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This entry was published on 2023-07-14
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ARTICLE 32
Insurance Contracts - Life, Accident and Health, Annuities
Insurance (ISC) CHAPTER 28
ARTICLE 32

INSURANCE CONTRACTS - LIFE, ACCIDENT AND HEALTH, ANNUITIES
Section 3201. Approval of life, accident and health, credit

unemployment, and annuity policy forms.

3202. Withdrawal of approval of policy forms.

3203. Individual life insurance policies; standard provisions

as to contractual rights and responsibilities of

policyholders and insurers.

3204. Policy to contain entire contract; statements of

applicant to be representations and not warranties;

alterations.

3205. Insurable interest in the person; consent required;

exceptions.

3206. Policies which provide for an adjustable maximum rate of

interest on policy loans.

3207. Life insurance contracts by or for the benefit of

minors; on the lives of minors, limitations on amount.

3208. Antedating of life insurance policies and burial

agreements prohibited.

3209. Life insurance, annuities and funding agreements

disclosure requirements.

3210. Incontestability after reinstatement.

3211. Notice of premium due under life or disability insurance

policy; notice to assignees of non-payment of premium.

3212. Exemption of proceeds and avails of certain insurance

and annuity contracts.

3213. Payment of proceeds.

3214. Interest upon proceeds of life insurance policies and

annuity contracts.

3215. Disability benefits in connection with life insurance

and annuities.

3216. Individual accident and health insurance policy

provisions.

3217. Minimum standards in the form, content and sale of

accident and health insurance; policies and subscriber

contracts.

3217-a. Disclosure of information.

3217-b. Prohibitions.

3217-c. Primary and preventive obstetric and gynecologic care.

3217-d. Grievance procedure and access to specialty care.

3217-e. Choice of health care provider.

3217-f. Prohibition on lifetime and annual limits.

3217-g. Maternal depression screenings.

3217-h. Telehealth delivery of services.

3217-i. Essential health benefits package and limit on

cost-sharing.

3217-j. Utilization review determinations for medically fragile

children.

3218. Medicare supplemental insurance policies.

3219. Annuity and pure endowment contracts and certain group

annuity certificates; standard provisions as to

contractual rights and responsibilities of contract

holders, certificate holders and insurers.

3220. Group life insurance policies; standard provisions.

3221. Group or blanket accident and health insurance policies;

standard provisions.

3222. Funding agreements.

3223. Group annuity contracts; standard provisions as to

contractual rights and responsibilities of contract

holders, certificate holders and annuitants, and

insurers.

3224. Standard claim forms; accident and health insurance.

3224-a. Standards for prompt, fair and equitable settlement of

claims for health care and payments for health care

services.

3224-b. Rules relating to the processing of health claims and

overpayments to physicians.

3224-c. Coordination of benefits.

3224-d. Prescription synchronization.

3225. Eligibility for health insurance in cases of exposure to

DES.

3226. Reinsurance contracts excepted.

3227. Interest upon surrenders, policy loans and other funds.

3228. Individual accident and health insurance policies;

premium refund at death of insured.

3229. Minimum benefit standards for certain long term care

plans.

3230. Accelerated payment of the death benefit or special

surrender value under a life insurance policy.

3231. Rating of individual and small group health insurance

policies; approval of superintendent.

3231*2. Health insurance policies and subscriber contracts;

prohibited claims.

3232. Pre-existing condition provisions in health policies.

3232-a. Certification of creditable coverage.

3233. Stabilization of health insurance markets and premium

rates.

3234. Pre-existing condition provisions in group and blanket

disability policies.

3234*2. Limitations on administrative services and stop-loss

coverage.

3235. Explanation of benefits forms relating to claims under

medicare supplemental insurance policies and limited

benefits health insurance policies or certificates

designed primarily to supplement medicare benefits.

3236. Public health law assessments.

3237. Health insurance coverage for full-time students on

medical leaves of absence.

3238. Pre-authorization of health care services.

3239. Wellness programs.

3240. Unclaimed benefits.

3240*2. Student accident and health insurance.

3241. Network coverage.

3242. Prescription drug coverage.

3243. Discrimination because of sex or marital status in

hospital, surgical or medical expense insurance.

3244. Explanation of benefits forms relating to claims under

certain accident and health insurance policies.

3245. Liability to providers in the event of an insolvency.