2012 Hawaii Revised Statutes
TITLE 24. INSURANCE
431. Insurance Code
431:10A-103 Family coverage defined.

Note

Article heading amended by L 2002, c 155, §48.

Cross References

Conformance to federal law, see §431:2-201.5.

Federally qualified health centers; rural health clinics; reimbursement, see §346-53.6.

Health maintenance organization act, see chapter 432D.

Medicaid-related mandates, see chapter 431L.

Mental health and alcohol and drug abuse treatment insurance benefits, see chapter 431M.

Patients' bill of rights and responsibilities act, see chapter 432E.

Proposed mandatory health insurance coverage and assessment report, see §§23-51, 52.

State health insurance program, see chapter 431N.

Attorney General Opinions

Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in §431:10A-103. Att. Gen. Op. 97-10.

The placement of §431:10A-601 in this article, regulating content of insurance contracts, makes clear that the legislative intent was to mandate benefits that must be made available by insurers that write contracts of insurance providing family coverage. Att. Gen. Op. 97-10.

Law Journals and Reviews

Tax Justice and Same-Sex Domestic Partner Health Benefits: An Analysis of the Tax Equity For Health Plan Beneficiaries Act. 32 UH L. Rev. 73.

PART I. INDIVIDUAL ACCIDENT AND HEALTH

OR SICKNESS POLICIES

Note

Part heading amended by L 2002, c 155, §48.

Attorney General Opinions

Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in §431:10A-103. Att. Gen. Op. 97-10.

Case Notes

Under this article and §431:10A-105(2)(A)(ii), standard "incontestability clause" of contract precluded insurer from denying insured "total disability benefit" contracted for, notwithstanding that HIV infection that caused the disability arguably "manifested" itself prior to policy's effective date of coverage. 86 H. 262, 948 P.2d 1103.

As chapter 432D does not cover the field of managed care regulation and because §§432D-2, 432E-1, and this article can be read together and there is no explicit language or policy reason not to give each statute effect, chapter 432D does not repeal chapter 432E by implication. 126 H. 326, 271 P.3d 621.

Properly licensed HMOs, like plaintiff, were authorized pursuant to §432D-1 to "provide or arrange", at their option, for the closed panel health care services required under the managed care plan program; accident and health insurers were authorized under §431:10A-205(b) to arrange for medical services for members using a defined network of providers, i.e., particular "hospitals or persons"; thus, this article and chapter 432D authorized both accident and health insurers and HMOs, as risk-bearing entities, to provide the closed panel product required by the managed care plan contracts. 126 H. 326, 271 P.3d 621.

§431:10A-103 Family coverage defined. As used in this part, family coverage means a policy that insures, originally or upon subsequent amendment, an adult member of a family who shall be deemed the policyholder and any two or more eligible members of that family, including spouse, dependent children or any children under a specified age which shall not exceed nineteen years, and any other person dependent upon the policyholder. [L 1987, c 347, pt of §2; am L 1993, c 205, §21]

Attorney General Opinions

Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in this section. Att. Gen. Op. 97-10.