Note
Article heading amended by L 2002, c 155, §48.
State innovation waiver task force; health care reform plan; reports to 2015-2017 legislature (dissolved June 30, 2017). L 2014, c 158; L 2015, c 184.
Cross References
Conformance to federal law, see §431:2-201.5.
Federally qualified health centers; rural health clinics; reimbursement, see §346-53.6.
Health maintenance organization act, see chapter 432D.
Medicaid-related mandates, see chapter 431L.
Mental health and alcohol and drug abuse treatment insurance benefits, see chapter 431M.
Patients' bill of rights and responsibilities act, see chapter 432E.
Prescription drug benefits, see chapter 431R.
Prescription drugs; mail order opt out option, see §87A-16.3.
Proposed mandatory health insurance coverage and assessment report, see §§23-51, 52.
State health insurance program, see chapter 431N.
Attorney General Opinions
Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in §431:10A-103. Att. Gen. Op. 97-10.
The placement of §431:10A-601 in this article, regulating content of insurance contracts, makes clear that the legislative intent was to mandate benefits that must be made available by insurers that write contracts of insurance providing family coverage. Att. Gen. Op. 97-10.
Law Journals and Reviews
Tax Justice and Same-Sex Domestic Partner Health Benefits: An Analysis of the Tax Equity For Health Plan Beneficiaries Act. 32 UH L. Rev. 73 (2009).
Case Notes
As chapter 432D does not cover the field of managed care regulation and because §§432D-2, 432E-1, and this article can be read together and there is no explicit language or policy reason not to give each statute effect, chapter 432D does not repeal chapter 432E by implication. 126 H. 326, 271 P.3d 621 (2012).
Properly licensed HMOs, like plaintiff, were authorized pursuant to §432D-1 to "provide or arrange", at their option, for the closed panel health care services required under the managed care plan program; accident and health insurers were authorized under §431:10A-205(b) to arrange for medical services for members using a defined network of providers, i.e., particular "hospitals or persons"; thus, this article and chapter 432D authorized both accident and health insurers and HMOs, as risk-bearing entities, to provide the closed panel product required by the managed care plan contracts. 126 H. 326, 271 P.3d 621 (2012).
PART I. INDIVIDUAL ACCIDENT AND HEALTH
OR SICKNESS POLICIES
Note
Part heading amended by L 2002, c 155, §48.
Attorney General Opinions
Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in §431:10A-103. Att. Gen. Op. 97-10.
Case Notes
Under this article and §431:10A-105(2)(A)(ii), standard "incontestability clause" of contract precluded insurer from denying insured "total disability benefit" contracted for, notwithstanding that HIV infection that caused the disability arguably "manifested" itself prior to policy's effective date of coverage. 86 H. 262, 948 P.2d 1103.
§431:10A-102 Accident and health or sickness insurance policy defined. The term, policy of accident and health or sickness insurance, includes any policy or contract covering the class of insurance described in section 431:1-205. [L 1987, c 347, pt of §2; am L 2002, c 155, §50]
Section: Previous 431-10-239 431-10-240 431-10-241 431-10-242 431-10-243 431-10-244 431-10a-101 431-10a-102 431-10a-102.5 431-10a-103 431-10a-104 431-10a-105 431-10a-105.5 431-10a-105.6 431-10a-106 NextLast modified: October 27, 2016