reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-16. Policies and Procedures for Timely Resolution of Grievances

Sec. 16. (a) An insurer shall establish written policies and procedures for the timely resolution of grievances filed under this chapter. The policies and procedures must include the following:
(1) An acknowledgment of the grievance, given orally or in writing, to the covered individual within five (5) business days after receipt of the grievance.
(2) Documentation of the substance of the grievance and any actions taken.
(3) An investigation of the substance of the grievance, including any aspects involving clinical care.
(4) Notification to the covered individual of the disposition of the grievance and the right to appeal.
(5) Standards for timeliness in:
(A) responding to grievances; and
(B) providing notice to covered individuals of:
(i) the disposition of the grievance; and
(ii) the right to appeal;
that accommodate the clinical urgency of the situation.
(b) An insurer shall appoint at least one (1) individual to resolve a grievance.
(c) A grievance must be resolved as expeditiously as possible, but not more than twenty (20) business days after the insurer receives all information reasonably necessary to complete the review. If an insurer is unable to make a decision regarding the grievance within the twenty (20) day period due to circumstances beyond the insurer's control, the insurer shall:
(1) before the twentieth business day, notify the covered individual in writing of the reason for the delay; and
(2) issue a written decision regarding the grievance within an additional ten (10) business days.
(d) An insurer shall notify a covered individual in writing of the resolution of a grievance within five (5) business days after completing an investigation. The grievance resolution notice must include the following:
(1) A statement of the decision reached by the insurer.
(2) A statement of the reasons, policies, and procedures that are the basis of the decision.
(3) Notice of the covered individual's right to appeal the decision.
(4) The department, address, and telephone number through which a covered individual may contact a qualified representative to obtain additional information about the decision or the right to appeal.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.1-2002, SEC.115.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-18. Insurer Prohibited From Taking Action

Sec. 18. An insurer may not take action against a provider solely on the basis that the provider represents a covered individual in a grievance filed under this chapter.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-19. Grievance Procedure Filing; Complaint Analysis and Reporting

Sec. 19. (a) An insurer shall each year file with the commissioner a description of the grievance procedure of the insurer established under this chapter, including:
(1) the total number of grievances handled through the procedure during the preceding calendar year;
(2) a compilation of the causes underlying those grievances; and
(3) a summary of the final disposition of those grievances.
(b) The information required by subsection (a) must be filed with the commissioner on or before March 1 of each year. The commissioner shall:
(1) make the information required to be filed under this section available to the public; and
(2) prepare an annual compilation of the data required under subsection (a) that allows for comparative analysis.
(c) The commissioner may require any additional reports as are necessary and appropriate for the commissioner to carry out the commissioner's duties under this article.
(d) The commissioner shall do the following:
(1) Compile and analyze complaints received by the department concerning a denial of coverage under an accident and sickness insurance policy for:
(A) an investigational or experimental treatment; or
(B) a treatment not considered to be medically necessary for a covered individual.
(2) If the commissioner determines that a pattern of denials of coverage is evident through the analysis performed under subdivision (1), report the pattern to the legislative council in an electronic format under IC 5-14-6.
(3) Remove from a report made under subdivision (2) any information that could be used to identify an individual.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.18-2016, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 28. Internal Grievance Procedures › 27-8-28-20. Adoption of Rules

Sec. 20. The department may adopt rules under IC 4-22-2 to implement this chapter.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-1. "Accident and Sickness Insurance Policy" Defined

Sec. 1. As used in this chapter, "accident and sickness insurance policy" has the meaning set forth in IC 27-8-28-1.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-2. "Appeal" Defined

Sec. 2. As used in this chapter, "appeal" means the procedure described in IC 27-8-28-17.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-3. "Commissioner" Defined

Sec. 3. As used in this chapter, "commissioner" refers to the insurance commissioner appointed under IC 27-1-1-2.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14. Amended by P.L.1-2002, SEC.117.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-4. "Covered Individual" Defined

Sec. 4. As used in this chapter, "covered individual" has the meaning set forth in IC 27-8-28-3.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-5. "Department" Defined

Sec. 5. As used in this chapter, "department" refers to the department of insurance.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-6. "External Grievance" Defined

Sec. 6. As used in this chapter, "external grievance" means the independent review under this chapter of a:
(1) grievance filed under IC 27-8-28; or
(2) denial of coverage based on a waiver described in IC 27-8-5-2.5(e) (expired July 1, 2007, and removed) or IC 27-8-5-19.2 (expired July 1, 2007, and repealed).
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14. Amended by P.L.211-2003, SEC.6; P.L.3-2008, SEC.215.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-7. "Grievance" Defined

Sec. 7. As used in this chapter, "grievance" has the meaning set forth in IC 27-8-28-6.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-8. "Grievance Procedure" Defined

Sec. 8. As used in this chapter, "grievance procedure" has the meaning set forth in IC 27-8-28-7.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-9. "Health Care Provider" Defined

Sec. 9. As used in this chapter, "health care provider" means a person:
(1) that provides physician services (as defined in IC 12-15-11-1(a)); or
(2) who is licensed under IC 25-33.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-10. "Insured" Defined

Sec. 10. As used in this chapter, "insured" has the meaning set forth in IC 27-8-28-8.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-11. "Insurer" Defined

Sec. 11. As used in this chapter, "insurer" has the meaning set forth in IC 27-8-28-9.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-12. Insurer to Establish External Grievance Procedures

Sec. 12. An insurer shall establish and maintain an external grievance procedure for the resolution of external grievances regarding the following:
(1) The following determinations made by the insurer or an agent of the insurer regarding a service proposed by the treating health care provider:
(A) An adverse determination of appropriateness.
(B) An adverse determination of medical necessity.
(C) A determination that a proposed service is experimental or investigational.
(D) A denial of coverage based on a waiver described in IC 27-8-5-2.5(e) (expired July 1, 2007, and removed) or IC 27-8-5-19.2 (expired July 1, 2007, and repealed).
(2) The insurer's decision to rescind an accident and sickness insurance policy.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14. Amended by P.L.211-2003, SEC.7; P.L.3-2008, SEC.216; P.L.160-2011, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-14. Rights of Individuals Who File Grievances

Sec. 14. (a) A covered individual who files an external grievance under this chapter:
(1) shall not be subject to retaliation for exercising the covered individual's right to an external grievance under this chapter;
(2) shall be permitted to utilize the assistance of other individuals, including health care providers, attorneys, friends, and family members throughout the review process;
(3) shall be permitted to submit additional information relating to the proposed service throughout the review process; and
(4) shall cooperate with the independent review organization by:
(A) providing any requested medical information; or
(B) authorizing the release of necessary medical information.
(b) An insurer shall cooperate with an independent review organization selected under section 13(b) of this chapter by promptly providing any information requested by the independent review organization.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14. Amended by P.L.1-2002, SEC.119.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-15. Independent Review Organizations; Determinations

Sec. 15. (a) An independent review organization shall:
(1) for an expedited external grievance filed under section 13(a)(2)(A) of this chapter, within seventy-two (72) hours after the external grievance is filed; or
(2) for a standard external grievance filed under section 13(a)(2)(B) of this chapter, within fifteen (15) business days after the external grievance is filed;
make a determination to uphold or reverse the insurer's appeal resolution under IC 27-8-28-17 based on information gathered from the covered individual or the covered individual's designee, the insurer, and the treating health care provider, and any additional information that the independent review organization considers necessary and appropriate.
(b) When making the determination under this section, the independent review organization shall apply:
(1) standards of decision making that are based on objective clinical evidence; and
(2) the terms of the covered individual's accident and sickness insurance policy.
(c) In an external grievance described in section 12(1)(D) of this chapter, the insurer bears the burden of proving that the insurer properly denied coverage for a condition, complication, service, or treatment because the condition, complication, service, or treatment is directly related to a condition for which coverage has been waived under IC 27-8-5-2.5(e) (expired July 1, 2007, and removed) or IC 27-8-5-19.2 (expired July 1, 2007, and repealed).
(d) The independent review organization shall notify the insurer and the covered individual of the determination made under this section:
(1) for an expedited external grievance filed under section 13(a)(2)(A) of this chapter, within seventy-two (72) hours after the external grievance is filed; and
(2) for a standard external grievance filed under section 13(a)(2)(B) of this chapter, within seventy-two (72) hours after making the determination.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14. Amended by P.L.211-2003, SEC.9; P.L.3-2008, SEC.218; P.L.81-2012, SEC.37; P.L.72-2016, SEC.21.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-15.5. Information From Independent Review Organization

Sec. 15.5. Upon the request of a covered individual who is notified under section 15(d) of this chapter that the independent review organization has made a determination, the independent review organization shall provide to the covered individual all information reasonably necessary to enable the covered individual to understand the:
(1) effect of the determination on the covered individual; and
(2) manner in which the insurer may be expected to respond to the determination.
As added by P.L.173-2007, SEC.42.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-16. Binding Determinations

Sec. 16. A determination made under section 15 of this chapter is binding on the insurer.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-17. Reconsideration of Resolution by Insurer

Sec. 17. (a) If, at any time during an external review performed under this chapter, the covered individual submits information to the insurer that is relevant to the insurer's resolution of the covered individual's appeal of a grievance decision under IC 27-8-28-17 and that was not considered by the insurer under IC 27-8-28:
(1) the insurer may reconsider the resolution under IC 27-8-28-17; and
(2) if the insurer chooses to reconsider, the independent review organization shall cease the external review process until the reconsideration under subsection (b) is completed.
(b) An insurer reconsidering the resolution of an appeal of a grievance decision due to the submission of information under subsection (a) shall reconsider the resolution under IC 27-8-28-17 based on the information and notify the covered individual of the insurer's decision:
(1) within seventy-two (72) hours after the information is submitted, for a reconsideration related to an illness, a disease, a condition, an injury, or a disability that would seriously jeopardize the covered individual's:
(A) life or health; or
(B) ability to reach and maintain maximum function; or
(2) within fifteen (15) days after the information is submitted, for a reconsideration not described in subdivision (1).
(c) If the decision reached under subsection (b) is adverse to the covered individual, the covered individual may request that the independent review organization resume the external review under this chapter.
(d) If an insurer to which information is submitted under subsection (a) chooses not to reconsider the insurer's resolution under IC 27-8-28-17, the insurer shall forward the submitted information to the independent review organization not more than two (2) business days after the insurer's receipt of the information.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14. Amended by P.L.1-2002, SEC.120.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-18. Applicability of Chapter

Sec. 18. This chapter does not add to or otherwise change the terms of coverage included in a policy, certificate, or contract under which a covered individual receives health care benefits under IC 27-8.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-20. Documents of Review Organizations

Sec. 20. Except as provided in section 19(g) of this chapter, documents and other information created or received by the independent review organization or the medical review professional in connection with an external grievance review under this chapter:
(1) are not public records;
(2) may not be disclosed under IC 5-14-3; and
(3) must be treated in accordance with confidentiality requirements of state and federal law.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-21. Filing Description of Grievance Procedure

Sec. 21. (a) An insurer shall each year file with the commissioner a description of the grievance procedure established by the insurer under this chapter, including:
(1) the total number of external grievances handled through the procedure during the preceding calendar year;
(2) a compilation of the causes underlying those grievances; and
(3) a summary of the final disposition of those grievances;
for each independent review organization used by the insurer during the reporting year.
(b) The information required by subsection (a) must be filed with the commissioner on or before March 1 of each year. The commissioner shall:
(1) make the information required to be filed under this section available to the public; and
(2) prepare an annual compilation of the data required under subsection (a) that allows for comparative analysis.
(c) The commissioner may require any additional reports that are necessary and appropriate for the commissioner to carry out the commissioner's duties under this article.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14. Amended by P.L.1-2002, SEC.122.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-22. Immunity From Civil Liability; Work Product or Determination

Sec. 22. (a) An independent review organization is immune from civil liability for actions taken in good faith in connection with an external review under this chapter.
(b) The work product or determination, or both, of an independent review organization under this chapter are admissible in a judicial or administrative proceeding. However, the work product or determination, or both, do not, without other supporting evidence, satisfy a party's burden of proof or persuasion concerning any material issue of fact or law.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-23. Medicare

Sec. 23. If a covered individual has the right to an external review of a grievance under Medicare, the covered individual may not request an external review of the same grievance under this chapter.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 29. External Review of Grievances › 27-8-29-24. Rules

Sec. 24. The department may adopt rules under IC 4-22-2 to implement this chapter.
As added by P.L.66-2001, SEC.3 and P.L.203-2001, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 30. Specific Accident and Sickness Insurance Reporting Requirements › 27-8-30-1. "Accident and Sickness Insurance Policy" Defined

Sec. 1. As used in this chapter, "accident and sickness insurance policy" means a policy that:
(1) provides the kinds of coverage described in Class 1(b) or Class 2(a) of IC 27-1-5-1; and
(2) includes a prescription drug benefit.
As added by P.L.107-2002, SEC.29.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 30. Specific Accident and Sickness Insurance Reporting Requirements › 27-8-30-2. "Covered Individual" Defined

Sec. 2. As used in this chapter, "covered individual" means an individual who is covered under an accident and sickness insurance policy.
As added by P.L.107-2002, SEC.29.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 30. Specific Accident and Sickness Insurance Reporting Requirements › 27-8-30-3. Allowing an Insurer to Report the Number of Covered Children Who Are Prescribed a Stimulant Medication for the Treatment of Certain Disorders

Sec. 3. An insurer that issues an accident and sickness insurance policy may report to the drug utilization review board established by IC 12-15-35-19 the number of covered individuals who are:
(1) less than eighteen (18) years of age; and
(2) prescribed a stimulant medication approved by the federal Food and Drug Administration for the treatment of attention deficit disorder or attention deficit hyperactivity disorder.
As added by P.L.107-2002, SEC.29.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-1. Purpose

Sec. 1. The purposes of this compact are, through means of joint and cooperative action among the compacting states, to:
(1) promote and protect the interest of consumers of individual and group annuity, life insurance, disability income, and long term care insurance products;
(2) develop uniform standards for insurance products covered under the compact;
(3) establish a central clearinghouse to receive and provide prompt review of insurance products covered under the compact and, in certain cases, advertisements related thereto, submitted by insurers authorized to do business in one (1) or more compacting states;
(4) give appropriate regulatory approval to product filings and advertisements satisfying the applicable uniform standard;
(5) improve coordination of regulatory resources and expertise between state insurance departments regarding the setting of uniform standards and review of insurance products covered under the compact;
(6) create the interstate insurance product regulation commission; and
(7) perform these and any other related functions as may be consistent with the state regulation of the business of insurance.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-3. Interstate Insurance Product Regulation Commission

Sec. 3. (a) The compacting states hereby establish a joint public agency known as the interstate insurance product regulation commission. Under section 4 of this chapter, the commission may:
(1) develop uniform standards for product lines;
(2) receive and provide prompt review of products filed with the commission; and
(3) give approval to product filings satisfying applicable uniform standards.
However, it is not intended for the commission to be the exclusive entity for receipt and review of insurance product filings. This chapter does not prohibit an insurer from filing the insurer's product in a state where the insurer is licensed to conduct the business of insurance and any such filing is subject to the laws of the state where filed.
(b) The commission is a body corporate and politic, and an instrumentality of the compacting states.
(c) The commission is solely responsible for the commission's liabilities except as otherwise specifically provided in this compact.
(d) Venue is proper, and judicial proceedings by or against the commission shall be brought solely and exclusively, in a court with jurisdiction where the principal office of the commission is located.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-7. Commission Action

Sec. 7. (a) The commission shall meet and take any actions that are consistent with this compact and the bylaws.
(b) Each member of the commission is entitled to cast a vote to which that compacting state is entitled and to participate in the business and affairs of the commission. A member shall vote in person or by other means as provided in the bylaws. The bylaws may provide for members' participation in meetings by telephone or other means of communication.
(c) The commission shall meet at least one (1) time during each calendar year. Additional meetings shall be held as set forth in the bylaws.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-10. Dispute Resolution

Sec. 10. The commission shall attempt, upon the request of a member, to resolve any disputes or other issues that are subject to this compact and that may arise between two (2) or more compacting states, or between compacting states and noncompacting states, and the commission shall adopt an operating procedure providing for resolution of any disputes.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-11. Product Filing and Approval

Sec. 11. (a) Insurers and third party filers seeking to have a product approved by the commission shall file the product with and pay applicable filing fees to the commission. Nothing in this chapter restricts or otherwise prevents an insurer from filing the insurer's product with the insurance department in any state where the insurer is licensed to conduct the business of insurance, and the filing is subject to the laws of the states where filed.
(b) The commission shall establish appropriate filing and review processes and procedures under commission rules and operating procedures. Notwithstanding any provision in this chapter to the contrary, the commission shall adopt rules to establish conditions and procedures under which the commission will provide public access to product filing information. In establishing any rules, the commission shall consider the interests of the public in having access to the information as well as protection of personal medical and financial information and trade secrets that may be contained in a product filing or supporting information.
(c) Any product approved by the commission may be sold or otherwise issued in the compacting states in which the insurer is legally authorized to do business.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-12. Disapproval; Appeal; Monitoring

Sec. 12. (a) Not later than thirty (30) days after the commission has given notice of a disapproved product or advertisement filed with the commission, the insurer or third party filer whose filing was disapproved may appeal the determination to a review panel appointed by the commission. The commission shall adopt rules to establish procedures for appointing the review panels and provide for notice and hearing. An allegation that the commission, in disapproving a product or an advertisement filed with the commission, acted arbitrarily, capriciously, or in a manner that is an abuse of discretion or otherwise not in accordance with the law, is subject to judicial review in accordance with section 3(e) of this chapter.
(b) The commission shall monitor, review, and reconsider products and advertisement subsequent to their filing or approval upon a finding that the product does not meet the relevant uniform standard. If appropriate, the commission may withdraw or modify the commission's approval after proper notice and hearing, subject to the appeal process in subsection (a).
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-13. Commission Finances

Sec. 13. (a) The commission shall pay or provide for the payment of the reasonable expenses of the commission's establishment and organization. To fund the cost of the commission's initial operations, the commission may accept contributions and other forms of funding from the NAIC, compacting states, and other sources. Contributions and other forms of funding from other sources shall be of such a nature that the independence of the commission concerning the performance of the commission's duties is not compromised.
(b) The commission shall collect a filing fee from each insurer and third party filer filing a product with the commission to cover the cost of the operations and activities of the commission and the commission's staff in an amount sufficient to cover the commission's annual budget.
(c) The commission's budget for a fiscal year may not be approved until the commission's budget has been subject to notice and comment as set forth in section 8(b) of this chapter.
(d) The commission is exempt from all taxation in and by the compacting states.
(e) The commission shall not pledge the credit of any compacting state, except by and with the appropriate legal authority of that compacting state.
(f) The commission shall keep complete and accurate accounts of all the commission's internal receipts, including grants and donations, and disbursements of all funds under the commission's control. The internal financial accounts of the commission are subject to the accounting procedures established under the commission's bylaws. The financial accounts and reports, including the system of internal controls and procedures of the commission, shall be audited annually by an independent certified public accountant. Upon the determination of the commission, but not less frequently than every three (3) years, the review of the independent auditor shall include a management and performance audit of the commission. The commission shall make an annual report, to the governor and legislature of the compacting states, including a report of the independent audit. The commission's internal accounts are not confidential and such internal account materials may be shared with the commissioner of any compacting state upon request. However, work papers related to internal or independent audit and information regarding the privacy of individuals and proprietary information of insurers, including trade secrets, is confidential.
(g) No compacting state shall have any claim to or ownership of any property held by or vested in the commission or to any commission funds held under the provisions of this compact.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-14. Effectiveness of Compact; Amendments

Sec. 14. (a) Any state is eligible to become a compacting state. The compact becomes effective and binding upon legislative enactment of the compact into law by two (2) compacting states. However, the commission shall become effective for purposes of adopting uniform standards for, reviewing, and giving approval or disapproval of products filed with the commission that satisfy applicable uniform standards only after twenty-six (26) states are compacting states or, alternatively, by states representing greater than forty percent (40%) of the premium volume for life insurance, annuity, disability income, and long term care insurance products, based on records of the NAIC for the prior year. Thereafter, it becomes effective and binding as to any other compacting state upon enactment of the compact into law by that state.
(b) Amendments to the compact may be proposed by the commission for enactment by the compacting states. An amendment does not become effective and binding upon the commission and the compacting states unless and until all compacting states enact the amendment into law.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-15. Withdrawal of Compacting State; Reinstatement

Sec. 15. (a) Once effective, the compact continues in force and remains binding upon each compacting state. However, a compacting state may withdraw from the compact by enacting a statute specifically repealing the statute that enacted the compact into law.
(b) The effective date of withdrawal is the effective date of the repealing statute. However, the withdrawal does not apply to any product filings approved or self-certified, or any advertisement of products, on the date the repealing statute becomes effective, except by mutual agreement of the commission and the withdrawing state, unless the approval is rescinded by the withdrawing state as provided in subsection (e).
(c) The commissioner of the withdrawing state shall immediately notify the management committee in writing upon the introduction of legislation repealing this compact in the withdrawing state.
(d) The commission shall notify the other compacting states of the introduction of the legislation within ten (10) days after the commission's receipt of notice of the introduction of the legislation.
(e) The withdrawing state is responsible for all obligations, duties, and liabilities incurred through the effective date of withdrawal, including any obligations, the performance of which extend beyond the effective date of withdrawal, except to the extent those obligations may have been released or relinquished by mutual agreement of the commission and the withdrawing state. The commission's approval of products and advertisement before the effective date of withdrawal shall continue to be effective and be given full force and effect in the withdrawing state, unless formally rescinded by the withdrawing state in the same manner as provided by the laws of the withdrawing state for the prospective disapproval of products or advertisement previously approved under state law.
(f) Reinstatement following withdrawal of any compacting state occurs on the effective date of the withdrawing state reenacting the compact.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-16. Default of Compacting State; Reinstatement

Sec. 16. (a) If the commission determines that any compacting state has at any time defaulted in the performance of any of the compacting state's obligations or responsibilities under this compact, the bylaws, or adopted rules or operating procedures, after notice and hearing as set forth in the bylaws, all rights, privileges, and benefits conferred by this compact on the defaulting state shall be suspended from the effective date of default as fixed by the commission. The grounds for default include:
(1) failure of a compacting state to perform its obligations or responsibilities; or
(2) any other grounds designated in commission rules.
The commission shall immediately notify the defaulting state in writing of the defaulting state's suspension pending a cure of the default. The commission shall stipulate the conditions and the period within which the defaulting state must cure the defaulting state's default. If the defaulting state fails to cure the default within the period specified by the commission, the defaulting state shall be terminated and the compact and all rights, privileges, and benefits conferred by this compact shall be terminated on the effective date of termination.
(b) Product approvals by the commission, product self-certifications, or any advertisement in connection with the product that is in force on the effective date of termination shall remain in force in the defaulting state in the same manner as if the defaulting state had withdrawn voluntarily under section 15 of this chapter.
(c) Reinstatement following termination of any compacting state requires a reenactment of the compact.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-17. Dissolution of Compact

Sec. 17. The compact dissolves effective on the date of the withdrawal or default of the compacting state that reduces membership in the compact to one (1) compacting state. Upon the dissolution of this compact, the compact is null and void and is of no further force or effect, and the business and affairs of the commission shall be wound up and any surplus funds shall be distributed in accordance with the bylaws.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-18. Severability

Sec. 18. The provisions of this compact are severable and if any phrase, clause, sentence, or provision is considered unenforceable, the remaining provisions of the compact are enforceable. The provisions of this compact shall be liberally construed to effectuate the compact's purposes.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-19. Effect on State Law

Sec. 19. (a) Nothing in this chapter prevents the enforcement of any other law of a compacting state, except as provided in subsection (b).
(b) For a product approved or certified to the commission, the rules, uniform standards, and any other requirements of the commission constitute the exclusive provisions applicable to the content, approval, and certification of the products. For an advertisement that is subject to the commission's authority, any rule, uniform standard, or other requirement of the commission that governs the content of the advertisement constitutes the exclusive provision that a commissioner may apply to the content of the advertisement. However, no action taken by the commission shall abrogate or restrict:
(1) the access of any person to state courts;
(2) remedies available under state law related to breach of contract, tort, or other laws not specifically directed to the content of the product;
(3) state law relating to the construction of insurance contracts; or
(4) the authority of the attorney general of the state, including maintaining actions or proceedings, as authorized by law.
(c) All insurance products filed with individual states are subject to the laws of those states.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31. Interstate Insurance Product Regulation Compact › 27-8-31-20. Commission Actions and Agreements; Effect on Compacting States; Constitutional Violation

Sec. 20. (a) All lawful actions of the commission, including all rules and operating procedures adopted by the commission, are binding upon the compacting states.
(b) All agreements between the commission and the compacting states are binding in accordance with the terms of the agreements.
(c) Upon the request of a party to a conflict over the meaning or interpretation of commission actions and upon a majority vote of the compacting states, the commission may issue advisory opinions regarding the meaning or interpretation in dispute.
(d) Any provision of this compact that violates the Constitution of the State of Indiana is ineffective in Indiana.
As added by P.L.138-2005, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.2. Mail Order and Internet Pharmacy Designation › 27-8-31.2-0.1. Application of Chapter

Sec. 0.1. The addition of this chapter by P.L.251-2003 applies to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2003.
As added by P.L.220-2011, SEC.453.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.2. Mail Order and Internet Pharmacy Designation › 27-8-31.2-1. "Insurer"

Sec. 1. As used in this chapter, "insurer" refers to an insurer (as defined in IC 27-1-2-3) that issues a policy of accident and sickness insurance.
As added by P.L.251-2003, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.2. Mail Order and Internet Pharmacy Designation › 27-8-31.2-2. "Insured"

Sec. 2. As used in this chapter, "insured" means an individual who is entitled to coverage under a policy of accident and sickness insurance.
As added by P.L.251-2003, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.2. Mail Order and Internet Pharmacy Designation › 27-8-31.2-3. "Mail Order or Internet Based Pharmacy"

Sec. 3. As used in this chapter, "mail order or Internet based pharmacy" has the meaning set forth in IC 25-26-18-1.
As added by P.L.251-2003, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.2. Mail Order and Internet Pharmacy Designation › 27-8-31.2-4. "Policy of Accident and Sickness Insurance"

Sec. 4. As used in this chapter, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1.
As added by P.L.251-2003, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.2. Mail Order and Internet Pharmacy Designation › 27-8-31.2-5. Designation of Mail Order or Internet Based Pharmacy

Sec. 5. (a) An insurer that provides coverage for prescription drugs may designate a mail order or an Internet based pharmacy to provide prescription drugs to an insured.
(b) An insurer may not require an insured to obtain a prescription drug from a pharmacy designated under subsection (a) as a condition of coverage.
As added by P.L.251-2003, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.4. Synchronized Medication Dispensing › 27-8-31.4-2. "Covered Individual"

Sec. 2. As used in this chapter, "covered individual" means an insured individual who is entitled to coverage under a policy of accident and sickness insurance.
As added by P.L.202-2017, SEC.20.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.4. Synchronized Medication Dispensing › 27-8-31.4-3. "Policy of Accident and Sickness Insurance"

Sec. 3. As used in this chapter, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1. The term includes only a policy that:
(1) is issued on an individual or a group basis; and
(2) provides coverage for prescription medications.
As added by P.L.202-2017, SEC.20.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.4. Synchronized Medication Dispensing › 27-8-31.4-4. "Synchronize"

Sec. 4. As used in this chapter, "synchronize" means to use a single pharmacy dispensing process as a means of coordinating the covered individual's medications at the same time when:
(1) a particular medication:
(A) is of a formulation that can be effectively split; and
(B) does not have quantity limits or dose optimization criteria as specified in the policy of accident and sickness insurance's formulary and prior authorization requirements;
(2) the covered individual is on a stabilized treatment plan for a chronic condition and the synchronization is for those drugs treating a chronic condition; and
(3) the medication is not:
(A) an opioid, stimulant, sedative, or hypnotic medication; or
(B) another medication that is addictive and subject to abuse.
As added by P.L.202-2017, SEC.20.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.4. Synchronized Medication Dispensing › 27-8-31.4-5. Denial of Coverage to Synchronize Prohibited

Sec. 5. A policy of accident and sickness insurance that provides coverage for prescription drugs may not deny coverage for the refill of any drug prescribed for the treatment of a chronic illness that is made in accordance with a plan between the covered individual and a pharmacist to synchronize the refilling of multiple prescriptions for the covered individual.
As added by P.L.202-2017, SEC.20.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 31.4. Synchronized Medication Dispensing › 27-8-31.4-6. Coverage of Synchronization

Sec. 6. A policy of accident and sickness insurance must provide coverage for a medication that is dispensed in a quantity that allows synchronization of the covered individual's medications in accordance with a plan made between the covered individual and the pharmacy to synchronize the covered individual's medications for chronic conditions.
As added by P.L.202-2017, SEC.20.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 32. Coverage for Chemotherapy › 27-8-32-1. Application of Chapter

Sec. 1. This chapter applies to a policy of accident and sickness insurance that provides coverage for both of the following:
(1) Orally administered cancer chemotherapy.
(2) Cancer chemotherapy that is administered intravenously or by injection.
As added by P.L.46-2009, SEC.1.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 32. Coverage for Chemotherapy › 27-8-32-2. "Cancer Chemotherapy"

Sec. 2. As used in this chapter, "cancer chemotherapy" means medication that is prescribed by a physician to kill or slow the growth of cancer cells.
As added by P.L.46-2009, SEC.1.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 32. Coverage for Chemotherapy › 27-8-32-4. "Policy of Accident and Sickness Insurance"

Sec. 4. As used in this chapter, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1.
As added by P.L.46-2009, SEC.1.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 32. Coverage for Chemotherapy › 27-8-32-5. Prohibition on Coverage Limitations

Sec. 5. Coverage for orally administered cancer chemotherapy under a policy of accident and sickness insurance must not be subject to dollar limits, copayments, deductibles, or coinsurance provisions that are less favorable to an insured than the dollar limits, copayments, deductibles, or coinsurance provisions that apply to coverage for cancer chemotherapy that is administered intravenously or by injection under the policy of accident and sickness insurance.
As added by P.L.46-2009, SEC.1.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 32.1. Coverage for Prescription Eye Drops › 27-8-32.1-2. "Insured"

Sec. 2. As used in this chapter, "insured" means an individual who is entitled to coverage under a policy of accident and sickness insurance.
As added by P.L.43-2015, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 32.1. Coverage for Prescription Eye Drops › 27-8-32.1-3. "Policy of Accident and Sickness Insurance"

Sec. 3. As used in this chapter, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1.
As added by P.L.43-2015, SEC.2.