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Title: 17 - CORPORATIONS AND INSTITUTIONS FOR FINANCE AND INSURANCE

Chapter: 48E -

17:48e-1: Definitions.

17:48e-2: Establishment of health service corporation

17:48e-3: Health service corporations

17:48e-4: Certificate of authority

17:48e-5: Merger procedure

17:48e-6: Board of health service corporation formed through merger

17:48e-7: Board of directors of health service corporation

17:48e-8: Vacancy procedure

17:48e-9: Executive committee

17:48e-10: Agreements with service providers

17:48e-10.1: Health service corporation to receive, transmit transactions electronically; standards.

17:48e-10.2: Payment of out-of-network dental benefits by health service corporation.

17:48e-11: Professional Advisory Committee

17:48e-12: Eligible providers' services.

17:48e-13: Approval of forms

17:48e-13.1: Health service corporation contract; compliance

17:48e-13.2: Filing of contract or related form

17:48e-13.3: Contract forms; certification memorandum

17:48e-14: Individual contract requirements

17:48e-15: Classification permitted

17:48e-15.1: Eligibility for enrollment in health service corporation

17:48e-15.2: Health service corporation contract, exclusion, rates, terms based on genetic information prohibited

17:48e-16: Joint ventures

17:48e-17: Expense limits; investments; administrative services

17:48e-17.1: Two special contingent surplus accounts

17:48e-17.2: Special contingent surplus required for health service corporation

17:48e-17.3: Examination of annual regulatory filings; annual audit.

17:48e-17.4: Health service corporation, aggregate benefits.

17:48e-18: Annual contract, renewal; family coverage

17:48e-19: Provisions of subscription certificates

17:48e-20: Coverage for newborn child

17:48e-21: Coverage for former spouse

17:48e-22: Coverage for child with intellectual disability, physical handicap.

17:48e-22.1: Health service corporations to offer basic health care contracts

17:48e-22.2: Provisions of basic health care contract

17:48e-23: Group contracts

17:48e-24: Provisions of group contract forms

17:48e-25: "Employee" coverage

17:48e-26: Experience rating

17:48e-27: Rate schedule filing

17:48e-27.1: Individual contract rate changes

17:48e-28: Group coverage for newborn child

17:48e-29: Nongroup coverage for former spouse

17:48e-30: Group coverage for child with intellectual disability, physical handicap.

17:48e-30.1: Coverage for certain dependents until age 31 by health service corporation.

17:48e-31: Family coverage after member's death

17:48e-32: Continuation of coverage for totally disabled

17:48e-32.1: Coverage provided by health service corporation for subscriber's child

17:48e-32.2: Requirements applicable to State Medicaid

17:48e-33: Second, third surgical opinions

17:48e-34: Alcoholism treatment benefits

17:48e-35: Reconstructive breast surgery benefits

17:48e-35.1: Benefits for home treatment of hemophilia

17:48e-35.2: Health service corporation insurance benefits for preexisting condition

17:48e-35.3: Health service corporation to pay benefits for treatment of Wilm's tumor

17:48e-35.4: Health service corporation contract, mammogram examination benefits.

17:48e-35.5: Health service corporation, benefits for "off-label" drugs required

17:48e-35.6: Health service corporation, benefits for health promotion

17:48e-35.7: Requirements for health service corporation providing benefits for pharmacy services.

17:48e-35.8: Benefits for certain cancer treatments

17:48e-35.9: Coverage for birth and natal care; health service corporation

17:48e-35.10: Health service corporation contracts, child screening, blood lead, hearing loss; immunizations.

17:48e-35.11: Coverage for diabetes treatment by individual group health service corporation

17:48e-35.12: Health service corporation contract, Pap smear benefits

17:48e-35.13: Health service corporation contract, prostate cancer testing

17:48e-35.14: Coverage for minimum inpatient care following mastectomy by individual, group health service corporation

17:48e-35.15: Applicability of Health Care Quality Act

17:48e-35.16: Coverage for treatment of inherited metabolic diseases by health service corporation.

17:48e-35.17: Health service corporation to cover certain audiology, speech-language pathology services.

17:48e-35.18: Coverage for treatment of domestic violence injuries by health service corporation.

17:48e-35.19: Coverage for certain dental procedures for the severely disabled or child age five or under by health service corporation

17:48e-35.20: Health service corporation to provide coverage for biologically-based mental illness.

17:48e-35.21: Coverage for hemophilia services by health service corporation

17:48e-35.22: Health service corporation to provide coverage for treatment of infertility.

17:48e-35.23: Health service corporation to provide coverage for colorectal cancer screening.

17:48e-35.24: Health service corporation prescription drug plans to cover certain infant formulas.

17:48e-35.25: Contract issued under C.17:48E-1 et seq. required to cover certain out-of-network services.

17:48e-35.26: Health service corporation to offer coverage for domestic partner.

17:48e-35.27: Health service corporation, high deductible, coverage for preventive care.

17:48e-35.28: Health service corporation, high deductible, deductible inapplicable, certain circumstances.

17:48e-35.29: Health service corporation, coverage for prescription female contraceptives.

17:48e-35.30: Health service corporation to provide benefits for orthotic and prosthetic appliances.

17:48e-35.31: Health service corporation to provide coverage for hearing aids for certain persons aged 15 or younger.

17:48e-35.32: Individual, group health service corporation to provide installment payments to obstetrical provider for maternity services.

17:48e-35.33: Health service corporation to provide benefits for treatment of autism or other developmental disability.

17:48e-35.34: Health service corporation to provide coverage for oral anticancer medications.

17:48e-35.35: Health service corporation to provide coverage for sickle cell anemia.

17:48e-35.36: Health service corporation to provide coverage for prescription eye drops.

17:48e-35.37: Health service corporation contract, coverage for synchronization of prescribed medications.

17:48e-35.38: Health service corporation to provide benefits for treatment of substance use disorder.

17:48e-35.39: Health service corporation to provide coverage regardless of gender identity, expression.

17:48e-35.40: Health service corporation contract to cover digital tomosynthesis of the breast.

17:48e-35.41: Health service corporation to provide coverage for donated human breast milk.

17:48e-35.42: Health service corporation to provide coverage for standard fertility preservation services.

17:48e-36: Annual financial statement

17:48e-37: Examination authority

17:48e-37.1: Definitions.

17:48e-37.2: Increase in amount of capital or surplus required of health service corporation.

17:48e-37.3: Determination of increase, revision or redetermination; factors.

17:48e-37.4: Suspension, revocation of authority to do business.

17:48e-37.5: Rules, regulations.

17:48e-38: Fee schedule

17:48e-39: Penalties for violations

17:48e-41: Health service corporation, exemption from taxes

17:48e-42: For-profit corporations excluded

17:48e-43: Subject to review

17:48e-44: Rules, regulations

17:48e-45: Definitions relative to conversion

17:48e-46: Conversion of health service corporation to domestic mutual insurer

17:48e-46.1: Findings, declarations relative to the reorganization of a health service corporation

17:48e-46.2: Definitions relative to the reorganization of a health service corporation

17:48e-46.3: Mutual holding company, not for pecuniary profit, mission

17:48e-46.4: Health service corporation to reorganize into mutual holding company system

17:48e-46.5: Health service corporation applicationto form mutual holding company system

17:48e-46.6: Monitoring mutual holding company's operations

17:48e-46.7: Investments; supplier program; mutualization; reorganization plans

17:48e-46.8: Non-obligation of distribution payment to members, policyholders

17:48e-46.9: Membership in mutual holding company

17:48e-46.10: Plan of dissolution

17:48e-46.11: Annual statements; report to the Governor

17:48e-46.12: Public records

17:48e-46.13: Initial and annual assessments

17:48e-46.14: Mutual holding company

17:48e-46.15: Board of the mutual holding company; membership, transitional period, diversity

17:48e-46.16: Full-time employees maintained for 36 months following transition

17:48e-46.17: Severability

17:48e-47: Filing, approval of conversion plan

17:48e-48: Directors and officers, terms

17:48e-49: Definitions relative to conversion of health service corporation to domestic stock insurer.

17:48e-50: Procedure for conversion.

17:48e-51: Filing of application.

17:48e-52: Approval of plan, certificate of authority.

17:48e-53: Issuance of subsequent order.

17:48e-54: Transfer of fair market value.

17:48e-55: Continuation of health service corporation.

17:48e-56: Conversion of policies.

17:48e-57: Receipt of compensation contingent upon approval of plan prohibited.

17:48e-58: Documents considered public records; exceptions.

17:48e-59: Conversion effective; conditions.

17:48e-60: Abandonment, amendment of plan of conversion.

17:48e-61: Directors, officers continue to serve.

17:48e-62: Participation of Attorney General.

17:48e-63: Orders, rules, regulations.

17:48e-64: Construction of act.

17:48e-65: Requirements prior to action constituting material change in form.

17:48e-66: Notification of action constituting material change in form, procedure.

17:48e-67: Petition for review of foundation plan.

17:48e-68: Health Service Corporation Conversion Temporary Advisory Commission; board of directors of foundation.

17:48e-35.43: Health service corporation to provide coverage for breastfeeding support.

17:48e-35.44: Health service corporation to cover preventive services.

17:48e-35.45: Health service corporation to provide certain coverage for prescription drugs.

17:48e-35.46: Health service corporation to cover adolescent depression screenings.

17:48e-35.47: Health service corporation to cover newborn home nurse visitations.

17:48e-35.48: Individual, group health service corporation contract, coverage, epinephrine auto-injector device.

17:48e-35.49: Individual, group health service corporation contract, coverage, prescription asthma inhaler.