§ 5-10-8-7.8 — Colorectal cancer testing coverage; exception for high deductible health plans

Indiana § 5-10-8-7.8

• Jurisdiction: Indiana
• Title 5: STATE AND LOCAL ADMINISTRATION
• Art. 10: PUBLIC EMPLOYEE BENEFITS
• Ch. 8: Group Insurance for Public Employees

Text

8. (a) As used in this section, "covered
individual" means an individual who is:
(1) covered under a self-insurance program established under
section 7(b) of this chapter to provide group health coverage; or
(2) entitled to services under a contract with a health maintenance
organization (as defined in IC 27-13-1-19) that is entered into or
renewed under section 7(c) of this chapter.
(b) A:
(1) self-insurance program established under section 7(b) of this
chapter to provide health care coverage; or
(2) contract with a health maintenance organization that is entered
into or renewed under section 7(c) of this chapter;
must provide coverage for colorectal cancer examinations and
laboratory tests for cancer for any nonsymptomatic covered individual.
(c) For a covered individual who is:
(1) at least forty-five (45) years of age; or
(2) less than forty-five (45) years of age and at high risk for
colorectal cancer;
the coverage required under this section must meet the requirements set
forth in subsection (d), except as provided in subsection (e).
(d) A covered individual may not be required to pay an additional
deductible or coinsurance for the colorectal cancer examination and
laboratory testing benefit required by this section that is greater than an
annual deductible or coinsurance established for similar benefits under
the self-insurance program or contract with a health maintenance
organization under which the covered individual is covered or entitled
to services. If the program or contract does not cover a similar benefit,
a deductible or coinsurance for the colorectal cancer examination and
laboratory testing benefit may not be set at a level that materially
diminishes the value of the colorectal cancer examination and
laboratory testing benefit.
(e) The requirements imposed under this section do not apply to a
high deductible health plan, as defined by Section 223 of the Internal
Revenue Code. High deductible health plans described in this
subsection may not excuse a deductible requirement with respect to
colorectal cancer screening in a manner inconsistent with Section
223(c)(2)(C) of the Internal Revenue Code.

Legislative History

As added by P.L.54-2000, SEC.1. Amended by P.L.36-2020, SEC.1.