reglab/statecodes huggingface dataset:
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:260 - Conversion policy minimum benefits

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO: KRS 304.17A,
				304.18-110,
				304.18-114,
				304.18-120(2),
				29 C.F.R
				2590.715-2713(a), 29 C.F.R
				2590.715-2713(b)
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				Commissioner of Insurance to promulgate administrative regulations necessary
				for or as an aid to the effectuation of any provision of the Kentucky Insurance
				Code as defined in
				KRS
				304.1-010.
				KRS
				304.18-120(2) requires the
				department to promulgate administrative regulations to establish minimum
				benefits for a conversion policy issued pursuant to the conversion privilege
				contained in a group health policy. This administrative regulation establishes
				those requirements.
Section 1.
			 Definitions.
(1) "Conversion policy" means an
			 individual health policy issued to an insured person pursuant to a conversion
			 privilege contained in a group health policy upon termination of the insured
			 person's coverage under the group policy.
(2) "FFS" means a fee-for-service product
			 type.
(3) "Group policy" is defined
			 by
			 KRS
			 304.18-110(1)(a).
(4) "HMO" means a health maintenance
			 organization product type.
(5)
			 "POS" means a point-of-service product type.
(6) "PPO" means a preferred provider
			 organization product type.
(7)
			 "Preventive Health Service" means the service described by
			 29 C.F.R
			 2590.715-2713(a) and
			 (b).
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:270 - Telehealth claim forms and records

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.17A-005,
				304.17A-138,
				304.17A-700
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				commissioner to promulgate reasonable administrative regulations necessary for
				or as an aid to the effectuation of any provision of the Kentucky Insurance
				Code as defined in
				KRS
				304.1-010.
				KRS
				304.17A-138 requires that the department
				promulgate an administrative regulation in accordance with KRS Chapter 13A to
				designate the claim forms and records required to be maintained for telehealth
				claims. This administrative regulation establishes requirements for telehealth
				claim forms and records.
Section 1.
			 Definitions.
(1) "ADA" means American Dental
			 Association.
(2) "Electronic" or
			 "electronically" is defined by
			 KRS
			 304.17A-700(7).
(3) "HCFA" means Health Care Financing
			 Administration.
(4) "Health benefit
			 plan" is defined by
			 KRS
			 304.17A-005(22).
(5) "Health care provider" or "provider" is
			 defined by
			 KRS
			 304.17A-005(23).
(6) "Insurer" is defined by
			 KRS
			 304.17A-005(29).
(7) "National Uniform Billing Committee
			 (NUBC)" is defined by
			 KRS
			 304.17A-700(14).
(8) "Telehealth" is defined by
			 KRS
			 311.550(17).
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:300 - Provider agreement and risk-sharing agreement filing requirements

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.17A-150,
				304.17A-235,
				304.17A-500,
				304.17A-527,
				304.17A-530,
				304.17A-532,
				304.17A-560,
				304.17A-575,
				304.17A-578,
				304.17A-728,
				304.17C-060,
				304.17C-070,
				304.99
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				executive director to promulgate reasonable administrative regulations
				necessary to the effectuation of any provision of the Kentucky Insurance Code.
				KRS
				304.17A-527(1) and
				KRS
				304.17C-060(1) require the
				Department to promulgate administrative regulations regarding the manner and
				form of required filings of sample copies of provider agreements. This
				administrative regulation establishes the filing requirements of provider
				agreements, subcontract agreements, and risk sharing arrangements.
Section 1. Definitions.
(1) "Provider agreement" means a contract
			 between an insurer offering a managed care plan and a provider for the
			 provision of health care services.
(2) "Subcontract agreement" means a contract
			 for the provision of health care services to:
(a) An enrollee, which is negotiated between
			 a participating health care provider with a managed care plan and a
			 nonparticipating provider with a managed care plan; or
(b) A covered person, which is negotiated
			 between a risk sharing entity as identified in
			 KRS
			 304.17A-500(13) and a
			 provider.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:360 - Prompt payment of claims

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.17A-005,
				304.17A-700,
				304.17A-702(1),
				304.17A-704,
				304.17A-706,
				304.17A-708(1),
				304.17A-720,
				304.17A-722(3),
				304.17A-730,
				304.17C-090,
				304.99-123
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				commissioner to promulgate reasonable administrative regulations necessary for
				or as an aid to the effectuation of any provision of the Kentucky Insurance
				Code.
				KRS
				304.17A-722(1) requires the
				office to promulgate administrative regulations establishing reporting
				requirements regarding the prompt payment of claims by insurers offering health
				benefit plans. This administrative regulation establishes requirements for
				insurers offering health benefit plans and insurers offering limited health
				service benefit plans for the provision of dental-only benefits.
Section 1. Definition.
(1) "Health care clearinghouse" means an
			 entity that converts health care transactions into standardized formats and
			 forwards them to an insurer.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:370 - Standardized health claim attachments

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.17A-005,
				304.17A-607,
				304.17A-700-304.17A-730,
				304.17C-010,
				304.17C-090,
				304.39-010-304.39-340,,
				42 C.F.R.
				411.32,
				441.203,
				441.206,
				441.207,
				441.208,
				441.250,
				441.255,
				441.256,
				441.258
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				commissioner to promulgate reasonable administrative regulations necessary for
				or as an aid to the effectuation of any provision of the Kentucky Insurance
				Code as defined in
				KRS
				304.1-010.
				KRS
				304.17A-720(1) requires the
				department to promulgate administrative regulations prescribing standardized
				health claim attachments to be used by insurers. This administrative regulation
				establishes requirements for standardized health claim attachments and minimum
				requirements for routinely requested medical information health claim
				attachments.
Section 1. Definitions.
(1) "Clean claim" is defined by
			 KRS
			 304.17A-700(3).
(2) "Health benefit plan" is defined by
			 KRS
			 304.17A-005(22).
(3) "Health care provider" or "provider" is
			 defined by
			 KRS
			 304.17A-700(9).
(4)"Health claim attachments" is defined by
			 KRS
			 304.17A-700(10).
(5) "Insurer" is defined by
			 KRS
			 304.17A-005(29).
(6) "Limited health services benefit plan" is
			 defined by
			 KRS
			 304.17C-010(5).
(7) "Practitioner" means an individual
			 licensed or certified to provide a health care service in Kentucky.
(8) "Reparation obligor" is defined by
			 KRS
			 304.39-020(13).
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:450 - Insurance purchasing outlet requirements

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.1-050,
				304.2-310,
				304.4-010,
				304.9-052,
				304.17A-200,
				304.17A-245,
				304.17A-750-304.17A-770,
				304.47-020
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				Commissioner of Insurance to promulgate reasonable administrative regulations
				necessary for or as an aid to the effectuation of any provision of the Kentucky
				Insurance Code as defined in
				KRS
				304.1-010.
				KRS
				304.17A-752(3) authorizes
				the commissioner to promulgate administrative regulations necessary to
				administer
				KRS
				304.17A-750 through
				304.17A-770.
				KRS
				304.17A-758(8) requires the
				commissioner to promulgate regulations to establish fees for the initial
				registration and renewal of registration of an insurance purchasing outlet.
				KRS
				304.17A-760(1)(i) requires
				the commissioner to promulgate administrative regulations to establish a
				process for insurance purchasing outlets to prepare and file annual reports on
				the operations of the insurance purchasing outlet.
				KRS
				304.17A-762(3)(c) requires
				the commissioner to promulgate regulations to establish disclosures that are
				required to be made by the insurance purchasing outlet to insurance purchasing
				outlet members when the member enrolls.
				KRS
				304.17A-768(8) requires the
				commissioner to promulgate administrative regulations to implement the
				provisions of that section involving vouchers. This administrative regulation
				establishes insurance purchasing outlet requirements, procedures for
				registering insurance purchasing outlets, and the voucher process.
Section 1. Definitions.
(1) "Business entity" means an applicant for
			 a certificate of registration to act as an insurance purchasing
			 outlet.
(2) "Commissioner" is
			 defined by
			 KRS
			 304.1-050(1).
(3) "Department" is defined by
			 KRS
			 304.1-050(2).
(4) "Eligible employee" is defined by
			 KRS
			 304.17A-750(1).
(5) "Employer" is defined by
			 KRS
			 304.17A-750(3).
(6) "Insurance purchasing outlet" is defined
			 by
			 KRS
			 304.17A-750(4).
(7) "Insurance purchasing outlet member" or
			 "member" is defined by
			 KRS
			 304.17A-750(5).
(8) "Voucher" is defined by
			 KRS
			 304.17A-750(7).
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:470 - Data reporting to an employer-organized association health benefit plan

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.1-050,
				304.2-110(1),
				304.17A-005,
				304.17A-700(7),
				304.17A-846(1),
				45 C.F.R. 160, 45 C.F.R. 164
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				commissioner to promulgate reasonable administrative regulations necessary for,
				or as an aid to, the effectuation of any provision of the Kentucky Insurance
				Code as defined in
				KRS
				304.1-010.
				KRS
				304.17A-846 requires the department to
				promulgate an administrative regulation to implement its provisions and define
				the extent that health benefit plan information shall be provided to an
				employer-organized association. This administrative regulation establishes
				requirements for the provision of health benefit plan information to an
				employer-organized association by an insurer offering a health benefit
				plan.
Section 1. Definitions.
(1) "Aggregate claims experience" means the
			 total dollar amount paid to health care providers of medical and pharmacy
			 services for persons covered under an employer-organized association health
			 benefit plan.
(2) "Commissioner" is
			 defined by
			 KRS
			 304.1-050(1).
(3) "Complete request" means a written
			 request for employer-organized association health benefit plan information,
			 including:
(a) A certification by a
			 designated representative of the employer-organized association stating the:
1. Employer-organized association health
			 benefit plan has adopted safeguards and standards for the treatment of health
			 information pursuant to
			 45 C.F.R.
			 164.504(f); and
2. Information requested is the minimum
			 amount necessary to accomplish the intended purpose of the use or disclosure
			 pursuant to
			 45
			 C.F.R. 164.502(b) and
			 164.514(d);
			 and
(b) Specific and
			 sufficient details relating to the requested health benefit plan
			 information.
(4)
			 "Department" is defined by
			 KRS
			 304.1-050(2).
(5) "Electronically" is defined by
			 KRS
			 304.17A-700(7).
(6) "Employer-organized association" is
			 defined by
			 KRS
			 304.17A-005(12).
(7) "Employer-organized association health
			 benefit plan" means a health benefit plan issued to an employer-organized
			 association or trust established by one (1) or more employer-organized
			 associations.
(8) "Health benefit
			 plan" is defined by
			 KRS
			 304.17A-005(22).
(9) "HIPAA" means Health Insurance
			 Portability and Accountability Act of 1996,
			 Pub.L.
			 104-191.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:480 - Uniform evaluation and reevaluation of providers

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				205.560(12),
				216B.155(2),
				304.17A-005,
				304.17A-500,
				304.17A-545,
				304.17A-575,
				304.17A-576
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				commissioner to promulgate reasonable administrative regulations necessary for,
				or as an aid to, the effectuation of any provision of the Kentucky Insurance
				Code.
				KRS
				304.17A-545(5) requires the
				commissioner to promulgate administrative regulations to establish a uniform
				application form and guidelines for the evaluation and reevaluation of health
				care providers, including psychologists, who will be on a managed care plan's
				list of participating providers. This administrative regulation establishes the
				uniform application form and guidelines for evaluation and reevaluation of a
				health care provider, including a psychologist.
Section 1. Definitions.
(1) "Applicant" is defined by
			 KRS
			 304.17A-575(1).
(2) "Evaluation" or "credentialing" means:
(a) A process for collecting and verifying
			 professional qualifications of a health care provider;
(b) An assessment of a health care provider's
			 professional competence and conduct; and
(c) A process to be completed before a health
			 care provider may participate in a provider network of an insurer on an initial
			 or ongoing basis.
(3)
			 "Form KAPER-1" means the uniform application for credentialing or
			 recredentialing of a health care provider pursuant to
			 KRS
			 304.17A-545(5).
(4) "Health care provider" or "provider"
			 means a:
(a) Health care provider pursuant to
			 KRS
			 304.17A-005(23);
			 or
(b) Psychologist licensed under
			 KRS Chapter 319.
(5)
			 "Participating health care provider" means a participating health care provider
			 pursuant to
			 KRS
			 304.17A-500(10), including a
			 psychologist licensed under KRS Chapter 319.
(6) "Reevaluation" or "recredentialing"
			 means:
(a) A process for collecting and
			 reverifying professional qualifications of a participating health care
			 provider; and
(b) An assessment of
			 a participating health care provider's professional competence and
			 conduct.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:490 - Hospice benefit requirements

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.14-130,
				304.32-160,
				304.38-050
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) authorizes the
				Commissioner of Insurance to promulgate administrative regulations necessary
				for or as an aid to the effectuation of any provision of the Kentucky Insurance
				Code as defined in
				KRS
				304.1-010.
				KRS
				304.17A-250(6) requires all
				health benefit plans to cover hospice care at least equal to the Medicare
				benefits. EO 2003-064, filed December 23, 2003, created the Environmental and
				Public Protection Cabinet. EO 2004-031, filed January 6, 2004, abolished the
				Department of Insurance and transferred all its "duties, functions,
				responsibilities, records, equipment, staff and support budgets" to the Office
				of Insurance. This administrative regulation clarifies the requirement that a
				health benefit plan shall provide a hospice benefit at least equal to the
				Medicare hospice benefit.
Section 1.
			 Definitions.
(1) "Health benefit plan" is
			 defined in
			 KRS
			 304.17A-005(22).
(2) "Health savings account" is defined in
			 26 U.S.C.
			 223(d).
(3) "High deductible health plan" means a
			 health benefit plan that qualifies as a high deductible health plan as defined
			 in
			 26 U.S.C.
			 223(c)(2).
(4) "Hospice" means an entity defined in
			 42
			 C.F.R. 418.3 and approved by Medicare or
			 licensed pursuant to KRS Chapter 216B.
(5) "Hospice benefit" means services
			 described in 42 C.F.R. Part 418 , Subpart F if provided by a hospice.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:510 - Health benefit plan exclusionary rider requirements (Repealed)

Current through Register Vol. 51, No. 1, July 1, 2024
STATUTORY AUTHORITY:
				  KRS
				  304.2-110(1),
				  304.17A-565
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:511 - Repeal of 806 KAR 017:095, 806 KAR 017:170, and 806 KAR 017:510 (Repealed)

Current through Register Vol. 51, No. 1, July 1, 2024
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:531 - Repeal of 806 KAR 17:350

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.17B-021(2),
				304.17B-023
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 authorizes the Commissioner of the
				Department of Insurance to promulgate regulations to aid in the effectuation of
				any provision of the Insurance Code, as defined in
				KRS
				304.1-010.
				KRS
				13A.310 requires that an administrative
				regulation, once adopted, cannot be withdrawn, but shall be repealed if it is
				desired that it no longer be effective. The intent of this administrative
				regulation is to repeal
				806 KAR 17:350. The Department
				would like to repeal
				806 KAR 17:350 Guaranteed
				Acceptance Program (GAP) reporting requirements, because this administrative
				regulation does not fall under the Insurance Code (KRS 304) any longer being
				that KRS
				304.17B was repealed in its entirety.
Section 1.
								806 KAR 17:350, Guaranteed
			 Acceptance Program (GAP) reporting requirements, is hereby repealed.
STATUTORY AUTHORITY:
				  KRS
				  304.2-110(1),
				  304.17B-031(1)
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:575 - Pharmacy benefit managers

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.1-050,
				304.2-160,
				304.2-165,
				304.9-020,
				304.17A-161,
				304.17A-162
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110(1) provides that
				the commissioner may make reasonable administrative regulations necessary for,
				or as an aid to, the effectuation of any provision of the Kentucky Insurance
				Code.
				KRS
				304.17A-162 requires the department to
				promulgate administrative regulations establishing the manner in which a
				pharmacy benefit manager shall respond to an appeal regarding maximum allowable
				cost pricing, the manner in which a pharmacy benefit manager makes available to
				contracted pharmacies information regarding sources for drug price data, a
				comprehensive list of drugs subject to maximum allowable cost and the actual
				maximum allowable cost for each drug, and weekly updates to the list.
				KRS 304.2-160,
				304.2-165,
				304.9-020,
				304.17A-161,
				and
				304.17A-162
				together provide authority for the department's regulation of pharmacy benefit
				managers and the specific maximum allowable cost pricing and appeal process set
				forth in this administrative regulation. This administrative regulation
				establishes the process for a pharmacy benefit manager's maximum allowable cost
				appeals process, the process for the department's review of a complaint
				associated with a maximum allowable cost appeal, and the requirements for the
				cost listings made available by a pharmacy benefit manager.
Section 1. Definitions.
(1) "Contracted pharmacy" or "pharmacy" is
			 defined by
			 KRS
			 304.17A-161(1).
(2) "Department" is defined by
			 KRS
			 304.1-050(2).
(3) "Maximum Allowable Cost" is defined by
			 KRS
			 304.17A-161(3).
(4) "Pharmacy Benefit Manager" is defined by
			 KRS
			 304.17A-161(4).
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:580 - Definition of health care provider

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.17A-005(23)
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 authorizes the Commissioner of
				Insurance to promulgate administrative regulations necessary for or as an aid
				to the effectuation of any provision of the Kentucky Insurance Code as defined
				in
				KRS
				304.1-010.
				KRS
				304.17A-005(23)(j)
				authorizes the Department to promulgate an administrative regulation to
				determine other health care practitioners to be added to the definition of
				"health care provider" or "provider" for use in KRS Chapter 304, Subtitle 17A.
				This administrative regulation implements
				KRS
				304.17A-005(23)(j).
Section 1. In addition to the health care
			 practitioners listed in
			 KRS
			 304.17A-005(23)(a) - (i),
			 the definition of "health care provider" or "provider" in
			 KRS
			 304.17A-005(23) shall
			 include a pharmacy licensed under the provisions of KRS Chapter 315.
STATUTORY AUTHORITY:
				  KRS
				  304.2-110,
				  304.17A-005(23)(j)
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:585 - Annual report mental health parity nonquantitative treatment limitation compliance

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.1-050(1),
				304.17A-660,
				304.17A-669,
				45 C.F.R.
				146.136,
				45 C.F.R.
				147.160,
				42 U.S.C.
				300gg-26
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 authorizes the Commissioner of
				Insurance to promulgate administrative regulations necessary for or as an aid
				to the effectuation of any provision of the Kentucky Insurance Code as defined
				in KRS
				304.1-010.
				KRS
				304.17A-661 requires an insurer that issues
				or renews a health benefit plan to annually report to the commissioner the
				self-compliance with the federal Mental Health Parity and Addiction Equity Act,
				42 U.S.C.
				300gg-26, related to nonquantitative
				treatment limitations between medical and surgical benefits and mental health
				substance use disorder benefits, to demonstrate that these treatment
				limitations are applied comparably and requires the commissioner to establish a
				form for this purpose. This administrative regulation establishes the format
				and submission time frame for the data reporting requirements in
				KRS
				304.17A-661.
Section 1. Definitions.
(1) "Commissioner" is defined by
			 KRS
			 304.1-050(1).
(2) "Insurer" is defined by
			 KRS
			 304.17A-005(29).
(3) "Nonquantitative treatment limitations"
			 as defined by KRS
			 304.17A-660(3).
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 17 - Health Insurance Contracts › Section 806 KAR 17:590 - Annual report on providers prescribing medication for addiction treatment

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO: KRS 304.1-050(1) 304.9-020, 304.9-055,
				304.17A-005(29), 304.17A-732
NECESSITY, FUNCTION, AND CONFORMITY: KRS 304.2-110 authorizes
				the Commissioner of the Department of Insurance to promulgate administrative
				regulations necessary for or as an aid to the effectuation of any provision of
				the Kentucky Insurance Code, as defined in KRS 304.1-010. KRS 304.17A-732
				requires insurers to annually report to the commissioner the number and type of
				providers that have prescribed medication for addiction treatment to its
				insureds in conjunction with behavioral therapy and not in conjunction with
				behavioral therapy. This administrative regulation sets forth the format and
				submission time frame for the data reporting requirements in KRS 304.17A-732.
Section 1. Definitions.
(1) "Commissioner" is defined by KRS 304.1-050(1).
(2) "Department" is
			 defined by KRS 304.1-050(2).
(3)
			 "Insurer" is defined by KRS 304.17A-005(29).
(4) "Medication for addiction treatment"
			 means a prescription drug that:
(a)
1. Is prescribed for use in the treatment of
			 alcohol or opioid addiction; and
2.
			 Contains methadone, buprenorphine, or naltrexone; or
(b) Was approved before January 1, 2022, by
			 the United States Food and Drug Administration for the mitigation of opioid
			 withdrawal symptoms.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 18 - Group and Blanket Health Insurance › Section 806 KAR 18:020 - Preferred and exclusive provider arrangements

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.12-010,
				304.18-040,
				304.32-080
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 and
				KRS
				304.32-250 provide that the commissioner may
				make reasonable administrative regulations necessary for or as an aid to the
				effectuation of any provision of the Kentucky Insurance Code. This
				administrative regulation establishes guidelines for the use of preferred
				provider arrangements for group health insurers.
Section 1. Definitions.
(1) "Alternative delivery system" means a
			 health care delivery system characterized by alliances between selected health
			 care providers and insurers, employers, or both, managed care through greater
			 utilization controls, or discounted fee or capitation payment arrangements with
			 health care providers, as distinguished from the traditional fee-for-service
			 delivery approach.
(2) "Exclusive
			 provider arrangement" means an alternative delivery system in which an insurer
			 contracts with health care providers for alternative rates of payment and
			 requires insureds or subscribers to use the health care providers under
			 contract with the insurer.
(3)
			 "Insurer" is defined by
			 KRS
			 304.17A-005(27).
(4) "Preferred provider arrangement" means an
			 alternative delivery system under which an insurer contracts with health care
			 providers for alternative rates of payment and allows insureds or subscribers
			 to choose between contract health care providers and noncontract health care
			 providers.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 19 - Credit Life Insurance and Credit Health Insurance › Section 806 KAR 19:010 - Credit transaction requirements

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.19-040,
				304.19-080,
				304.19-090
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 provides that the Commissioner of
				Insurance may make reasonable rules and regulations necessary for or as an aid
				to the effectuation of any provision of the Kentucky Insurance Code. This
				administrative regulation delineates conditions that must be met in the
				issuance of life insurance in connection with a credit transaction.
Section 1.
(1) The premiums charged for life insurance
			 issued in connection with credit transactions shall conform to the loan
			 schedule in the installment contract. Level term life insurance will be
			 permitted on level loans, as well as coverage which provides for term insurance
			 on consecutive reducing levels designed to reflect periodic (annual or
			 semiannual) reductions of the loan balance, and decreasing term or group
			 indebtedness coverage for loans providing for regular uniform monthly reduction
			 corresponding to the loan balance.
(2) The debtor shall acknowledge receipt of a
			 statement that indicates the maximum percentage of the loan payable at death
			 under the insurance policy if the policy does not cover the full amount of the
			 loan.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 19 - Credit Life Insurance and Credit Health Insurance › Section 806 KAR 19:020 - Claims; secondary beneficiary

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.19-070,
				304.16-040
NECESSITY, FUNCTION, AND CONFORMITY: KRS 304.2-10 provides that
				the Commissioner of Insurance may make reasonable rules and regulations
				necessary for or as an aid to the effectuation of any provision of the Kentucky
				Insurance Code. This administrative regulation sets forth who is responsible
				for making claims under a credit life insurance policy and how payment is to be
				made if there is any balance due to a secondary beneficiary or the debtor's
				estate.
Section 1. It shall be the
			 duty of the creditor to furnish to the insurer, as soon as practical following
			 a loss under a credit life insurance policy, a notice of loss setting forth
			 complete and accurate details as to the net amount due it, computed on an early
			 payment basis, including the balance, if any, due to the secondary beneficiary
			 or the debtor's estate. It shall be the insurer's duty to pay such balance, if
			 any, by separate check, and deliver it to the creditor for proper disbursement
			 or delivery.
Section 2. In the case
			 of a debtor group policy only, creditor-beneficiary shall have the right as
			 policyholder to terminate coverages and to receive dividends and rate
			 credits.
STATUTORY AUTHORITY:
				  KRS
				  304.2-100
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 19 - Credit Life Insurance and Credit Health Insurance › Section 806 KAR 19:040 - Extinguishment of debt; options

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS 304.19-060,
				304.19-070
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 provides that the Commissioner of
				Insurance may make reasonable rules and regulations necessary for or as an aid
				to the effectuation of any provision of the Kentucky Insurance Code. This
				administrative regulation provides the debtor a choice, when a debt
				extinguished which is covered by any type of credit insurance, to retain the
				insurance coverage or to receive a pro rata return of the premium.
Section 1. In the event of extinguishment of
			 a debt by prepayment wherein the credit transaction is secured by any type of
			 credit insurance, and the debt is not renewed or refinanced, termination of
			 such insurance is not required, and may, at the option of the debtor, continue
			 for the benefit of the secondary beneficiary. The agent shall, within ten (10)
			 days of the extinguishment of the debt, notify the debtor of the debtor's
			 option to continue the insurance or receive a pro rata return of the
			 premiums.
Section 2. In the event
			 the debtor elects to continue such insurance in force, the agent shall give
			 written notice to the insurer within ten (10) days of the date the debtor makes
			 his election, that the debt is extinguished and that the insurance is to remain
			 in force for the benefit of the secondary beneficiary.
STATUTORY AUTHORITY:
				  KRS
				  304.2-110
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 19 - Credit Life Insurance and Credit Health Insurance › Section 806 KAR 19:050 - Combined health and dismemberment restrictions

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.19-080,
				304.19-120
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 authorizes the Commissioner of
				Insurance to promulgate administrative regulations necessary for or as an aid
				to the effectuation of any provision of the Kentucky Insurance Code as defined
				in
				KRS
				304.1-010. This administrative regulation
				prohibits the writing of health and dismemberment insurance in connection with
				a credit transaction unless the debtor has a choice upon extinguishment of the
				debt, to receive a refund of premiums paid for the unused insurance, or to
				continue the coverage under the unused insurance.
Section 1. An insurer shall not write or
			 issue any health and dismemberment insurance policy in connection with a credit
			 transaction subject to the provisions of KRS Chapter 304, Subtitle 19 that,
			 alone or in conjunction with the policy, is expressly written as security for a
			 loan. Unless the debt is extinguished prior to maturity at the end of the
			 claim, the insurer shall grant the debtor the choice to receive a refund of
			 premiums paid for the unused insurance or to continue the coverage afforded by
			 the unused policy.
STATUTORY AUTHORITY:
				  KRS
				  304.2-110
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 19 - Credit Life Insurance and Credit Health Insurance › Section 806 KAR 19:060 - Joint lives

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS 288.560,
				291.480,
				304.19-020,
				304.19-080
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 authorizes the Commissioner of
				Insurance to promulgate administrative regulations necessary for or as an aid
				to the effectuation of any provision of the Kentucky Insurance Code as defined
				in
				KRS
				304.1-010. This administrative regulation
				prohibits the insuring of joint lives, unless the spouse of the debtor is a
				cosigner to the credit or finance transaction.
Section 1. An agent or insurer shall not
			 deliver or issue for delivery in this state any policy of credit life, or
			 health insurance, or any certificate of group insurance, that insures the life
			 or health of more than one (1) individual, unless the spouse of the debtor is
			 cosigner to the credit or finance transaction.
Section 2. If a married couple is insured
			 under the exception provided in Section 1 of this administrative regulation,
			 the premium rate charged shall not exceed one hundred fifty (150) percent of
			 the rate permissible in
			 KRS
			 304.19-080.
Section 3. Only one (1) individual credit
			 life insurance policy and one (1) credit health insurance policy shall be
			 issued as security for a single indebtedness.
Section 4. This administrative regulation
			 shall not be construed to authorize the insuring of joint lives by credit life
			 or credit health insurance in credit transactions involving a small loan or
			 industrial loan in violation of
			 KRS
			 288.560(2) or
			 291.480(1)(b).
STATUTORY AUTHORITY:
				  KRS
				  304.2-110
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 20 - Casualty Insurance Contracts › Section 806 KAR 20:010 - Declination, cancellation, and nonrenewal of property and casualty insurance and automobile liability insurance policies

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.12-020,
				304.14-120,
				304.14-210,
				304.20-040,
				304.20-160,
				304.20-300-304.20-350,
				304.30-110
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 authorizes the Commissioner of the
				Department of Insurance to make reasonable administrative regulations necessary
				for or as an aid to the effectuation of any provision of the Kentucky Insurance
				Code.
				KRS
				304.30-070 authorizes the Commissioner of the
				Department of Insurance to make reasonable administrative regulations necessary
				for the effectuation of any provision of KRS Chapter 304.30. This
				administrative regulation establishes guidelines for the declination,
				cancellation, and nonrenewal of property and casualty insurance pursuant to
				KRS
				304.20-300 to
				304.20-350,
				and automobile liability insurance policies under
				KRS
				304.20-040.
Section 1. Notice of Reason for Declination,
			 Cancellation, or Nonrenewal.
(1) All notices
			 requiring reasons for declination, cancellation, or nonrenewal under
			 KRS
			 304.20-320 shall provide specific grounds,
			 and shall not rely on general underwriting reasons.
(2) All notices of cancellation and
			 nonrenewal of automobile liability insurance policies under
			 KRS
			 304.20-040 shall be in writing and inform the
			 applicant or insured of the specific reason for cancellation or
			 nonrenewal.
(3) Subsection (1) of
			 this section shall not apply for a declination, cancellation, or nonrenewal
			 where specific information available for review by the commissioner of the
			 Department of Insurance indicates the insured has contributed to the loss by
			 arson or fraud.
(4) The fact that
			 the reason or reasons for declination, cancellation, or nonrenewal have been
			 obtained through an investigative consumer report subject to the Fair Credit
			 Reporting Act,
			 15 U.S.C.
			 1681 et seq., shall not relieve the insurer
			 from the requirement of notifying the insured of the declination, cancellation,
			 or nonrenewal pursuant to
			 KRS
			 304.20-040 and
			 KRS
			 304.20-300 to
			 304.20-350.
			 However, any insured wishing to learn the substance of an investigative
			 consumer report shall be directed to contact the consumer reporting agency and
			 follow the procedures contained in the Fair Credit Reporting Act.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 26 - Insider Trading of Equity Securities › Section 806 KAR 26:010 - Proxies, consents and authorizations

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.26-050
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 provides that the Commissioner of
				Insurance may make reasonable rules and administrative regulations necessary
				for or as an aid to the effectuation of any provision of the Kentucky Insurance
				Code.
				KRS
				304.26-050 gives the commissioner the
				authority to regulate any form of proxies, consents and authorizations. This
				administrative regulation sets out the requirements for proxies and their
				solicitation, consents, and authorizations.
Section
			 1. Definitions.
(1) The
			 definitions set out in Schedule SIS, as promulgated by the National Association
			 of Insurance Commissioners, shall be applicable for purposes of this
			 administrative regulation.
(2) The
			 terms "solicit" and "solicitation" for purposes of this administrative
			 regulation shall include:
(a) Any request for
			 proxy, whether or not accompanied by or included in a form of proxy;
			 or
(b) Any request to execute or
			 not to execute, or to revoke a proxy; or
(c) The furnishing of a proxy or other
			 communications to security holders under circumstances reasonably calculated to
			 result in the procurement, withholding or revocation of a proxy.
(3) The terms "solicit" and
			 "solicitation" shall not include:
(a) Any
			 solicitation by a person in respect to equity security of which he is the
			 beneficial owner;
(b) Action by a
			 broker or other person in respect to equity security carried in his name or in
			 the name of his nominee in forwarding to the beneficial owner of such equity
			 security soliciting material received from the company, or impartially
			 instructing the beneficial owner to forward a proxy to the person, if any, to
			 whom the beneficial owner with respect to the authority to be conferred by the
			 proxy and stating that a proxy will be given if the instructions are received
			 by a certain date;
(c) The
			 furnishing of a form of proxy to a security holder upon the unsolicited request
			 of such security holder, or the performance by any person of ministerial acts
			 on behalf of a person soliciting a proxy.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 30 - Insurance Premium Finance Companies › Section 806 KAR 30:010 - License procedure

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.3-230,
				304.30-030
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.30-070 authorizes the commissioner to
				make reasonable administrative regulations to effectuate subtitle 30 of the
				Kentucky Insurance Code and to regulate the manner in which licensed insurance
				premium finance companies conduct their business. This administrative
				regulation sets forth license procedures.
Section
			 1. Application for Original or Renewal License. Each application
			 for an original or renewal license as an insurance premium finance company
			 shall be made on the Application for License as an Insurance Premium Finance
			 Company form. It shall be accompanied by all required documents and the license
			 fee provided by
			 806 KAR
			 4:010 which shall not be prorated. Each application
			 for renewal of a license as an insurance premium finance company shall be made
			 on or before May 1 of each year and shall be accompanied by the renewal fee
			 provided by
			 806 KAR
			 4:010.
Section
			 2. Biographical Questionnaire.
(1) Each application for an original license
			 as an insurance premium finance company shall be accompanied by biographical
			 information for the persons specified in this section on the Biographical
			 Questionnaire for Premium Finance Companies form. A separate form shall be
			 completed and executed:
(a) In the case of a
			 sole proprietor, by the sole proprietor;
(b) In the case of a partnership or limited
			 partnership, by each partner or limited partner;
(c) In the case of a corporation, by each
			 officer, director, and owner of more than ten (10) percent, directly or
			 indirectly, of the outstanding shares of stock; and
(d)In the case of any other business
			 organization, by each member or holder of record or beneficial interest
			 therein.
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 30 - Insurance Premium Finance Companies › Section 806 KAR 30:020 - Abuse of minimum service charge

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.30-050,
				304.30-090(3)
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.30-070 authorizes the commissioner to
				promulgate administrative regulations to effectuate the provisions of the
				Kentucky Insurance Code, as defined in
				KRS
				304.1-010, and to regulate the manner in
				which licensed insurance premium finance companies conduct their business. This
				administrative regulation establishes a prohibition on abuse of the finance
				agreement service charge.
Section 1.
			 Abuse of Finance Agreement Service Charge Prohibited. An insurance agent,
			 broker, or premium finance agency shall not induce an insured to become
			 obligated under more than one (1) premium finance agreement for the purpose of
			 obtaining more than one (1) service charge, as specified in
			 KRS
			 304.30-090(3).
STATUTORY AUTHORITY:
				  KRS
				  304.30-070
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 30 - Insurance Premium Finance Companies › Section 806 KAR 30:030 - Representations of licensee limited

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS 304.30-020
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.30-070 authorizes the commissioner to
				make reasonable administrative regulations to effectuate Subtitle 30 of the
				Kentucky Insurance Code. This administrative regulation limits the
				representations of a licensee.
Section
			 1. No licensee shall represent, either orally or in writing,
			 directly or indirectly, by any means whatsoever, including but not limited to
			 the use of any office sign (except its duly issued license) or the use and
			 circulation of any letterheads, bill heads, blank forms, notes, receipts,
			 certificates, circulars, or any written or printed or partly written or printed
			 matter whatever, that it is licensed by or subject to the supervision of the
			 Commissioner of Insurance, except by use of the following phrase: "Licensed,
			 pursuant to Chapter 304 of the Kentucky Revised Statutes, only for the purpose
			 of engaging in the business of a premium finance agency." Provided, however,
			 the use or use and circulation of any written or printed matter containing the
			 foregoing phrase may only be in connection with the licensee's business as a
			 premium finance agency.
STATUTORY AUTHORITY:
				  KRS
				  304.30-070
Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 30 - Insurance Premium Finance Companies › Section 806 KAR 30:040 - Statement of account and receipt

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.30-050
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.30-070 authorizes the commissioner to
				make reasonable administrative regulations to effectuate the provisions of
				Subtitle 30 of the Kentucky Insurance Code and to regulate the manner in which
				licensed insurance premium finance companies conduct their business. This
				administrative regulation requires a premium finance company to give a
				statement of account and receipt.
Section
			 1. Statement of Account, Receipts.
(1) At any time after its execution, but not
			 later than one (1) year after the last payment thereunder, a licensee holding a
			 premium finance agreement shall, upon written request of the insured, give or
			 mail to him a written statement of the dates and amounts of payments and the
			 total amount, if any, unpaid thereunder. Such a statement shall be supplied
			 once each year without charge; if any additional statement is requested, the
			 premium finance agency shall supply such statement at a charge not exceeding
			 one (1) dollar for each additional statement so supplied.
(2) After the payment of all sums for which
			 an insured is obligated under a premium finance agreement, and upon his written
			 demand, the premium finance company holding the agreement shall deliver or mail
			 to the insured at his last known address such one (1) or more good and
			 sufficient instruments as may be necessary to acknowledge payment in full and
			 to release all interests in or rights to the insurance contracts the premiums
			 for which are advanced or are to be advanced under the agreement.
(3) The insured shall be given a receipt for
			 a payment when made in cash.