58-17-70 Application of 58-17-66 to 58-17-87, inclusive.
58-17-70.
Application of 58-17-66 to 58-17-87, inclusive.
Sections 58-17-66 to 58-17-87,
inclusive, apply to any individual health benefit plan or certificate delivered or issued for delivery
in the state. Sections 58-17-66 to 58-17-87, inclusive, apply to any certificate issued to an eligible
person that evidences coverage under a policy or contract issued to a trust or association or other
similar grouping of persons, regardless of the situs of delivery of the policy or contract, if the eligible
person pays the premium and is not being covered under the policy or contract pursuant to
continuation of benefit provisions applicable under federal or state law. The following are not
subject to the provisions of §§ 58-17-66 to 58-17-87, inclusive:
(1)
Any medicare supplement policy;
(2)
Any long-term care policy;
(3)
Any contract or certificate marketed on a group basis that is subject to regulation under
chapter 58-18B or §§ 58-18-42 to 58-18-51.1, inclusive;
(4)
Any certificate issued to an eligible person that evidences coverage under a professional
association plan;
(5)
Any policy or certificate of specified disease, short-term hospital-surgical care of six
months or less duration, hospital confinement indemnity, limited benefit health insurance,
or other policy or certificate that provide benefits less than as provided for under
subdivision 58-17-69(2) if the carrier offering the policy or certificate at the time of filing
for policy form approval, submits a statement certifying that policies or certificates
described in this section are being offered and marketed as supplemental health insurance
or as individual health benefit plans of six-month duration or less and not renewable, and
not as a substitute for hospital or medical expense insurance or major medical insurance.
For policy forms approved prior to July 1, 1996, the carrier shall submit such a statement
with the director. If such a statement certifying that the policies or certificates are being
offered as supplemental health insurance and not as a substitute for major medical
insurance is either not filed or is withdrawn, the carrier offering such coverage shall, in
addition to the policy or certificate providing coverage that is less than major medical,
offer and actively market an individual major medical policy to any person who is
solicited for coverage for the nonmajor medical products it offers.
Source: SL 1996, ch 286, § 5; SL 1998, ch 289, § 2; SL 2003 (SS), ch 1, § 29.
Chapter 58-17