Estimates

Sec. 13. A provider facility may provide a good faith estimate to an individual under this chapter:
(1) in a writing delivered to the individual;
(2) by electronic mail; or
(3) through a mobile application or other Internet web based method, if available;
according to the preference expressed by the individual.
As added by P.L.93-2020, SEC.12.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 46. Provider Facility Good Faith Estimates › 27-1-46-14. Requirements of Good Faith Estimates; Provision of Information by Health Carriers and Practitioners to Provider Facility

Sec. 14. (a) A good faith estimate provided by a provider facility to an individual under this chapter must:
(1) provide a summary of the services and material items that the good faith estimate is based on; and
(2) include a total figure that is a sum of the estimated prices referred to in subdivision (1).
(b) Subsection (a) does not prohibit a provider facility from providing to an individual a good faith estimate that indicates how much of the total figure stated under subsection (a)(2) will be the individual's out-of-pocket expense after the health carrier's payment of charges.
(c) A health carrier or practitioner must provide a provider facility with the information needed by the provider facility to comply with the requirements under this chapter not more than two (2) business days after receiving the request.
(d) A provider facility is not subject to the penalties under section 17 of this chapter if:
(1) a health carrier or practitioner fails to provide the provider facility with the information as required under subsection (c);
(2) the provider facility provides the individual with a good faith estimate based on any information that the provider facility has; and
(3) the provider facility provides the individual with an updated good faith estimate after the health carrier or practitioner has provided the information required under subsection (c).
As added by P.L.93-2020, SEC.12.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 46. Provider Facility Good Faith Estimates › 27-1-46-15. Provider Facility or Practitioner Duty to Communicate Right to Good Faith Estimate by at Least Three Means

Sec. 15. (a) Each provider must make diligent attempts to ensure that the patient is aware of the patient's right to request a good faith estimate under this chapter. The communication by a provider to the patient concerning the right to a good faith estimate must be conspicuous and must be provided by at least three (3) of the following means:
(1) Notice on the provider's Internet web site.
(2) On hold messaging.
(3) Waiting room notification.
(4) Preappointment reminders, including through electronic mail (email) or text messaging.
(5) During appointment or services check in.
(6) During appointment or services check out.
(7) During patient financial services or billing department inquiries.
(8) Through an electronic medical and patient communication portal.
(b) The communication required under subsection (a) must state the following, or words to the same effect: "A patient may ask for an estimate of the amount the patient will be charged for a nonemergency health care service provided in our facility. The law requires that an estimate be provided within 5 business days.".
As added by P.L.93-2020, SEC.12. Amended by P.L.202-2021, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 46. Provider Facility Good Faith Estimates › 27-1-46-16. Good Faith Estimate Request From Patient Eligible for Medicare

Sec. 16. If:
(1) a provider facility receives a request for a good faith estimate under this chapter; and
(2) the patient is eligible for Medicare coverage;
the provider facility shall provide a good faith estimate to the patient within five (5) business days based on available Medicare cost sharing rates.
As added by P.L.93-2020, SEC.12. Amended by P.L.202-2021, SEC.15.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 46. Provider Facility Good Faith Estimates › 27-1-46-17. Provider Facility Failure to Provide Estimate or Communication About Right to Estimate; Civil Penalty

Sec. 17. (a) If a provider facility fails or refuses:
(1) to provide a good faith estimate as required by this chapter; or
(2) to provide communication to a patient of information concerning the patient's right to a good faith estimate as required under section 15 of this chapter;
the insurance commissioner may, after notice and hearing under IC 4-21.5, impose on the provider facility a civil penalty of not more than one thousand dollars ($1,000) for each violation.
(b) A civil penalty collected under this section shall be deposited in the department of insurance fund established by IC 27-1-3-28.
As added by P.L.93-2020, SEC.12. Amended by P.L.202-2021, SEC.16.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 46. Provider Facility Good Faith Estimates › 27-1-46-18. Compliance With Federal Requirements

Sec. 18. The requirements of this chapter do not apply to a facility or practitioner that:
(1) is required to comply with; and
(2) is in compliance with;
45 CFR Part 149, Subparts E and G, as may be enforced and amended by the federal Department of Health and Human Services.
As added by P.L.165-2022, SEC.10. Amended by P.L.190-2023, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47. Activities Not Prohibited as Rebates › 27-1-47-1. Definitions; Permitted Activities

Sec. 1. (a) The following definitions apply throughout this section:
(1) "Drawing" means an activity in which:
(A) multiple participating persons could possibly receive a prize; and
(B) the person or persons who receive a prize are determined by chance, as by randomly drawing one (1) or more names or numbers from among many names or numbers.
(2) "Gift" means the voluntary transfer of anything of value without consideration.
(3) "Prize" means something of value received by a person as the result of a drawing.
(b) Notwithstanding any other provision of this title, an insurer, an employee of an insurer, or an insurance producer may do the following:
(1) Offer and give one (1) or more gifts to a person in connection with marketing for the sale or retention of a contract of insurance if the reasonable value of all gifts given by the insurer, employee, or producer to a person in one (1) year does not exceed two hundred fifty dollars ($250).
(2) Conduct a drawing if:
(A) persons participating in the drawing do not pay or incur a cost for their participation; and
(B) the value of the prize or prizes received by any single person participating in the drawing does not exceed five hundred dollars ($500).
(c) Neither:
(1) a gift given under subsection (b)(1); nor
(2) a prize received in a drawing conducted under subsection (b)(2);
may be in the form of cash.
As added by P.L.196-2021, SEC.33. Amended by P.L.9-2022, SEC.50.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47. Activities Not Prohibited as Rebates › 27-1-47-2. Permitted Products and Services

Sec. 2. (a) An insurer, by or through its employees, affiliates, insurance producers, or third-party representatives, or an insurance producer acting on the insurance producer's own behalf, may offer or provide, for free or at a discounted price, value-added products or services:
(1) that relate to or are provided in conjunction with a policy of insurance; and
(2) that:
(A) are primarily intended to:
(i) educate about;
(ii) assess;
(iii) monitor;
(iv) mitigate;
(v) reduce;
(vi) control; or
(vii) prevent;
risk, severity, or frequency of loss to persons or to persons' lives, health, or property;
(B) are primarily designed to enhance the health, financial wellness, or safety of persons or of persons' lives, health, or property; or
(C) have a nexus to or enhance the value of the insurance benefits of the policy.
(b) Offering or providing products or services under this section is not a violation of IC 27-1-20-30, IC 27-1-22-18, or IC 27-4-1-4(a)(8).
As added by P.L.196-2021, SEC.33. Amended by P.L.226-2023, SEC.18.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47. Activities Not Prohibited as Rebates › 27-1-47-3. Value-Added Products or Services That May Be Offered or Provided

Sec. 3. (a) A person holding a license under this title may offer or provide, for free or for less than fair market value, value-added products or services that are at least tangentially related to an insurance contract or the administration of an insurance contract if:
(1) the value-added products or services:
(A) are not offered in a manner that is unfairly discriminatory; and
(B) are made available based on documented, objective criteria; and
(2) the documented, objective criteria under which the value-added products or services are offered are maintained for inspection by the insurance commissioner within thirty (30) days after the insurance commissioner's request for inspection.
(b) The products and services that may be offered or provided for free or for less than fair market value under subsection (a) include but are not limited to the following:
(1) Loss control, including wellness programs.
(2) Claim filing assistance.
(3) Administration of the continuation of health benefits requirements of the Consolidated Omnibus Budget Reconciliation Act (COBRA).
(4) Compliance with the requirements of the Health Insurance Portability and Accountability Act (HIPAA).
(5) Risk management or analysis.
(6) Regulatory and legislative updates.
(7) Group policy administration.
(8) Payroll, accounting, and tax services.
(9) Legal and human resources.
(10) Referrals to third-party service providers that offer discounted rates.
(c) A value-added product or service that is provided for free or for less than fair market value under subsection (a) by:
(1) an insurer, acting by or through its employee, affiliate, insurance producer, or a third-party representative; or
(2) an insurance producer, acting on the insurance producer's own behalf;
shall be provided along with contact information for the purpose of ensuring that the consumer is assisted with questions concerning the product or service.
As added by P.L.196-2021, SEC.33. Amended by P.L.226-2023, SEC.19.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47.5. Oversight of Health Care Costs › 27-1-47.5-1. "Governmental Hospital"

Sec. 1. As used in this chapter, "governmental hospital" means an acute care hospital licensed under IC 16-21-2 that is governed by:
(1) IC 16-22-2;
(2) IC 16-22-8; or
(3) IC 16-23.
As added by P.L.203-2023, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47.5. Oversight of Health Care Costs › 27-1-47.5-2. "Independent Hospital"

Sec. 2. As used in this chapter, "independent hospital" means a private nonprofit acute care hospital licensed under IC 16-21-2 that meets the following criteria:
(1) Is either:
(A) not directly or indirectly owned or controlled by an entity that is headquartered outside of the county where the hospital is located; or
(B) owned or controlled by an entity that owns or operates hospitals on not more than three (3) acute care hospital licenses in Indiana. For purposes of this clause, a critical access hospital that meets the criteria under 42 CFR 485.601 et seq. does not count toward the number of acute care hospital licensed operated by an entity.
(2) Except as provided in subdivision (1)(B), does not directly or indirectly own another acute care hospital.
As added by P.L.203-2023, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47.5. Oversight of Health Care Costs › 27-1-47.5-3. "Indiana Nonprofit Hospital System"

Sec. 3. (a) As used in this chapter, "Indiana nonprofit hospital system" means a hospital that:
(1) is organized as a nonprofit corporation or a charitable trust under Indiana law or the laws of any other state or country and that is:
(A) eligible for tax exempt bond financing; or
(B) exempt from state or local taxes;
(2) is licensed under IC 16-21-2;
(3) filed jointly one (1) hospital audited financial statement with the Indiana department of health in 2021; and
(4) has an annual patient service revenue of at least two billion dollars ($2,000,000,000) based on the hospital system's 2021 audited financial statement filed with the Indiana department of health. As used in this subdivision, "patient service revenue" includes similar terms, including net patient service revenue and patient care service revenue.
(b) The term does not apply to the following:
(1) A nonprofit hospital that is owned by a county.
(2) A critical access hospital that meets the criteria under 42 CFR 485.601 et seq.
(3) An independent hospital.
(4) A governmental hospital.
As added by P.L.203-2023, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47.5. Oversight of Health Care Costs › 27-1-47.5-5. Pricing; Report

Sec. 5. The department shall contract with a third party to do the following:
(1) Calculate an Indiana nonprofit hospital system's prices from the commercially insured market, categorized by:
(A) self-funded plan prices;
(B) fully-funded plan prices;
(C) the individual market prices; and
(D) the total combined prices of clauses (A) through (C);
expressed as a percentage of how much Medicare would have paid for the same services for the 2021 calendar year, the 2022 calendar year, and the 2023 calendar year.
(2) Not later than December 1, 2024, prepare a report of the findings in subdivision (1) and submit the report to the following:
(A) The department.
(B) The health care cost oversight task force established by IC 2-5-47.
(C) The budget committee for review.
As added by P.L.203-2023, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47.5. Oversight of Health Care Costs › 27-1-47.5-6. Reporting Requirements; Records

Sec. 6. (a) Before March 1, 2024, and before March 1 of each subsequent year, an Indiana nonprofit hospital system shall submit the following:
(1) Information the department or the department's third party contractor determines is necessary to make the assessments required in this chapter.
(2) Standard charge information required to be made public by the federal Centers for Medicare and Medicaid Services for price transparency for each hospital facility within the Indiana nonprofit hospital system.
(b) Information required under this section shall be submitted to the department in a manner prescribed by the department.
(c) Except as provided in section 8 of this chapter, any records or documents disclosed to, received by, or generated by the department for purposes of this chapter are exempt from the requirements of IC 5-14-3.
As added by P.L.203-2023, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47.5. Oversight of Health Care Costs › 27-1-47.5-7. Calculating and Comparing Prices; Review of Data and Resources

Sec. 7. (a) The department shall contract with a third party to make the calculations required by this section. The third party contractor shall make the calculations described in subsection (b) concerning an Indiana nonprofit hospital system's prices from the commercially insured market, categorized by:
(1) self-funded plan prices;
(2) fully-funded plan prices;
(3) the individual market prices; and
(4) the total combined prices of subdivisions (1) through (3);
expressed as a percentage of how much Medicare would have paid for the same services.
(b) Before November 1, 2024, and before November 1 of each subsequent year, the department's third party contractor shall compare:
(1) hospital inpatient prices;
(2) hospital outpatient prices; and
(3) practitioner services prices;
calculated separately and combined in total as a percentage of Medicare for all patient care services provided to the commercially insured market. The third party contractor shall make these calculations for each Indiana nonprofit hospital within an Indiana nonprofit hospital system and for the Indiana nonprofit hospital system, expressed as a percentage of how much Medicare would have paid for the same services in comparison to what two hundred eighty-five percent (285%) of Medicare would have been for the same services.
(c) The department and the department's third party contractor shall review the data and resources submitted concerning prices in Indiana specific to each Indiana nonprofit hospital system.
As added by P.L.203-2023, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 47.5. Oversight of Health Care Costs › 27-1-47.5-8. Annual Report

Sec. 8. Before December 1, 2024, and before December 1 of each subsequent year, the department shall submit a report of the third party contractor's findings in section 7 of this chapter in an electronic format under IC 5-14-6 to the health care cost oversight task force established by IC 2-5-47.
As added by P.L.203-2023, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 48. Health Plan Notices › 27-1-48-2. "Cpt Code"

Sec. 2. As used in this chapter, "CPT code" refers to the medical billing code that applies to a specific health care service, as published in the Current Procedural Terminology code set maintained by the American Medical Association.
As added by P.L.190-2023, SEC.24.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 48. Health Plan Notices › 27-1-48-3. "Health Care Service"

Sec. 3. (a) As used in this chapter, "health care service" means a health care related service or product rendered or sold by a health care provider within the scope of the health care provider's license or legal authorization, including hospital, medical, surgical, mental health, and substance abuse services or products.
(b) The term does not include the following:
(1) Dental services.
(2) Vision services.
(3) Long term rehabilitation treatment.
(4) Pharmaceutical services or products.
As added by P.L.190-2023, SEC.24.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 48. Health Plan Notices › 27-1-48-4. "Health Plan"

Sec. 4. (a) As used in this chapter, "health plan" means any of the following that provides coverage for health care services:
(1) A policy of accident and sickness insurance (as defined in IC 27-8-5-1). However, the term does not include the coverages described in IC 27-8-5-2.5(a).
(2) A contract with a health maintenance organization (as defined in IC 27-13-1-19) that provides coverage for basic health care services (as defined in IC 27-13-1-4).
(3) The Medicaid risk based managed care program under IC 12-15.
(b) The term includes a person that administers any of the following:
(1) A policy described in subsection (a)(1).
(2) A contract described in subsection (a)(2).
(3) Medicaid risk based managed care.
As added by P.L.190-2023, SEC.24.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 48. Health Plan Notices › 27-1-48-5. "Participating Provider"

Sec. 5. As used in this chapter, "participating provider" refers to the following:
(1) A health care provider that has entered into an agreement with an insurer under IC 27-8-11-3.
(2) A participating provider (as defined in IC 27-13-1-24).
As added by P.L.190-2023, SEC.24.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 48. Health Plan Notices › 27-1-48-6. "Prior Authorization"

Sec. 6. As used in this chapter, "prior authorization" means a practice implemented by a health plan through which coverage of a health care service is dependent on the covered individual or health care provider obtaining approval from the health plan before the health care service is rendered. The term includes prospective or utilization review procedures conducted before a health care service is rendered.
As added by P.L.190-2023, SEC.24.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 48. Health Plan Notices › 27-1-48-7. Alternative Method for Claims Submission

Sec. 7. A health plan must:
(1) offer an alternative method for submission of a claim for when the health plan has technical difficulties with the health plan's claims submission system; and
(2) post notice of the alternative method for claims submission on the health plan's website.
As added by P.L.190-2023, SEC.24.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 48. Health Plan Notices › 27-1-48-8. Information Required to Be Posted on Health Plan's Website

Sec. 8. (a) Not later than February 1 of each calendar year, a health plan must post on the health plan's website:
(1) the thirty (30) most frequently submitted CPT codes that were submitted by participating providers for prior authorization during the previous calendar year; and
(2) the percentage of the thirty (30) most frequently submitted CPT codes that were approved in the previous calendar year, disaggregated by CPT code.
(b) A health plan must maintain the information required under subsection (a) on the health plan's website, organized by year and on a single and easily accessible web page.
As added by P.L.190-2023, SEC.24.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 49. Individual Prescription Drug Rebates › 27-1-49-0.5. Application of Chapter

Sec. 0.5. This chapter applies to a policy of health insurance coverage that is issued, delivered, amended, or renewed after December 31, 2024.
As added by P.L.166-2023, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 49. Individual Prescription Drug Rebates › 27-1-49-2. "Defined Cost Sharing"

Sec. 2. As used in this chapter, "defined cost sharing" means a deductible payment or coinsurance amount imposed on a covered individual for a covered prescription drug under the covered individual's health insurance coverage.
As added by P.L.166-2023, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 49. Individual Prescription Drug Rebates › 27-1-49-3. "Health Insurance Coverage"

Sec. 3. (a) As used in this chapter, "health insurance coverage" includes:
(1) an individual policy of accident and sickness insurance (as defined in IC 27-8-5-1);
(2) an individual contract (as defined in IC 27-13-1-21) that provides coverage for basic health care services (as defined in IC 27-13-1-4); and
(3) any other health plan that is issued on an individual basis;
and that is subject to state law regulating insurance and offers health insurance coverage (as defined in 42 U.S.C. 300gg-91). The term includes coverage of a dependent of the covered individual under an individual policy or contract described in subdivisions (1) through (3).
(b) The term does not include a self-funded health benefit plan that complies with the federal Employee Retirement Income Security Act (ERISA) of 1974 (29 U.S.C. 1001 et seq.).
As added by P.L.166-2023, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 49. Individual Prescription Drug Rebates › 27-1-49-5. "Price Protection Rebate"

Sec. 5. As used in this chapter, "price protection rebate" means a negotiated price concession that accrues directly or indirectly to an insurer, or another party on behalf of an insurer, if there is an increase in the wholesale acquisition cost of a prescription drug above a specified threshold.
As added by P.L.166-2023, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 49. Individual Prescription Drug Rebates › 27-1-49-6. "Rebate"

Sec. 6. As used in this chapter, "rebate" means:
(1) a discount or other negotiated price concession, including base price concessions (whether described as a rebate or otherwise) and reasonable estimates of price protection rebates, and performance based price concessions, that may accrue directly or indirectly or are anticipated to be passed through to an insurer during the coverage year from a manufacturer, dispensing pharmacy, or other party concerning the dispensing or administration of a prescription drug; and
(2) a reasonable estimate of any negotiated price concession, fee, or other administrative cost that is passed through, or is reasonably anticipated to be passed through, to the insurer and serves to reduce the insurer's liability for a prescription drug.
As added by P.L.166-2023, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 49. Individual Prescription Drug Rebates › 27-1-49-7. Defined Cost Sharing for Prescription Drugs

Sec. 7. A covered individual's defined cost sharing for a prescription drug must be:
(1) calculated at the point of sale; and
(2) based on a price that is reduced by an amount equal to at least eighty-five percent (85%) of all rebates in connection with the dispensing or administration of the prescription drug.
As added by P.L.166-2023, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 49. Individual Prescription Drug Rebates › 27-1-49-8. Decrease of Defined Cost Sharing

Sec. 8. Nothing in this chapter prohibits an insurer from decreasing a covered individual's defined cost sharing by an amount greater than the amount required under section 7 of this chapter.
As added by P.L.166-2023, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 49. Individual Prescription Drug Rebates › 27-1-49-11. Disclosure of Information; Trade Secret; Confidentiality Requirements

Sec. 11. (a) In complying with the requirements of this chapter, an insurer or an insurer's agent may not publish or otherwise reveal information regarding the actual amount of rebates the insurer receives on a product, manufacturer, or pharmacy specific basis. This information is protected as a trade secret (as defined in IC 24-2-3-2) and may not be published or otherwise disclosed directly or indirectly.
(b) An insurer shall impose the confidentiality requirements of this section on any vendor or third party that performs health care or administrative services on behalf of the insurer and that may receive or have access to rebate information.
As added by P.L.166-2023, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-0.5. Application of Chapter

Sec. 0.5. This chapter applies to a policy of health insurance coverage that is issued, delivered, amended, or renewed after December 31, 2024.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-2. "Defined Cost Sharing"

Sec. 2. As used in this chapter, "defined cost sharing" means a deductible payment or coinsurance amount imposed on a covered individual for a covered prescription drug under the covered individual's health insurance coverage.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-3. "Health Insurance Coverage"

Sec. 3. (a) As used in this chapter, "health insurance coverage" includes:
(1) a group policy of accident and sickness insurance (as defined in IC 27-8-5-1);
(2) a group contract (as defined in IC 27-13-1-16) that provides coverage for basic health care services (as defined in IC 27-13-1-4); and
(3) any other group health plan that limits eligibility to members of a specific group;
and that is subject to state law regulating insurance and offers health insurance coverage (as defined in 42 U.S.C. 300gg-91). The term includes coverage of a dependent of the covered individual under a group policy or contract described in subdivisions (1) through (3).
(b) The term does not include a self-funded health benefit plan that complies with the federal Employee Retirement Income Security Act (ERISA) of 1974 (29 U.S.C. 1001 et seq.).
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-6. "Price Protection Rebate"

Sec. 6. As used in this chapter, "price protection rebate" means a negotiated price concession that accrues directly or indirectly to an insurer, or another party on behalf of an insurer, if there is an increase in the wholesale acquisition cost of a prescription drug above a specified threshold.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-7. "Rebate"

Sec. 7. As used in this chapter, "rebate" means:
(1) a discount or other negotiated price concession, including base price concessions (whether described as a rebate or otherwise) and reasonable estimates of price protection rebates, and performance based price concessions, that may accrue directly or indirectly or are anticipated to be passed through to an insurer during the coverage year from a manufacturer, dispensing pharmacy, or other party concerning the dispensing or administration of a prescription drug; and
(2) a reasonable estimate of any negotiated price concession, fee, or other administrative cost that is passed through, or is reasonably anticipated to be passed through, to the insurer and serves to reduce the insurer's liability for a prescription drug.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-8. Rebates; Pass Through to Plan Sponsor

Sec. 8. An insurer shall pass through to a plan sponsor one hundred percent (100%) of all rebates concerning the dispensing or administration of prescription drugs to the covered individuals of the plan sponsor.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-9. Option to Calculate Defined Cost Sharing at Point of Sale

Sec. 9. At the time of contracting, an insurer shall provide plan sponsors the option of calculating defined cost sharing for covered individuals of the plan sponsor at the point of sale based on a price that is reduced by some or all of the rebates received or estimated to be received by the insurer concerning the dispensing or administration of the prescription drug.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-10. Decrease of Defined Cost Sharing

Sec. 10. Nothing in this chapter prohibits an insurer from decreasing a covered individual's defined cost sharing by an amount greater than the amount required under section 8 of this chapter.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-11. Disclosure of Information to Plan Sponsor

Sec. 11. An insurer shall disclose the following information to a plan sponsor on at least an annual basis:
(1) The approximate amount of rebates expected to be received by the insurer concerning the dispensing or administration of prescription drugs to the covered individuals of the plan sponsor.
(2) An explanation that the plan sponsor may choose to:
(A) apply the rebates to reduce premiums for all covered individuals; or
(B) calculate defined cost sharing for a covered individual at the point of sale based on a price that is reduced by rebates received or estimated to be received by the insurer concerning the dispensing or administration of the covered individual's prescription drugs.
(3) An explanation that, in the individual market, IC 27-1-49 requires that covered individual defined cost sharing be calculated at the point of sale based on a price that is reduced by at least eighty-five percent (85%) of the rebates concerning the dispensing or administration of the covered individual's prescription drugs.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 1. Department of Insurance › Chapter 50. Group Prescription Drug Rebates › 27-1-50-14. Disclosure of Information; Trade Secret; Confidentiality Requirements

Sec. 14. (a) In complying with the requirements of this chapter, an insurer may not publish or otherwise reveal information regarding the actual amount of rebates the insurer receives on a product, manufacturer, or pharmacy specific basis. This information is protected as a trade secret (as defined in IC 24-2-3-2) and may not be published or otherwise disclosed directly or indirectly.
(b) An insurer shall impose the confidentiality requirements of this section on any vendor or third party that performs health care or administrative services on behalf of the insurer and that may receive or have access to the rebate information.
As added by P.L.166-2023, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 1. Actuaries' Authority to Administer Oaths › 27-2-1-1. Administration of Oaths

Sec. 1. Actuaries of mutual fire insurance companies or associations organized by virtue of the laws of this state for the purpose of mutual insurance of the property of its members against loss by fire or damage by lightning, which property to be insured shall embrace dwelling-houses, barns, accompanying outbuildings and their contents, farm implements, hay, grain, wool and other farm products, live stock, wagons, carriages, harness, household goods, wearing apparel, provisions, musical instruments and libraries, such property being upon farms as farm property, shall have the authority to administer oaths to the insured and all persons necessary to be examined as witnesses in the adjustment of losses to the property of persons insured in said companies or associations where such loss was caused by fire or lightning.
Formerly: Acts 1891, c.158, s.1.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 2. Annual Statement by Special Charter Companies › 27-2-2-1. Time of Filing; Contents; Duties of Insurance Commissioner

Sec. 1. (a) Every company created by special act of the general assembly of the state of Indiana for the purpose of transacting the business of insurance shall, on or before the third Monday of January of each year, furnish the insurance commissioner with a statement, verified by the oaths of the president and secretary of said company and signed by a majority of the directors of such company, which statement shall show the following:
(1) First, the name and locality of the company.
(2) Second, the amount of its capital stock.
(3) Third, the amount of its capital stock paid-in.
(4) Fourth, the assets of the company, including the following:
(A) The amount of cash on hand and in the hands of agents or other persons.
(B) The value of its real estate.
(C) The bonds owned by the company and how they are secured, with the rate of interest.
(D) Debts to the company secured by mortgage.
(E) Debts otherwise secured.
(F) Debts for premiums.
(G) All other securities.
(5) Fifth, the amount of liabilities due or not due to banks or other creditors of the company.
(6) Sixth, losses adjusted and due.
(7) Seventh, losses adjusted and not due.
(8) Eighth, losses unadjusted.
(9) Ninth, losses in suspense waiting for further proof.
(10) Tenth, all other claims against the company.
(11) Eleventh, the greatest amount insured in any one (1) risk.
(12) Twelfth, the greatest amount allowed by the rules of the company to be insured in any one (1) city or town.
(13) Thirteenth, the greatest amount allowed to be insured in any one (1) block.
(b) The insurance commissioner shall cause a copy of such annual statement to be published in the two (2) leading daily newspapers of the state having the largest general circulation and also in some newspaper of general circulation, printed and published in the city or town in which the principal office of such company is located, provided that not more than one dollar ($1) per square shall be paid for each one (1) of such publications, the expense to be paid by the company; and provided further, that it shall be the duty of the commissioner to furnish such company with a certified copy of such statement or report whenever so requested to do by any officer of such company.
Formerly: Acts 1899, c.134, s.1. As amended by P.L.252-1985, SEC.125; P.L.11-1987, SEC.29.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 2. Annual Statement by Special Charter Companies › 27-2-2-2. Fees of Insurance Commissioner

Sec. 2. The insurance commissioner shall charge and collect for the state of Indiana the sum of five dollars ($5) in each and every case for the examination of the charter and five dollars ($5) in each and every case for the examination of the statement and investigation of evidence of the investment of the assets of such company in accordance with the provisions of their respective charters, and two dollars ($2) for each certified copy of such statement, and shall pay the same over to the treasurer of state to go into the general fund of the state; provided, however, the provisions of this chapter shall not apply to farmers' mutual fire insurance associations organized under special act since the year 1852, and doing business strictly under the assessment plan.
Formerly: Acts 1899, c.134, s.2. As amended by P.L.252-1985, SEC.126.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 3. Disbursements by Vouchers › 27-2-3-1. Contents of Vouchers; Affidavit

Sec. 1. No domestic life insurance corporation shall make any disbursements unless the same be evidenced by a voucher signed by or on behalf of the person, firm, limited liability company, or corporation receiving the money and correctly describing the consideration for the payment, and, if the same be for services and disbursements, setting forth the services rendered and an itemized statement of the disbursements made, and if it be in connection with any matter pending before any legislative or public body or before any department or officer of any government, correctly describing, in addition, the nature of the matter and of the interest of such corporation in the matter, or, if such a voucher cannot be obtained, by an affidavit stating the reasons the voucher cannot be obtained and setting forth the particulars mentioned in this section.
Formerly: Acts 1907, c.168, s.1. As amended by P.L.1-1994, SEC.133; P.L.136-2018, SEC.168.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 4. Receivers › 27-2-4-1. Powers of Attorney General

Sec. 1. No suit or action seeking the appointment of a receiver for any domestic insurance company, whether stock or mutual, organized and doing business under the laws of Indiana and subject to supervision and examination of the insurance commissioner or other department of state, shall be instituted or maintained, or a receiver appointed by any court, except and only in an action instituted by the attorney general, on the request of the insurance commissioner or other department of state having supervision of such corporation; provided, nothing in this section shall affect any litigation pending on May 15, 1919, in any court of record.
Formerly: Acts 1919, c.101, s.1. As amended by P.L.252-1985, SEC.127.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 5. Provisions Concerning Alienation of Benefits › 27-2-5-1. Spendthrift Laws; Exemption From Judicial Process

Sec. 1. (a) As used in this section, "premium" includes any deposit or contribution.
(b) No person entitled to receive benefits under a life insurance or life annuity contract, or under a written agreement supplemental thereto, issued by domestic life insurance company, shall be permitted to commute, anticipate, encumber, alienate, or assign such benefits, if the right to do so is expressly prohibited or withheld by a provision contained in such contract or supplemental agreement. And if such contract, policy, or supplemental agreement so provides, such benefits, except when payable to the person who provided the consideration for such contract, shall not be subject to such persons' debts, contracts, or engagements, nor to any judicial process to levy upon or attach the same for payment thereof.
(c) A premium paid for an individual life insurance policy that names as a beneficiary, or is legally assigned to, a spouse, child, or relative who is dependent upon the policy owner is not exempt from the claims of the creditors of the policy owner if the premium is paid:
(1) not more than one (1) year before the date of the filing of a voluntary or involuntary petition by; or
(2) to defraud the creditors of;
the policy owner.
(d) The insurer issuing the policy is discharged from all liability by payment of the proceeds and avails of the policy (as defined in IC 27-1-12-14(b)) in accordance with the terms of the policy unless, before payment, the insurer has received at the insurer's home office, written notice by or on behalf of a creditor of the policy owner that specifies the amount claimed against the policy owner.
Formerly: Acts 1931, c.20, s.1. As amended by P.L.253-1995, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 6. Investment in Certain Bonds › 27-2-6-1. Authorized Investments

Sec. 1. Any life insurance, fire insurance, livestock insurance, casualty or accident insurance, or bonding or surety company, or trust company or savings bank now or hereafter organized under the laws of the state of Indiana, in addition to the investments now authorized by law, be and it hereby is authorized and empowered to invest its funds in obligations issued by or for federal land banks, federal intermediate credit banks and banks for cooperatives under the Farm Credit Act of 1971 (12 U.S.C. 2001 et seq.) and such obligations are hereby declared eligible for any deposit required of any such company under the laws of this state.
Formerly: Acts 1931, c.55, s.1; Acts 1975, P.L.44, SEC.3. As amended by P.L.124-2018, SEC.61.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 7. Compliance With Other States' Regulations › 27-2-7-1. Power of Compliance; Payment of Fees and Taxes

Sec. 1. Every domestic insurer shall have power to comply with any statute, ordinance or other law of any state, territory or political subdivision thereof (including the District of Columbia) imposing any license, excise, privilege, premium, occupation or other fee or tax and to pay such fee or tax unless prior to such payment such statute, ordinance or other law shall have been expressly held invalid by the state court having final appellate jurisdiction in the premises, or by the Supreme Court of the United States.
Formerly: Acts 1945, c.123, s.1.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 7. Compliance With Other States' Regulations › 27-2-7-2. Exemption From Personal Liability

Sec. 2. No officer, director or trustee of any insurer shall be subject to any personal liability by reason of any payment, or determination not to contest payment, deemed by the board of directors or trustees to be in the corporate interests of such insurer, of any license, excise, privilege, premium, occupation or other fee or tax to any state, territory or political subdivision thereof (including the District of Columbia), unless prior to such payment the statute, ordinance or other law imposing such fee or tax shall have been expressly held invalid by the state court having final appellate jurisdiction in the premises, or by the Supreme Court of the United States.
Formerly: Acts 1945, c.123, s.2.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 7. Compliance With Other States' Regulations › 27-2-7-3. Application of Act

Sec. 3. This chapter shall be applicable to acts done and payments made on and after March 3, 1945; provided, however, that nothing contained in this chapter shall be construed as directly or indirectly limiting, minimizing, or interpreting the rights and powers and duties of insurers and their officers, directors, and trustees, existing before March 3, 1945, except as specifically exempted by this chapter.
Formerly: Acts 1945, c.123, s.3. As amended by P.L.252-1985, SEC.128.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 8. Commissioner's List of Motor Vehicle Insurers › 27-2-8-1. List of Motor Vehicle Insurers Agreeable to Meeting State Standards

Sec. 1. The insurance commissioner shall annually forward to all departments and divisions of the state requiring the posting of security because of motor vehicle accidents and resultant damage and loss a list of those insurers which are, or which are agreeable to be, examined by the insurance department in the same manner as set out in IC 27-1-3-7 and IC 27-1-3.1, and set up and maintain liabilities and reserves in the same manner as set out in IC 27-1-13-8, and submit a written statement of their financial condition and their operations on the forms as prescribed by the NAIC and adopted in rules adopted under IC 4-22-2 by the insurance commissioner, and in the same manner as set out in IC 27-1-3-7 and IC 27-1-20-21. No certificates or policies shall be accepted by such departments or divisions as such security unless the insurer so filing the certificate or policy shall have met or is agreeable to meeting the requirements as set out above.
Formerly: Acts 1949, c.240, s.1. As amended by P.L.252-1985, SEC.129; P.L.26-1991, SEC.24; P.L.124-2018, SEC.62.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 9.1. Prescription Drug Purchases › 27-2-9.1-2. "Health Plan"

Sec. 2. As used in this chapter, "health plan" means a plan that is compliant with the PPACA and offered by an insurer to provide, deliver, arrange for, pay for, or reimburse the cost of health care items or services. The term includes the following:
(1) A policy of accident and sickness insurance (as defined in IC 27-8-5-1).
(2) An individual contract (as defined by IC 27-13-1-21) and a group contract (as defined by IC 27-13-1-16).
As added by P.L.114-2020, SEC.17.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 9.1. Prescription Drug Purchases › 27-2-9.1-4. "Ppaca"

Sec. 4. As used in this chapter, "PPACA" refers to the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended thereafter, including by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152).
As added by P.L.114-2020, SEC.17.
2023 Indiana Code › Title 27. Insurance › Article 2. Powers and Duties of Insurers › Chapter 9.1. Prescription Drug Purchases › 27-2-9.1-5. Health Plan Procedure Allowing Cost of Prescription Drug to Be Counted Against Deductible

Sec. 5. (a) A health plan shall implement a procedure to allow a covered individual to submit a claim to offset the covered individual's deductible for the cost of a purchase by the covered individual of a prescription drug that:
(1) is covered under the covered individual's health plan; and
(2) was purchased by the covered individual without submitting at the point of purchase the claim through the health plan.
(b) If a covered individual submits a claim to the health plan in accordance with the procedure established under subsection (a), the health plan shall verify the purchase described under subsection (a) and count the amount paid by the covered individual for the purchased covered prescription drug against the covered individual's deductible.
As added by P.L.114-2020, SEC.17.