Status: Enacted
Year Enacted: 2001
If a health maintenance organization requires the selection or assignment of a primary care physician, the health maintenance organization shall provide an enrollee who is a student enrolled at a postsecondary institution certain options
Status: Enacted
Year Enacted: 1997
Upon request, healthcare insurers must provide the following information in a clear and understandable form to all prospective policyholders, policyholders, and covered persons: Coverage provisions, benefits, and exclusions by category of service and provider; A […]
Ark. Code §§ 23-86-401 through 23-86-406: Freedom of Choice Among Health Benefit Plans Act of 1999 – Arkansas
Status: Enacted
Year Enacted: 1999
In order to provide affordable delivery of health care services, health benefit plans which utilize contractual arrangements with providers and encourage quality services at discounted prices should be promoted and citizens should have the option […]
Ark. Code §§ 23-99-401 through 23-99-416: Healthcare Providers — Arkansas Health Care Consumer Act – Arkansas
Status: Enacted
Year Enacted: 1997
As the state’s insurance sector becomes increasingly dominated by managed care features that include decisions regarding coverage and appropriateness of health care, there is a vital need to protect patients in this environment.
Status: Enacted
Year Enacted: 1993
For purpose of point-of-service health care Service plan contracts, the definitions as specified shall apply. A point-of-service plan contract, in which any risk for out-of-network coverage or services is transferred from a health care service […]
Cal. Health & Safety Code §§ 1395 through 1399.5: Knox-Keene Health Care Service Plan Act of 1975 – Miscellaneous – California
Status: Enacted
Year Enacted: 1975
Any price advertisement shall be exact, without the use of such phrases as “as low as,” “and up,” “lowest prices” or words or phrases of similar import. Any advertisement that refers to services, or costs […]
Status: Enacted
Year Enacted: 1999
Sets requirements for a contract established between a health plan/carrier and a provider, including that the provider shall not be subjected to financial disincentives based on the number of referrals made to participating providers so […]
Status: Enacted
Year Enacted: 2017
States that health plans/ carriers should develop standards for the selection of providers, including developing standards for tiering.
Status: Enacted
Year Enacted: 1997
Stipulates that a health plan/ carrier’s managed care plan must maintain an adequate network of providers to assure that all covered benefits will be accessible to covered persons. Provides protections against surprise billing.
Status: Enacted
Year Enacted: 2011
Requires health plans to establish and maintain a network that includes a sufficient number of appropriate types of pparticipating providers, including those that serve predominantly low-income, medically underserve individuals, to assure that all covered benefits […]
Status: Enacted
Year Enacted: 2005
States that the Insurance Commissioner shall approve any health insurance policy or contract that uses variable networks and enrollee cost-sharing if the policy meets certain requirements, includes the rate filing in submission to commissioner, and […]
Conn. Gen. Stat. § 38a-503b. Carriers to permit direct access to obstetrician-gynecologist: Individual Health Insurance – Connecticut
Status: Enacted
Year Enacted: 1995
Requires health plans to permit a female enrollee to have direct access to a participating in-network obstetrician-gynecologist for any gynecological examination or care related to pregnancy and shall allow direct access to participating in-network obstetrician-gynecologist […]
Status: Enacted
Year Enacted: 2010
Describes the information that insurers, or any group providing insurance coverage, must provide to employer customers, such as complete and accurate medical utilization data, claims paid aggregated by practice type, preimums paid by month, and […]
Conn. Gen. Stat. §§ 38a-479aa through 479gg: Health Insurance: Preferred Provider Networks – Connecticut
Status: Enacted
Year Enacted: 2001
States that managed care organizations cannot enter into or renew a contract with a preferred provider network that is not licensed in accordance with section 38a-479aa. Requires managed care organizations that contract with a preferred […]
D.C. Code § 31-3303.06. Availability: Group Insurance – District of Columbia
Status: Enacted
Year Enacted: 1999
If coverage is offered to small employers under this subchapter, such coverage shall be offered and made available to every small employer that applies for such coverage. Participation in such plan shall be made available […]
D.C. Code § 31-3429. Point of service plan: Health Maintenance Organizations – District of Columbia
Status: Enacted
Year Enacted: 1997
If an employer, association, or other private group arrangement offers health benefit plan coverage to employees or individuals only through a health maintenance organization, the health maintenance organization with which the employer, association, or other […]
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