Idaho Administrative Code › Title IDAPA 18 - Insurance, Department of › Rule 18.04.08 - INDIVIDUAL AND GROUP SUPPLEMENTARY DISABILITY INSURANCE MINIMUM STANDARDS RULE › Section 18.04.08.030 - MINIMUM STANDARDS FOR BENEFITS

Current through August 31, 2023
01.
Minimum
			 Standards
. The following minimum standards for benefits are prescribed
			 for the categories of coverage noted in Sections
			 035 through
			 040 of this chapter. Such an
			 insurance policy or certificate will not be offered, delivered, issued for
			 delivery, or renewed in this state or to a resident of this state unless it
			 meets the minimum standards for the specified categories or the Director finds
			 that the policies or contracts are allowable as limited benefit health
			 insurance, and the outline of coverage complies with the applicable model
			 outline of coverage for each category of coverage. An insurer will deliver an
			 outline of coverage to an applicant or enrollee with the sale.
			 (3-31-22)
02.
Renewability
. A "noncancellable," "guaranteed renewable," or
			 "noncancellable and guaranteed renewable" policy or certificate will not
			 provide for termination of coverage of the spouse solely because of the
			 occurrence of an event specified for termination of coverage of the insured,
			 other than nonpayment of premium. In addition, the policy will provide that in
			 the event of the insured's death, the spouse of the insured, if covered under
			 the policy, will become the insured. (3-31-22)
a. The terms "noncancellable," "guaranteed
			 renewable," or "noncancellable and guaranteed renewable" will not be used
			 without further explanatory language in accordance with the disclosure
			 requirements of Section
			 101 of this chapter.
			 (3-31-22)
b. The terms
			 "noncancellable" or "noncancellable and guaranteed renewable" may be used only
			 in a policy that the insured has the right to continue in force by the timely
			 payment of premiums set forth in the policy, during which period the insurer
			 has no right to make unilaterally any change in any provision of the policy
			 while the policy is in force. (3-31-22)
c. An individual accident and sickness or
			 individual accident-only policy that provides for periodic payments, weekly or
			 monthly, for a specified period during the continuance of disability resulting
			 from accident or sickness may provide that the insured has the right to
			 continue the policy only to age sixty (60) if, at age sixty (60), the insured
			 has the right to continue the policy in force at least to age sixty-five (65)
			 while actively and regularly employed. (3-31-22)
d. Except as provided in Subsection
			 030.02 of this chapter, (the
			 term "guaranteed renewable" may be used only in a policy that the insured has
			 the right to continue in force by the timely payment of premiums and, until the
			 age of sixty-five (65) or until eligibility for Medicare and to the extent not
			 in conflict with the federal Health Insurance Portability and Accountability
			 Act (HIPAA), during which period the insurer has no right to make unilaterally
			 any change in any provision of the policy while the policy is in force, except
			 where the insurer is able to show good cause for changing the policy provisions
			 and obtains prior written approval from the Director. The insurer may make
			 changes in premium rates by classes. (3-31-22)