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 …
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Colo. Rev. Stat. § 10-16-705.5. Participating Provider Networks-definitions-selection standards-informational reconsideration-enforcement-legislative declaration: Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2017
States that health plans/ carriers should develop standards for the selection of providers, including developing standards for tiering.
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Colo. Rev. Stat. §§ 10-16-701 through 10-16-709: Consumer Protection Standards Act for the Operation of Managed Care Plans – Colorado
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.
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Conn. Gen. Stat. § 38a-472f. Network adequacy. Health carrier duties and responsibilities. Access plan filing: Health Insurance – Connecticut
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 …
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Conn. Gen. Stat. § 38a-476c. Policies and contracts with variable network and enrollee cost-sharing. Approval. Limitations: Health Insurance: In General – Connecticut
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 …
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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 …
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Conn. Gen. Stat. § 38a-513f. Claims information to be provided to certain employers. Restrictions. Subpoenas: Group Health Insurance – Connecticut
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 …
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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 …
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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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Fla. Stat. § 641.54. Information disclosure: Health Care Services – Florida
Status: Enacted Year Enacted: 1985
Requires HMOs to maintain a list of hospitals used, physicians employed, and estimated copayments, coinsurance, or deductible for any covered services.
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Fla. Stat. §§ 409.961 through 409.977: Medicaid Managed Care – Florida
Status: Enacted Year Enacted: 2011
Describes requirements for Medicaid managed care networks and provider payment.
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Ga. Code Ann. § 33-20-13. Management of corporations; general powers; requirements as to reserves, minimum subscriber’s surpluses, and charges: Health Care Plan Act – Georgia
Status: Enacted Year Enacted: 1976
A health care corporation may in its discretion limit the benefits that it will furnish, may divide such benefits as it elects to furnish into classes or kinds, and may furnish different benefits with different …
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Ga. Code Ann. § 33-20-3. Definitions: Health Care Plan Act – Georgia
Status: Enacted Year Enacted: 1976
“Health care corporation” means a corporation established in accordance with the provisions of this chapter to administer one or more health care plans. “Health care plan” means a plan or arrangement under which health care …
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Ga. Code Ann. § 33-20C-1. Definitions: Accurate Provider Directories – Georgia
Status: Enacted Year Enacted: 2016
Definitions relate to Chapter 20 Accurate Provider Directories (sections 33-20C-1 through 33-20C-7).
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Ga. Code Ann. § 33-20C-2. Online provider directories; printed directories by request; required content; accessibility: Accurate Provider Directories – Georgia
Status: Enacted Year Enacted: 2016
An insurer shall post on its website a current and accurate electronic provider directory for each of its network plans and include information such as how the insurer designates the different provider tiers or levels.
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Ga. Code Ann. § 33-20C-3. Required and accurate information in directories; reporting; reimbursement for reliance: Accurate Provider Directories – Georgia
Status: Enacted Year Enacted: 2016
The insurer shall include in both its online and print directories a clearly identifiable telephone number and either a dedicated e-mail address or a link to a dedicated webpage that covered persons or the general …
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