reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 12. Long Term Care Insurance › 27-8-12-16. Application of General Insurance Law

Sec. 16. All other applicable provisions of IC 27 not in conflict with the provisions of this chapter apply to insurance policies issued under this chapter. A long term care insurance policy issued under this chapter is not subject to any rule adopted under IC 27-1-3-7(c).
As added by P.L.275-1987, SEC.1.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 12. Long Term Care Insurance › 27-8-12-17. Group Policies Issued in Another State; Requirements

Sec. 17. Group long term care insurance may not be offered to a resident of Indiana under a group policy issued in another state unless the commissioner determines that the group long term care insurance policy substantially complies with insurance requirements similar to those established under this chapter.
As added by P.L.114-1991, SEC.19.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 12. Long Term Care Insurance › 27-8-12-18. Insurance Producer Commissions

Sec. 18. (a) An insurer or other entity that provides a commission to an insurance producer or other representative for the sale of a long term care insurance policy may not violate the following conditions:
(1) The insurer or other entity shall, for at least six (6) years, pay to the insurance producer or other representative an annual commission for selling or servicing the policy.
(2) The amount of commission provided in years after the first year must be determined based on the premium charged for the long term care insurance policy during the first year.
(b) If an existing long term care policy or certificate is replaced, the insurer or other entity that issues the replacement policy may not provide, and its insurance producer may not accept, a commission in an amount greater than the renewal commission payable by the replacing insurer on renewal policies, unless the benefits of the replacement policy or certificate are clearly and substantially greater than the benefits under the replaced policy or certificate.
(c) This section does not apply to the following:
(1) Life insurance policies and certificates.
(2) A policy or certificate that is sponsored by an employer for the benefit of:
(A) the employer's employees; or
(B) the employer's employees and their dependents.
As added by P.L.114-1991, SEC.20. Amended by P.L.178-2003, SEC.67; P.L.173-2007, SEC.29; P.L.115-2011, SEC.10.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 12. Long Term Care Insurance › 27-8-12-19. Violations; Civil Penalty; Amount

Sec. 19. (a) In addition to any other sanction provided under this article, the commissioner may impose a civil penalty against an insurer who has violated this chapter or rules adopted under this chapter. A penalty imposed under this section must be the greater of:
(1) three (3) times the amount of the commissions paid for each policy involved in the violation; or
(2) ten thousand dollars ($10,000).
(b) In addition to any other sanction provided under this title, the commissioner may impose a penalty against an insurance producer who has violated this chapter or rules adopted under this chapter. The penalty must be the greater of:
(1) up to three (3) times the amount of the commissions paid to that insurance producer for each policy involved in the violation; or
(2) twenty-five hundred dollars ($2,500).
As added by P.L.114-1991, SEC.21. Amended by P.L.178-2003, SEC.68.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-0.1. Application of Certain Amendments to Chapter

Sec. 0.1. The addition of section 10.1 of this chapter by P.L.195-1991 applies only to policies issued after December 31, 1991.
As added by P.L.220-2011, SEC.442.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-1. "Medicare" Defined

Sec. 1. As used in this chapter, "medicare" means Title XVIII of the federal Social Security Act (42 U.S.C. 1395 et seq.).
As added by P.L.275-1987, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-2. "Medicare Supplement Insurance Solicitation" Defined

Sec. 2. As used in this chapter, "Medicare supplement insurance solicitation" means a meeting between an insurance producer and another individual at which the insurance producer discusses the possible issuance of a medicare supplement policy to the other individual.
As added by P.L.275-1987, SEC.2. Amended by P.L.178-2003, SEC.69.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-3. "Medicare Supplement Policy"

Sec. 3. (a) As used in this chapter, "Medicare supplement policy" means a group or individual policy of accident and sickness insurance or a subscriber contract of health maintenance organizations that is advertised, marketed, or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical, or surgical expenses of persons eligible for Medicare benefits.
(b) The term does not include a group policy issued:
(1) to or for the benefit of employees;
(2) to one (1) or more labor organizations; or
(3) to the trustees of a fund established:
(A) by one (1) or more employees or former employees; or
(B) for members or former members of a labor organization.
(c) The term does not include:
(1) a policy issued under a contract under Section 1876 or 1833 of the federal Social Security Act (42 U.S.C. 1395 et seq.); or
(2) a policy issued under a demonstration project authorized under amendments to the federal Social Security Act (42 U.S.C. Chapter 7).
As added by P.L.275-1987, SEC.2. Amended by P.L.255-1989, SEC.1; P.L.126-1992, SEC.1; P.L.124-2018, SEC.79.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-4. Receipt for Materials Received by Soliciting Insurance Producer; "Materials" Defined

Sec. 4. (a) Following a Medicare supplement insurance solicitation, an insurance producer shall give the individual involved in the solicitation a receipt for materials received by the insurance producer as a result of the solicitation.
(b) The receipt required under subsection (a) must be dated and signed by the insurance producer and must set forth the following:
(1) An itemized list of the materials received by the insurance producer.
(2) The insurance producer's name.
(3) The address and telephone number of the insurance producer's office.
(c) As used in this section, "materials" includes any:
(1) document;
(2) cash;
(3) money order; or
(4) check or draft;
received by the insurance producer. The term does not include an application for a policy.
As added by P.L.275-1987, SEC.2. Amended by P.L.178-2003, SEC.70.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-5. "Applicant" Defined

Sec. 5. As used in this chapter, "applicant" means:
(1) in the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits; and
(2) in the case of a group Medicare supplement policy, the proposed certificate holder.
As added by P.L.255-1989, SEC.2. Amended by P.L.126-1992, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-6. "Certificate" Defined

Sec. 6. As used in this chapter, "certificate" means a certificate:
(1) issued under a group Medicare supplement policy; and
(2) delivered or issued for delivery in Indiana.
As added by P.L.255-1989, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-6.2. "Certificate Form" Defined

Sec. 6.2. As used in this chapter, "certificate form" means the form on which a certificate is delivered or issued for delivery by the issuer.
As added by P.L.126-1992, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-7.3. "Issuer" Defined

Sec. 7.3. As used in this chapter, "issuer" includes:
(1) an insurance company;
(2) a fraternal benefit society;
(3) a health care service plan;
(4) a health maintenance organization; and
(5) any other entity;
that delivers a Medicare supplement policy or certificate in Indiana or issues a Medicare supplement policy or certificate for delivery in Indiana.
As added by P.L.126-1992, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-7.6. "Policy Form" Defined

Sec. 7.6. As used in this chapter, "policy form" means the form on which a policy is delivered or issued for delivery by the issuer.
As added by P.L.126-1992, SEC.5.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-8. Application of Chapter

Sec. 8. (a) Except as otherwise specifically provided, this chapter applies to the following:
(1) All Medicare supplement policies delivered or issued for delivery in Indiana on or after June 1, 1989.
(2) All certificates issued under group Medicare supplement policies that have been delivered or issued for delivery in Indiana.
(b) This chapter does not apply to insurance policies or health care benefit plans, including group conversion policies, provided to Medicare eligible persons that are not marketed or held to be Medicare supplement policies or benefit plans.
As added by P.L.255-1989, SEC.5. Amended by P.L.126-1992, SEC.6.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-9. Medicare Supplement Policies; Standards; Preexisting Medical Conditions

Sec. 9. (a) A Medicare supplement policy, contract, or certificate in force in Indiana may not contain benefits that duplicate benefits provided by Medicare. However, a change in Medicare coverage that becomes effective after a Medicare supplement policy, contract, or certificate is in force in Indiana and that causes a duplication of benefits does not void the policy, contract, or certificate.
(b) The commissioner shall adopt rules under IC 4-22-2 to establish specific standards for policy provisions of Medicare supplement policies and certificates. Such standards shall be in addition to and in accordance with Indiana law. No requirement of IC 27 relating to minimum required policy benefits other than the minimum standards contained in this chapter apply to Medicare supplement policies and certificates. The standards may cover, but are not limited to:
(1) terms of renewability;
(2) initial and subsequent conditions of eligibility;
(3) nonduplication of coverage;
(4) probationary periods;
(5) benefit limitations, exceptions, and reductions;
(6) elimination periods;
(7) requirements for replacement;
(8) recurrent conditions; and
(9) definitions of terms.
(c) The commissioner may adopt rules under IC 4-22-2 that specify prohibited policy provisions not specifically authorized by statute that, in the opinion of the commissioner, are unjust, unfair, or unfairly discriminatory to a person insured or proposed to be insured under a Medicare supplement policy or certificate.
(d) Notwithstanding any other law, a Medicare supplement policy or certificate shall not exclude or limit benefits for a loss incurred more than six (6) months after the effective date of the policy because the loss involves a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage.
(e) After June 30, 2020, an issuer that makes a Medicare supplement policy or certificate available to a person who is at least sixty-five (65) years of age and eligible for Medicare benefits as described in 42 U.S.C. 1395c(1) shall make at least one (1) Medicare supplement policy or certificate that meets the requirements of section 9.5 of this chapter available to an individual who is eligible for and enrolled in Medicare by reason of disability as described in 42 U.S.C. 1395c(2).
As added by P.L.255-1989, SEC.6. Amended by P.L.126-1992, SEC.7; P.L.227-2019, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-9.5. Medicare Supplement Policy or Certificate Requirements; Enrollment; Compensation

Sec. 9.5. (a) This section applies:
(1) after June 30, 2020; and
(2) to a Medicare supplement policy or certificate made available under section 9(e) of this chapter to an individual who is eligible for and enrolled in Medicare by reason of disability as described in 42 U.S.C. 1395c(2).
(b) A Medicare supplement policy or certificate described in subsection (a) must meet the following requirements:
(1) Except as provided in this section, meet all requirements of this chapter that apply to a Medicare supplement policy or certificate made available to a person who is at least sixty-five (65) years of age and eligible for Medicare as described in 42 U.S.C. 1395c(1).
(2) Be standardized as Plan A by the federal Centers for Medicare and Medicaid Services.
(c) An individual may enroll in a Medicare supplement policy or certificate under this section as follows:
(1) At any time the individual is authorized or required to enroll under federal law.
(2) Either:
(A) on July 1, 2020; or
(B) six (6) months after enrolling in Medicare Part B;
whichever is later.
(3) Within six (6) months after receiving notice that the individual has been retroactively enrolled in Medicare Part B due to a retroactive eligibility decision under 42 U.S.C. 1395.
(4) Within six (6) months after experiencing a qualifying event under 42 U.S.C. 1395.
(d) Notwithstanding any other law, an issuer or another entity may provide to an insurance producer or another agent of the issuer or other entity a commission or other compensation of not more than two percent (2%) of the premium for the sale of a Medicare supplement policy or certificate described in subsection (a).
As added by P.L.227-2019, SEC.3. Amended by P.L.156-2020, SEC.110.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-10. Medicare Supplement Policy and Certificate Standards; Conformity With Federal Law and Regulations

Sec. 10. (a) The commissioner shall adopt rules under IC 4-22-2 to establish minimum standards for:
(1) claims payment;
(2) marketing practices;
(3) compensation arrangements; and
(4) reporting practices;
for Medicare supplement policies and certificates.
(b) The commissioner may adopt rules under IC 4-22-2 that are necessary to conform Medicare supplement policies and certificates to the requirements of federal law and federal regulations. A rule adopted under this subsection may do the following:
(1) Require refunds or credits if the policies or certificates do not meet loss ratio requirements.
(2) Establish a uniform methodology for calculating and reporting loss ratios.
(3) Assure public access to policies, premiums, and loss ratio information of issuers of Medicare supplement insurance.
(4) Establish a process for approving or disapproving policy forms and certificate forms and proposed premium increases.
(5) Establish a policy for holding public hearings before approval of premium increases.
(6) Establish standards for Medicare Select policies and certificates.
As added by P.L.255-1989, SEC.7. Amended by P.L.149-1990, SEC.5; P.L.195-1991, SEC.1; P.L.126-1992, SEC.8.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-10.1. Model Medicare Supplement Policy Standards

Sec. 10.1. (a) The commissioner shall adopt rules under IC 4-22-2 to establish standards for model Medicare supplement policies. The standards must include standards for benefits.
(b) An insurer may issue a Medicare supplement policy or certificate in Indiana only if the policy or certificate is one (1) of the model policies adopted by the department under subsection (a).
As added by P.L.195-1991, SEC.2. Amended by P.L.126-1992, SEC.9.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-12. Reasonable Benefits; Loss Ratio Standards

Sec. 12. (a) Medicare supplement policies must return to policyholders benefits that are reasonable in relation to the premium charged.
(b) The commissioner shall adopt rules under IC 4-22-2 to establish minimum standards for loss ratios of Medicare supplement policies on the basis of incurred claims experience, or incurred health care expenses if coverage is provided by a health maintenance organization on a service rather than reimbursement basis, and earned premiums in accordance with accepted actuarial principles and practices.
As added by P.L.255-1989, SEC.9. Amended by P.L.126-1992, SEC.10.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-14. Outline of Coverage; Contents

Sec. 14. (a) In order to provide for full and fair disclosure in the sale of Medicare supplement policies, a Medicare supplement policy or certificate may not be delivered in Indiana unless an outline of coverage is delivered to the applicant at the time application is made.
(b) The commissioner shall prescribe by rule adopted under IC 4-22-2 the form and content of the outline of coverage required by subsection (a). For purposes of this section, "form" means style, arrangements, and overall appearance, including such items as the size, color, and prominence of type and arrangement of text and captions. The outline of coverage must include the following:
(1) A description of the principal benefits and coverage provided in the policy.
(2) A statement of the renewal provisions, including a reservation by the issuer of a right to change premiums, and a disclosure of the existence of any automatic premium increases based on the policyholder's age.
(3) A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.
As added by P.L.255-1989, SEC.11. Amended by P.L.126-1992, SEC.11.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-15. Informational Brochures

Sec. 15. (a) The commissioner may prescribe by rule adopted under IC 4-22-2 a standard form and the contents of an informational brochure for persons eligible for Medicare that is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of Medicare.
(b) Except in the case of direct response insurance policies, the commissioner may require by rule adopted under IC 4-22-2 that the information brochure be provided to a prospective insured eligible for Medicare concurrently with delivery of the outline of coverage required under section 14 of this chapter.
(c) With respect to direct response insurance policies, the commissioner may require by rule adopted under IC 4-22-2 that the prescribed brochure be provided upon request to a prospective insured eligible for Medicare, but not later than the time of policy delivery.
As added by P.L.255-1989, SEC.12. Amended by P.L.126-1992, SEC.12.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-16. Disclosures Distinguishing Medicare Supplement Coverages From Accident and Sickness Coverages

Sec. 16. (a) The commissioner may adopt rules under IC 4-22-2 for captions or notice requirements that are determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not Medicare supplement coverages. The captions or notice requirements may apply to all accident and sickness insurance policies sold to persons eligible for Medicare by reason of age, other than:
(1) Medicare supplement policies;
(2) disability income policies;
(3) basic, catastrophic, or major medical expense policies; and
(4) single premium, nonrenewable policies.
(b) The commissioner may also adopt rules under IC 4-22-2 to govern the full and fair disclosure of the information in connection with the replacement of accident and sickness policies, subscriber contracts, or certificates by persons eligible for Medicare.
As added by P.L.255-1989, SEC.13. Amended by P.L.126-1992, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-17. Return Privilege Notice; Refund

Sec. 17. (a) Medicare supplement policies and certificates must have a notice prominently printed on the first page of the policy or certificate or attached to the first page stating in substance that the applicant has the right to return the policy or certificate within thirty (30) days of delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason.
(b) A refund made under this section shall be paid directly to the applicant by the issuer in a timely manner.
As added by P.L.255-1989, SEC.14. Amended by P.L.126-1992, SEC.14.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-18. Review and Approval of Proposed Advertisements

Sec. 18. Every issuer of Medicare supplement insurance policies or certificates in Indiana shall provide a copy of any Medicare supplement advertisement intended for use in Indiana whether through written, radio, or television medium to the commissioner for review or approval by the commissioner to the extent required under Indiana law.
As added by P.L.255-1989, SEC.15. Amended by P.L.126-1992, SEC.15.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-19. Penalties for Noncompliance

Sec. 19. In addition to any other penalties for violations of IC 27, the commissioner may take either or both of the following actions:
(1) Require issuers violating this chapter or rules adopted under this chapter to cease marketing a Medicare supplement policy or certificate in Indiana that is related directly or indirectly to a violation.
(2) Require the issuer to take the action necessary to comply with this chapter.
As added by P.L.255-1989, SEC.16. Amended by P.L.126-1992, SEC.16.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13. Medicare Supplement Insurance Solicitations › 27-8-13-20. Refund of Unused Premiums

Sec. 20. (a) All Medicare supplement policies issued for delivery in Indiana after June 30, 1990, must provide for the refund of unused premiums upon the death of the insured during the contract period.
(b) The amount of premium refund shall be prorated from the date following the date of death of the insured to the end of the contract period for which the premium has been paid.
(c) The refund required by this section shall be paid as follows:
(1) If a person other than the insured paid the premium, to that person. A person entitled to a refund under this subdivision must provide proof of payment to the insurer.
(2) If the insured paid the premium, to the surviving spouse of the insured. If there is no surviving spouse, the premium shall be paid in the same manner as distributions of the net estate of a person who dies intestate under IC 29-1-2-1(d).
(d) A person entitled to receive a refund under this section must do the following:
(1) Submit a written request for the refund.
(2) Furnish proof of the insured's death.
As added by P.L.151-1990, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13.4. Coverage for Abortion › 27-8-13.4-1. "Accident and Sickness Insurance Policy"

Sec. 1. (a) As used in this chapter, "accident and sickness insurance policy" means an insurance policy that:
(1) provides one (1) or more of the types of insurance described in IC 27-1-5-1, Class 1(b) and Class 2(a); and
(2) is issued on a group or individual basis.
(b) As used in this chapter, "accident and sickness insurance policy" does not include the following:
(1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.
(2) Coverage issued as a supplement to liability insurance.
(3) Worker's compensation or similar insurance.
(4) Automobile medical payment insurance.
(5) A specified disease policy.
(6) A short term insurance plan that:
(A) may be renewed for the greater of:
(i) thirty-six (36) months; or
(ii) the maximum period permitted under federal law;
(B) has a term of not more than three hundred sixty-four (364) days; and
(C) has an annual limit of at least two million dollars ($2,000,000).
(7) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:
(A) hospital confinement, critical illness, or intensive care; or
(B) gaps for deductibles or copayments.
(8) A supplemental plan that always pays in addition to other coverage.
(9) An employer sponsored health benefit plan that is:
(A) provided to individuals who are eligible for Medicare; and
(B) not marketed as, or held out to be, a Medicare supplement policy.
As added by P.L.124-2014, SEC.1. Amended by P.L.288-2019, SEC.9.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13.4. Coverage for Abortion › 27-8-13.4-2. Prohibition on Coverage of Abortion; Exceptions; Coverage Through Rider or Endorsement

Sec. 2. (a) An accident and sickness insurance policy that is issued, delivered, amended, or renewed after December 31, 2014, may not provide coverage for abortion, except in the following cases:
(1) The pregnant woman became pregnant through an act of rape or incest.
(2) An abortion is necessary to avert the pregnant woman's death or a substantial and irreversible impairment of a major bodily function of the pregnant woman.
(b) An insurer that issues an accident and sickness insurance policy described in subsection (a) may offer coverage for abortion through a rider or an endorsement.
As added by P.L.124-2014, SEC.1.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13.5. Coverage for Medical Services for Women With High Breast Density › 27-8-13.5-1. Application of Chapter

Sec. 1. This chapter applies to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2013.
As added by P.L.126-2013, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13.5. Coverage for Medical Services for Women With High Breast Density › 27-8-13.5-2. "High Breast Density"

Sec. 2. As used in this chapter, "high breast density" means a condition in which there is a greater amount of breast and connective tissue in comparison to fat in the breast.
As added by P.L.126-2013, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13.5. Coverage for Medical Services for Women With High Breast Density › 27-8-13.5-3. "Insured"

Sec. 3. 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.126-2013, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13.5. Coverage for Medical Services for Women With High Breast Density › 27-8-13.5-4. "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. The term does not include the following:
(1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.
(2) Coverage issued as a supplement to liability insurance.
(3) Automobile medical payment insurance.
(4) A specified disease policy.
(5) A short term insurance plan that:
(A) may be renewed for the greater of:
(i) thirty-six (36) months; or
(ii) the maximum period permitted under federal law;
(B) has a term of not more than three hundred sixty-four (364) days; and
(C) has an annual limit of at least two million dollars ($2,000,000).
(6) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:
(A) hospital confinement, critical illness, or intensive care; or
(B) gaps for deductibles or copayments.
(7) Worker's compensation or similar insurance.
(8) A student health plan.
(9) A supplemental plan that always pays in addition to other coverage.
(10) An employer sponsored health benefit plan that is:
(A) provided to individuals who are eligible for Medicare; and
(B) not marketed as, or held out to be, a Medicare supplement policy.
As added by P.L.126-2013, SEC.4. Amended by P.L.288-2019, SEC.10.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 13.5. Coverage for Medical Services for Women With High Breast Density › 27-8-13.5-5. High Breast Density

Sec. 5. A policy of accident and sickness insurance must provide coverage for an appropriate medical screening, test, or examination for a female insured who is at least forty (40) years of age and who has been determined to have high breast density.
As added by P.L.126-2013, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14. Coverage for Services Related to Breast Cancer Screening › 27-8-14-0.1. Application of Chapter; Application of Certain Amendments to Chapter

Sec. 0.1. (a) The addition of this chapter and the amendments made to IC 13-1-2-11 (before its repeal, now codified at IC 16-41-35-30) by P.L.119-1991 apply to an insurance policy that is issued or renewed after June 30, 1991.
(b) The amendments made to section 6 of this chapter by P.L.170-1999 apply to accident and sickness insurance policies that are issued, delivered, or renewed after June 30, 1999.
As added by P.L.220-2011, SEC.443.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14. Coverage for Services Related to Breast Cancer Screening › 27-8-14-1. "Accident and Sickness Insurance Policy"

Sec. 1. (a) As used in this chapter, "accident and sickness insurance policy" means an insurance policy that:
(1) provides one (1) or more of the types of insurance described in IC 27-1-5-1, classes 1(b) and 2(a); and
(2) is issued on a group basis.
(b) The term does not include the following:
(1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.
(2) Coverage issued as a supplement to liability insurance.
(3) Worker's compensation or similar insurance.
(4) Automobile medical payment insurance.
(5) A specified disease policy.
(6) A short term insurance plan that:
(A) may be renewed for the greater of:
(i) thirty-six (36) months; or
(ii) the maximum period permitted under federal law;
(B) has a term of not more than three hundred sixty-four (364) days; and
(C) has an annual limit of at least two million dollars ($2,000,000).
(7) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:
(A) hospital confinement, critical illness, or intensive care; or
(B) gaps for deductibles or copayments.
(8) A supplemental plan that always pays in addition to other coverage.
(9) A student health plan.
(10) An employer sponsored health benefit plan that is:
(A) provided to individuals who are eligible for Medicare; and
(B) not marketed as, or held out to be, a Medicare supplement policy.
As added by P.L.119-1991, SEC.3. Amended by P.L.173-2007, SEC.30; P.L.288-2019, SEC.11.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14. Coverage for Services Related to Breast Cancer Screening › 27-8-14-2. "Breast Cancer Screening Mammography"

Sec. 2. (a) As used in this chapter, "breast cancer screening mammography" means a standard, two (2) view per breast, low-dose radiographic examination of the breasts that is:
(1) furnished to an asymptomatic woman; and
(2) performed by a mammography services provider using equipment designed by the manufacturer for and dedicated specifically to mammography in order to detect unsuspected breast cancer.
(b) The term includes the interpretation of the results of a breast cancer screening mammography by a physician.
As added by P.L.119-1991, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14. Coverage for Services Related to Breast Cancer Screening › 27-8-14-3. "Insured"

Sec. 3. 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.119-1991, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14. Coverage for Services Related to Breast Cancer Screening › 27-8-14-4. "Mammography Services Provider"

Sec. 4. As used in this chapter, "mammography services provider" means a person or facility that:
(1) has been accredited by the American College of Radiology;
(2) meets equivalent guidelines established by the Indiana department of health; or
(3) certified by the Federal Department of Health and Human Services for participation in the Medicare program (42 U.S.C. 1395 et seq.).
As added by P.L.119-1991, SEC.3. Amended by P.L.2-1992, SEC.787; P.L.56-2023, SEC.247.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14. Coverage for Services Related to Breast Cancer Screening › 27-8-14-5. "Woman at Risk"

Sec. 5. As used in this chapter, "woman at risk" means a woman who meets at least one (1) of the following descriptions:
(1) A woman who has a personal history of breast cancer.
(2) A woman who has a personal history of breast disease that was proven benign by biopsy.
(3) A woman whose mother, sister, or daughter has had breast cancer.
(4) A woman who is at least thirty (30) years of age and has not given birth.
As added by P.L.119-1991, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14. Coverage for Services Related to Breast Cancer Screening › 27-8-14-6. Breast Cancer Screening Mammography; Coverage

Sec. 6. (a) Except as provided in subsection (f), an insurer must provide coverage for breast cancer screening mammography in any accident and sickness insurance policy that the insurer issues in Indiana.
(b) Except as provided in subsection (f), the coverage that an insurer must provide under this section must include the following:
(1) If the insured is at least thirty-five (35) but less than forty (40) years of age, coverage for at least one (1) baseline breast cancer screening mammography performed upon the insured before she becomes forty (40) years of age.
(2) If the insured is:
(A) less than forty (40) years of age; and
(B) a woman at risk;
one (1) breast cancer screening mammography performed upon the insured every year.
(3) If the insured is at least forty (40) years of age, one (1) breast cancer screening mammography performed upon the insured every year.
(4) Any additional mammography views that are required for proper evaluation.
(5) Ultrasound services, if determined medically necessary by the physician treating the insured.
(c) Except as provided in subsection (f), the coverage that an insurer must provide under this section must provide reimbursement for breast cancer screening mammography at a level at least as high as:
(1) the limitation on payment for screening mammography services established in 42 CFR 405.534(b)(3) according to the Medicare Economic Index at the time the breast cancer screening mammography is performed; or
(2) the rate negotiated by a contract provider according to the provisions of the insurance policy;
whichever is lower.
(d) Except as provided in subsection (f), the coverage that an insurer must provide under this section may not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to the insured than the dollar limits, deductibles, or coinsurance provisions applying to physical illness generally under the accident and sickness insurance policy.
(e) Except as provided in subsection (f), the coverage that an insurer must provide is in addition to any benefits specifically provided for x-rays, laboratory testing, or wellness examinations.
(f) In the case of insurance policies that are not employer based, the insurer must offer to provide the coverage described in subsections (a) through (e).
As added by P.L.119-1991, SEC.3. Amended by P.L.170-1999, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.1. Coverage for Services Related to Morbid Obesity › 27-8-14.1-0.1. Application of Certain Amendments to Chapter

Sec. 0.1. The amendments made to section 4 of this chapter by P.L.196-2005 apply to an accident and sickness insurance policy that is issued, delivered, amended, or renewed after June 30, 2005.
As added by P.L.220-2011, SEC.444.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.1. Coverage for Services Related to Morbid Obesity › 27-8-14.1-1. "Accident and Sickness Insurance Policy"

Sec. 1. (a) As used in this chapter, "accident and sickness insurance policy" means an insurance policy that:
(1) provides one (1) or more of the types of insurance described in IC 27-1-5-1, classes 1(b) and 2(a); and
(2) is issued on a group basis.
(b) As used in this chapter, "accident and sickness insurance policy" does not include the following:
(1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.
(2) Coverage issued as a supplement to liability insurance.
(3) Worker's compensation or similar insurance.
(4) Automobile medical payment insurance.
(5) A specified disease policy.
(6) A short term insurance plan that:
(A) may be renewed for the greater of:
(i) thirty-six (36) months; or
(ii) the maximum period permitted under federal law;
(B) has a term of not more than three hundred sixty-four (364) days; and
(C) has an annual limit of at least two million dollars ($2,000,000).
(7) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:
(A) hospital confinement, critical illness, or intensive care; or
(B) gaps for deductibles or copayments.
(8) A supplemental plan that always pays in addition to other coverage.
(9) A student health plan.
(10) An employer sponsored health benefit plan that is:
(A) provided to individuals who are eligible for Medicare; and
(B) not marketed as, or held out to be, a Medicare supplement policy.
As added by P.L.78-2000, SEC.2. Amended by P.L.173-2007, SEC.31; P.L.288-2019, SEC.12.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.1. Coverage for Services Related to Morbid Obesity › 27-8-14.1-2. "Health Care Provider" Defined

Sec. 2. As used in this chapter, "health care provider" means a:
(1) physician licensed under IC 25-22.5; or
(2) hospital licensed under IC 16-21;
that provides health care services for surgical treatment of morbid obesity.
As added by P.L.78-2000, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.1. Coverage for Services Related to Morbid Obesity › 27-8-14.1-3. "Morbid Obesity" Defined

Sec. 3. As used in this chapter, "morbid obesity" means:
(1) a body mass index of at least thirty-five (35) kilograms per meter squared, with comorbidity or coexisting medical conditions such as hypertension, cardiopulmonary conditions, sleep apnea, or diabetes; or
(2) a body mass index of at least forty (40) kilograms per meter squared without comorbidity.
For purposes of this section, body mass index is equal to weight in kilograms divided by height in meters squared.
As added by P.L.78-2000, SEC.2. Amended by P.L.196-2005, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.1. Coverage for Services Related to Morbid Obesity › 27-8-14.1-4. Coverage for Nonexperimental, Surgical Treatment of Morbid Obesity

Sec. 4. (a) Except as provided in subsection (b), an insurer that issues an accident and sickness insurance policy shall offer coverage for nonexperimental, surgical treatment by a health care provider of morbid obesity:
(1) that has persisted for at least five (5) years; and
(2) for which nonsurgical treatment that is supervised by a physician has been unsuccessful for at least six (6) consecutive months.
(b) An insurer that issues an accident and sickness insurance policy may not provide coverage for a surgical treatment of morbid obesity for an insured who is less than twenty-one (21) years of age unless two (2) physicians licensed under IC 25-22.5 determine that the surgery is necessary to:
(1) save the life of the insured; or
(2) restore the insured's ability to maintain a major life activity (as defined in IC 4-23-29-6);
and each physician documents in the insured's medical record the reason for the physician's determination.
As added by P.L.78-2000, SEC.2. Amended by P.L.196-2005, SEC.5; P.L.102-2006, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.2. Insurance Coverage for Pervasive Developmental Disorders › 27-8-14.2-1. "Accident and Sickness Insurance Policy"

Sec. 1. (a) As used in this chapter, "accident and sickness insurance policy" means an insurance policy that provides one (1) or more of the types of insurance described in IC 27-1-5-1, classes 1(b) and 2(a).
(b) The term does not include the following:
(1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.
(2) Coverage issued as a supplement to liability insurance.
(3) Worker's compensation or similar insurance.
(4) Automobile medical payment insurance.
(5) A specified disease policy.
(6) A short term insurance plan that:
(A) may be renewed for the greater of:
(i) thirty-six (36) months; or
(ii) the maximum period permitted under federal law;
(B) has a term of not more than three hundred sixty-four (364) days; and
(C) has an annual limit of at least two million dollars ($2,000,000).
(7) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:
(A) hospital confinement, critical illness, or intensive care; or
(B) gaps for deductibles or copayments.
(8) A supplemental plan that always pays in addition to other coverage.
(9) A student health plan.
(10) An employer sponsored health benefit plan that is:
(A) provided to individuals who are eligible for Medicare; and
(B) not marketed as, or held out to be, a Medicare supplement policy.
As added by P.L.148-2001, SEC.2. Amended by P.L.173-2007, SEC.32; P.L.288-2019, SEC.13.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.2. Insurance Coverage for Pervasive Developmental Disorders › 27-8-14.2-2. "Insured" Defined

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.148-2001, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.2. Insurance Coverage for Pervasive Developmental Disorders › 27-8-14.2-3. "Autism Spectrum Disorder"

Sec. 3. As used in this chapter, "autism spectrum disorder" means a neurological condition, including Asperger's syndrome and autism, as defined in the Diagnostic and Statistical Manual of Mental Disorders.
As added by P.L.148-2001, SEC.2. Amended by P.L.188-2013, SEC.21; P.L.124-2018, SEC.80.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.2. Insurance Coverage for Pervasive Developmental Disorders › 27-8-14.2-4. Group Coverage Required

Sec. 4. (a) An accident and sickness insurance policy that is issued on a group basis must provide coverage for the treatment of an autism spectrum disorder of an insured. Coverage provided under this section is limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan. An insurer may not deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on an individual under an insurance policy solely because the individual is diagnosed with an autism spectrum disorder.
(b) The coverage required under this section may not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to an insured than the dollar limits, deductibles, or coinsurance provisions that apply to physical illness generally under the accident and sickness insurance policy.
As added by P.L.148-2001, SEC.2. Amended by P.L.188-2013, SEC.22.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.2. Insurance Coverage for Pervasive Developmental Disorders › 27-8-14.2-5. Individual Coverage Required

Sec. 5. (a) An insurer that issues an accident and sickness insurance policy on an individual basis must offer to provide coverage for the treatment of an autism spectrum disorder of an insured. Coverage provided under this section is limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan. An insurer may not deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on an individual under an insurance policy solely because the individual is diagnosed with an autism spectrum disorder.
(b) The coverage that must be offered under this section may not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to an insured than the dollar limits, deductibles, or coinsurance provisions that apply to physical illness generally under the accident and sickness insurance policy.
As added by P.L.148-2001, SEC.2. Amended by P.L.188-2013, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 14.5. Coverage for Services Related to Diabetes › 27-8-14.5-0.1. Application of Chapter

Sec. 0.1. The addition of this chapter by P.L.190-1997 applies to all health insurance plans issued or renewed after December 31, 1997.
As added by P.L.220-2011, SEC.445.