Except as provided in sections 17 and 24 of
this chapter, no policy of group accident and sickness insurance may
be delivered or issued for delivery to a group that has a legal situs in
Indiana unless it conforms to one (1) of the following descriptions:
(1)A policy issued to an employer or to the trustees of a fund
established by an employer (which employer or trustees must be
deemed the policyholder) to insure employees of the employer for
the benefit of persons other than the employer, subject to the
following requirements:
(A)The employees eligible for insurance under the policy must
be all of the employees of the employer, or all of any class or
classes of employees. The policy may provide that the term
"employees" includes the employees of one (1) or more
subsidiary corporations an
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Except as provided in sections 17 and 24 of
this chapter, no policy of group accident and sickness insurance may
be delivered or issued for delivery to a group that has a legal situs in
Indiana unless it conforms to one (1) of the following descriptions:
(1) A policy issued to an employer or to the trustees of a fund
established by an employer (which employer or trustees must be
deemed the policyholder) to insure employees of the employer for
the benefit of persons other than the employer, subject to the
following requirements:
(A) The employees eligible for insurance under the policy must
be all of the employees of the employer, or all of any class or
classes of employees. The policy may provide that the term
"employees" includes the employees of one (1) or more
subsidiary corporations and the employees, individual
proprietors, members, and partners of one (1) or more affiliated
corporations, proprietorships, limited liability companies, or
partnerships if the business of the employer and of the affiliated
corporations, proprietorships, limited liability companies, or
partnerships is under common control. The policy may provide
that the term "employees" includes retired employees, former
employees, and directors of a corporate employer. A policy
issued to insure the employees of a public body may provide
that the term "employees" includes elected or appointed
officials.
(B) The premium for the policy must be paid either from the
employer's funds, from funds contributed by the insured
employees, or from both sources of funds. Except as provided
in clause (C), a policy on which no part of the premium is to be
derived from funds contributed by the insured employees must
insure all eligible employees, except those who reject the
coverage in writing.
(C) An insurer may exclude or limit the coverage on any person
as to whom evidence of individual insurability is not
satisfactory to the insurer.
(2) A policy issued to a creditor or its parent holding company or
to a trustee or trustees or agent designated by two (2) or more
creditors (which creditor, holding company, affiliate, trustee,
trustees, or agent must be deemed the policyholder) to insure
debtors of the creditor, or creditors, subject to the following
requirements:
(A) The debtors eligible for insurance under the policy must be
all of the debtors of the creditor or creditors, or all of any class
or classes of debtors. The policy may provide that the term
"debtors" includes:
(i) borrowers of money or purchasers or lessees of goods,
services, or property for which payment is arranged through
a credit transaction;
(ii) the debtors of one (1) or more subsidiary corporations;
and
(iii) the debtors of one (1) or more affiliated corporations,
proprietorships, limited liability companies, or partnerships
if the business of the policyholder and of the affiliated
corporations, proprietorships, limited liability companies, or
partnerships is under common control.
(B) The premium for the policy must be paid either from the
creditor's funds, from charges collected from the insured
debtors, or from both sources of funds. Except as provided in
clause (C), a policy on which no part of the premium is to be
derived from the funds contributed by insured debtors
specifically for their insurance must insure all eligible debtors.
(C) An insurer may exclude any debtors as to whom evidence
of individual insurability is not satisfactory to the insurer.
(D) The amount of the insurance payable with respect to any
indebtedness may not exceed the greater of the scheduled or
actual amount of unpaid indebtedness to the creditor. The
insurer may exclude any payments that are delinquent on the
date the debtor becomes disabled as defined in the policy.
(E) The insurance may be payable to the creditor or any
successor to the right, title, and interest of the creditor. Each
payment under this clause must reduce or extinguish the unpaid
indebtedness of the debtor to the extent of the payment, and any
excess of the insurance must be payable to the insured or the
estate of the insured.
(F) Notwithstanding clauses (A) through (E), insurance on
agricultural credit transaction commitments may be written up
to the amount of the loan commitment on a nondecreasing or
level term plan, and insurance on educational credit transaction
commitments may be written up to the amount of the loan
commitment less the amount of any repayments made on the
loan.
(3) A policy issued to a labor union or similar employee
organization (which must be deemed to be the policyholder) to
insure members of the union or organization for the benefit of
persons other than the union or organization or any of its officials,
representatives, or agents, subject to the following requirements:
(A) The members eligible for insurance under the policy must
be all of the members of the union or organization, or all of any
class or classes of members.
(B) The premium for the policy must be paid either from funds
of the union or organization, from funds contributed by the
insured members specifically for their insurance, or from both
sources of funds. Except as provided in clause (C), a policy on
which no part of the premium is to be derived from funds
contributed by the insured members specifically for their
insurance must insure all eligible members, except those who
reject the coverage in writing.
(C) An insurer may exclude or limit the coverage on any person
as to whom evidence of individual insurability is not
satisfactory to the insurer.
(4) A policy issued to a trust or to one (1) or more trustees of a
fund established or adopted by two (2) or more employers, or by
one (1) or more labor unions or similar employee organizations,
or by one (1) or more employers and one (1) or more labor unions
or similar employee organizations (which trust or trustees must be
deemed the policyholder) to insure employees of the employers
or members of the unions or organizations for the benefit of
persons other than the employers or the unions or organizations,
subject to the following requirements:
(A) The persons eligible for insurance must be all of the
employees of the employers or all of the members of the unions
or organizations, or all of any class or classes of employees or
members. The policy may provide that the term "employees"
includes the employees of one (1) or more subsidiary
corporations and the employees, individual proprietors, and
partners of one (1) or more affiliated corporations,
proprietorships, limited liability companies, or partnerships if
the business of the employer and of the affiliated corporations,
proprietorships, limited liability companies, or partnerships is
under common control. The policy may provide that the term
"employees" includes retired employees, former employees, and
directors of a corporate employer. The policy may provide that
the term "employees" includes the trustees or their employees,
or both, if their duties are principally connected with the
trusteeship.
(B) The premium for the policy must be paid from funds
contributed by the employer or employers of the insured
persons, by the union or unions or similar employee
organizations, or by both, or from funds contributed by the
insured persons or from both the insured persons and one (1) or
more employers, unions, or similar employee organizations.
Except as provided in clause (C), a policy on which no part of
the premium is to be derived from funds contributed by the
insured persons specifically for their insurance must insure all
eligible persons, except those who reject the coverage in
writing.
(C) An insurer may exclude or limit the coverage on any person
as to whom evidence of individual insurability is not
satisfactory to the insurer.
(5) A policy issued to an association or to a trust or to one (1) or
more trustees of a fund established, created, or maintained for the
benefit of members of one (1) or more associations. The
association or associations must have at the outset a minimum of
one hundred (100) persons, must have been organized and
maintained in good faith for purposes other than that of obtaining
insurance, must have been in active existence for at least one (1)
year, and must have a constitution and bylaws that provide that
the association or associations hold regular meetings not less than
annually to further purposes of the members, that, except for
credit unions, the association or associations collect dues or
solicit contributions from members, and that the members have
voting privileges and representation on the governing board and
committees. The policy must be subject to the following
requirements:
(A) The policy may insure members or employees of the
association or associations, employees of members, one (1) or
more of the preceding, or all of any class or classes of members,
employees, or employees of members for the benefit of persons
other than the employee's employer.
(B) The premium for the policy must be paid from funds
contributed by the association or associations, by employer
members, or by both, from funds contributed by the covered
persons, or from both the covered persons and the association,
associations, or employer members.
(C) Except as provided in clause (D), a policy on which no part
of the premium is to be derived from funds contributed by the
covered persons specifically for the insurance must insure all
eligible persons, except those who reject such coverage in
writing.
(D) An insurer may exclude or limit the coverage on any person
as to whom evidence of individual insurability is not
satisfactory to the insurer.
(6) A policy issued to a credit union, or to one (1) or more trustees
or an agent designated by two (2) or more credit unions (which
credit union, trustee, trustees, or agent must be deemed the
policyholder) to insure members of the credit union or credit
unions for the benefit of persons other than the credit union or
credit unions, trustee, trustees, or agent, or any of their officials,
subject to the following requirements:
(A) The members eligible for insurance must be all of the
members of the credit union or credit unions, or all of any class
or classes of members.
(B) The premium for the policy shall be paid by the
policyholder from the credit union's funds and, except as
provided in clause (C), must insure all eligible members.
(C) An insurer may exclude or limit the coverage on any
member as to whom evidence of individual insurability is not
satisfactory to the insurer.
(7) A policy issued to cover persons in a group specifically
described by another law of Indiana as a group that may be
covered for group life insurance. The provisions of the group life
insurance law relating to eligibility and evidence of insurability
apply to a group health policy to which this subdivision applies.
(8) A policy issued to a trustee or agent designated by two (2) or
more small employers (as defined in IC 27-8-15-14) as
determined by the commissioner under rules adopted under IC 4-22-2.