2024 Indiana Code
Title 27. Insurance
Article 13. Health Maintenance Organizations
Chapter 9. Information to Enrollees or Subscribers
27-13-9-7. Electronic Data Base Requirements; Rulemaking Authority

Sec. 7. (a) The electronic data base by which a health maintenance organization or by which a third party administrator of benefits and health care services offered under a health maintenance organization contract allows an enrollee or a provider to verify an enrollee's coverage or benefits under a health maintenance organization contract must include the following information for each enrollee:

(1) Whether benefits and health care services under the health maintenance organization contract are provided by:

(A) the health maintenance organization; or

(B) a third party administrator.

(2) Whether the health maintenance organization contract is a self-funded or fully-funded plan.

(b) The department shall adopt rules under IC 4-22-2 to ensure compliance with this section.

As added by P.L.111-2020, SEC.15.