§ 27-8-5-1 — Policy of accident and sickness insurance; filing; review; conformity with federal act

(a) The term "policy of accident and sickness
insurance", as used in this chapter, includes any policy or contract
covering one (1) or more of the kinds of insurance described in Class
1(b) or 2(a) of IC 27-1-5-1. Such policies may be on the individual
basis under this section and sections 2 through 9 of this chapter, on the
group basis under this section and sections 16 through 19 of this
chapter, on the franchise basis under this section and section 11 of this
chapter, or on a blanket basis under section 15 of this chapter and
(except as otherwise expressly provided in this chapter) shall be
exclusively governed by this chapter.
(b) No policy of accident and sickness insurance may be issued or
delivered to any person in this state, nor may any application, rider, or
endorsement be used in connection with an accident and sickness
insurance policy, until a copy of the form of the policy and of the
classification of risks and the premium rates, or, in the case of
assessment companies, the estimated cost pertaining thereto, have been
filed with and reviewed by the commissioner under section 1.5 of this
chapter. This section is applicable also to assessment companies and
fraternal benefit associations or societies.
(c) This chapter shall be applied in conformity with the
requirements of the federal Patient Protection and Affordable Care Act
(P.L. 111-148), as amended by the federal Health Care and Education
Reconciliation Act of 2010 (P.L. 111-152), as in effect on September
23, 2010.
(d) A policy of accident and sickness insurance that is issued or
delivered through a health benefit exchange established under the
federal Patient Protection and Affordable Care Act (P.L. 111-148), as
amended by the federal Health Care and Education Reconciliation Act
of 2010 (P.L. 111-152), is subject to the requirements of this chapter.
The commissioner may adopt rules under IC 4-22-2 to implement this
subsection, including rules concerning:
(1) certification or decertification of a qualified health plan (as
defined in IC 27-19-2-16); and
(2) open enrollment.
Formerly: Acts 1953, c.15, s.169.1; Acts 1975, P.L.281, SEC.1.
As amended by P.L.257-1985, SEC.1; P.L.7-1987, SEC.154;
P.L.173-2007, SEC.21; P.L.160-2011, SEC.17; P.L.278-2013,
SEC.23.