§ 31A-22-633 — Exemptions from standards.

Notwithstanding the provisions of this title, any accident and health insurer or health maintenance organization may offer a choice of coverage that is less or different than is otherwise required by applicable state law if:
(1) the Department of Health and Human Services offers a choice of coverage as part of a Medicaid waiver under Title 26B, Chapter 3, Health Care - Administration and Assistance, which includes:

(1)(a) less or different coverage than the basic coverage;
(1)(b) less or different coverage than is otherwise required in an insurance policy or health maintenance organization contract under applicable state law; or
(1)(c) less or different coverage than required by Subsection 31A-22-605(4)(b); and
(2) the choice of coverage offered by the carrier:

(2)(a) is the same or similar coverage as the coverage offered by the Department of Health and Human Services under Subsection (1);
(2)(b) is offered to the same or similar population as the coverage offered by the Department of Health and Human Services under Subsection (1); and
(2)(c) contains an explanation for each insured of coverage exclusions and limitations.

Legislative History

Amended by Chapter 328, 2023 General Session