Louisiana Revised Statutes 22:2393 – A. This Chapter shall apply to any health insurance issuer that offers a health benefit plan as defined in this Chapter.
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Terms Used In Louisiana Revised Statutes 22:2393
- Health benefit plan: means a policy, contract, certificate, or agreement entered into, offered, or issued by a health insurance issuer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services. See Louisiana Revised Statutes 22:2392
- Health insurance issuer: means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including through a health benefit plan as defined in this Section, and shall include a sickness and accident insurance company, a health maintenance organization, a preferred provider organization or any similar entity, or any other entity providing a plan of health insurance or health benefits. See Louisiana Revised Statutes 22:2392
A. This Chapter shall apply to any health insurance issuer that offers a health benefit plan as defined in this Chapter.
B. For purposes of claims related to a dental insurance policy, this Chapter shall apply only to external review or adverse determinations involving individual claims in excess of two hundred fifty dollars.
Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2021, No. 89, §1, eff. June 4, 2021.