§ 27-13-34-13 — Evidence of coverage; required information

(a) Every subscriber of a limited service
health maintenance organization shall be issued an evidence of
coverage in electronic or paper form, which must contain a clear and
complete statement of the following:
(1) The limited health services to which each enrollee is entitled.
(2) Any limitation of the services, kinds of services, or benefits to
be provided.
(3) Any exclusions, including any copayment or other charges.
(4) Where and in what manner information is available as to
where and how services may be obtained.
(5) The method for resolving complaints.
(b) Any amendment to the evidence of coverage may be provided
to the subscriber in a separate document in electronic or paper form.
(c) A limited service health maintenance organization shall issue the
evidence of coverage described in subsection (a) and an amendment
described in subsection (b) in paper form upon the request of the
subscriber.
(d) A limited service health maintenance organization shall include
in the limited service health maintenance organization's enrollment
materials information concerning the manner in which a subscriber
may:
(1) obtain an evidence of coverage; and
(2) request the evidence of coverage in paper form.

Legislative History

As added by P.L.26-1994, SEC.25. Amended by P.L.125-2005, SEC.8.