§ 27-13-9-7 — Electronic data base requirements; rulemaking authority

Indiana § 27-13-9-7

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 13: HEALTH MAINTENANCE ORGANIZATIONS
• Ch. 9: Information to Enrollees or Subscribers

Text

(a) The electronic data base by which a health
maintenance organization or by which a third party administrator of
benefits and health care services offered under a health maintenance
organization contract allows an enrollee or a provider to verify an
enrollee's coverage or benefits under a health maintenance organization
contract must include the following information for each enrollee:
(1) Whether benefits and health care services under the health
maintenance organization contract are provided by:
(A) the health maintenance organization; or
(B) a third party administrator.
(2) Whether the health maintenance organization contract is a
self-funded or fully-funded plan.
(b) The department shall adopt rules under IC 4-22-2 to ensure
compliance with this section.

Legislative History

As added by P.L.111-2020, SEC.15.