Group accident and health insurance is declared to be that form of accident and health insurance covering groups of persons as defined in this section, with or without one (1) or more members of their families or one (1) or more of their dependents, or covering one (1) or more members of the families or one (1) or more dependents of the groups of persons, and issued upon the following basis:
(1)(A) Under a policy issued to an employer or trustees of a fund established by an employer, who shall be deemed the policyholder, insuring employees of the employer for the benefit of persons other than the employer.
(B)The term "employees" as used in this subdivision (1) shall be deemed to include the:
(i)Officers, managers, and employees of the employer;
(ii)Individual proprietor or partner, if
Free access — add to your briefcase to read the full text and ask questions with AI
Group accident and health insurance is declared to be that form of accident and health insurance covering groups of persons as defined in this section, with or without one (1) or more members of their families or one (1) or more of their dependents, or covering one (1) or more members of the families or one (1) or more dependents of the groups of persons, and issued upon the following basis: (1) (A) Under a policy issued to an employer or trustees of a fund established by an employer, who shall be deemed the policyholder, insuring employees of the employer for the benefit of persons other than the employer. (B) The term "employees" as used in this subdivision (1) shall be deemed to include the: (i) Officers, managers, and employees of the employer; (ii) Individual proprietor or partner, if the employer is an individual proprietor or partnership; (iii) Officers, managers, and employees of subsidiary or affiliated corporations; and (iv) Individual proprietors, partners, and employees of individuals and firms, if the business of the employer and the individual or firm is under common control through stock ownership, contract, or otherwise. (C) The term "employees" as used in this subdivision (1): (i) May include retired employees; and (ii) Shall include members of limited liability corporations and members of limited liability partnerships. (D) A policy issued to insure employees of a public body may provide that the term "employees" shall include elected or appointed officials. (E) The policy may provide that the term "employees" shall include the trustees or their employees, or both, if their duties are principally connected with the trusteeship; (2) (A) Under a policy issued to an association, including a labor union, when the Insurance Commissioner finds that regardless of where the association is domiciled or does business, the association has: (i) Articles of incorporation and bylaws; (ii) At least one hundred (100) members; and (iii) Been organized and maintained in good faith in active existence for at least two (2) years for purposes other than that of obtaining insurance or insuring members, employees, or employees of members of the association for the benefit of persons other than the association or its officers or trustees. (B) The term "employees" as used in this subdivision (2) may include retired employees. (C) (i) Before issuing a group accident and health insurance policy to an association, the association or its insurer on behalf of the association shall file with the commissioner proof that the association meets the requirements of subdivision (2)(A) of this section. (ii) The commissioner shall approve or disapprove the association as an eligible group policyholder and maintain a list of approved associations. (iii) An insurer has satisfied the requirements of subdivision (2)(A) of this section if before July 31, 2009, the insurer has: (a) Filed its association plan or plans with the commissioner; and (b) Received the commissioner's approval of its forms. (D) The commissioner may: (i) Require a previously approved association to provide proof that the association meets the requirements of subdivision (2)(A) of this section; and (ii) Revoke the authority of a previously approved association to operate as an eligible group policyholder. (E) An insurer may not issue a group accident and health insurance policy to an association in which the insurer has an affiliation, including without limitation, common: (i) Board members, officers, executives, or employees; (ii) Ownership or control of the insurer and the association; or (iii) Use of office space or equipment utilized by the insurer to transact the business of insurance; (3) (A) Under a policy issued to the trustees of a fund established by two (2) or more employers in the same or related industry or by one (1) or more labor unions or by one (1) or more employers and one (1) or more labor unions or by an association as defined in subdivision (2) of this section, who shall be deemed the policyholder, to insure employees of the employers or members of the unions or of the association, or employees of members of the association, for the benefit of persons other than the employers or the unions or the association. (B) The term "employees" as used in this subdivision (3) may include: (i) The officers, managers, and employees of the employer and the individual proprietor or partners, if the employer is an individual proprietor or partnership; and (ii) Retired employees. (C) The policy may provide that the term "employees" shall include the trustees or their employees, or both, if their duties are principally connected with such trusteeship; (4) Under a policy issued to any person or organization to which a policy of group life insurance may be issued or delivered in this state to insure any classes of individuals that could be insured under the group life policy; and (5) Under a policy issued to cover any other substantially similar group that, in the discretion of the commissioner, may be subject to the issuance of a group accident and health policy or contract.