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-118 Genetic information nondiscrimination in accident and health or sickness insurance coverage. (a) No insurer may:
(1) Use an individual's or a family member's genetic information, or request for genetic services, to deny or limit any coverage or establish eligibility, continuation, enrollment, or premium payments;
(2) Request or require collection or disclosure of an individual's or a family member's genetic information; or
(3) Disclose an individual's or a family member's genetic information without the written consent of the person affected, the person's legal guardian, or a person with power of attorney for health care for the person affected. This consent shall be required for each disclosure and shall include the name of each person or organization to whom the disclosure will be made.
(b) As used in this section:
"Family member" means, with respect to the individual, another individual related by blood to that individual.
"Genetic information" means information about genes, gene products, hereditary susceptibility to disease, or inherited characteristics that may derive from the individual or family member.
"Genetic services" means health services to obtain, assess, or interpret genetic information for diagnosis, therapy, or genetic counseling.
(c) This section shall not apply to any action taken in connection with policies of life insurance, disability income insurance, and long-term care insurance delivered or issued for delivery in this State. [L 1997, c 91, §1; am L 2003, c 212, §75]
Law Journals and Reviews
Privacy and Genetics: Protecting Genetic Test Results in Hawai‘i. 25 UH L. Rev. 449.
Section: Previous 431-10a-115.5 431-10a-116 431-10a-116.2 431-10a-116.5 431-10a-116.6 431-10a-116.7 431-10a-117 431-10a-118 431-10a-119 431-10a-120 431-10a-121 431-10a-122 431-10a-125 431-10a-126 431-10a-131 NextLast modified: October 27, 2016