Indiana Code 27-8-5.9-6. Use of preferred provider plan
Current as of: 2023 | Check for updates
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Sec. 6. (a) This section applies to an insurer that issues a short term insurance plan and undertakes a preferred provider plan under IC 27-8-11 to render health care services to covered individuals under the short term insurance plan.
(1) The preferred provider plan includes essential community providers in accordance with PPACA.
(b) An insurer described in subsection (a) shall ensure that the preferred provider plan meets the following requirements:
Terms Used In Indiana Code 27-8-5.9-6
- PPACA: has the meaning set forth in IC 27-19-2-14. See Indiana Code 27-8-5.9-2
- short term insurance plan: means a policy of accident and sickness insurance (as defined in IC 27-8-5-1) that:
Indiana Code 27-8-5.9-3
(2) The preferred provider plan is sufficient in number and types of providers (other than mental health and substance abuse treatment providers) to assure covered individuals’ access to all health care services without unreasonable delay.
(3) The preferred provider plan is consistent with the network adequacy requirements that:
(A) apply to qualified health plan issuers under 45 C.F.R. § 156.230(a) and 45 C.F.R. § 156.230(b); and
(B) are consistent with subdivisions (1) and (2).
As added by P.L.288-2019, SEC.7.