§ 27-8-5-11 — Franchise plan; accident and sickness insurance; definitions, limitations, requirements, and standards

No policy of accident and sickness insurance
on a franchise plan shall be delivered or issued for delivery to any
person in this state unless it conforms to the definitions, limitations,
requirements and standards in this section prescribed:
(A) Qualified Groups.
(1) Two (2) or more employees of any employer, inclusive of any
governmental division, department or agency.
(2) Ten (10) or more members of any trade, occupational or
professional association or of a labor union, or of any other association
or group which has had an active existence for at least two (2) years
and which has a constitution or by-laws and was formed in good faith
for purposes other than that of obtaining insurance.
(3) Members of the family and dependents of persons eligible under
(1) or (2) above may be included in the group with such eligible
persons.
(B) Nature of Insurance Coverage. The insurance policies issued to
members of a qualified group shall be written on identical individual
policy form or forms, varying only as to amounts and kinds of coverage
applied for by such persons, and such policy form or forms shall
otherwise fulfill the requirements of sections 2 through 9 of this
chapter. The premiums for such policies may be paid to the insurer
periodically by the employer, with or without payroll deduction, or by
the association for its members, or by some designated person acting
on behalf of such employer or association.
(C) Rates, Benefits, Underwriting Procedures. Premium rates,
benefits and underwriting procedures relating to such individual
policies may differ from those relating to comparable individual
policies issued singly, but as between comparable groups such rates,
benefits and procedures shall be nondiscriminatory.
Formerly: Acts 1953, c.15, s.169.11. As amended by Acts 1981,
P.L.248, SEC.1.