2013 Kentucky Revised Statutes CHAPTER 304 - INSURANCE CODE Subtitle 18 - Group and Blanket Health Insurance 18.18-020 "Group health insurance" defined -- Eligible groups and benefits.
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304.18-020 "Group health insurance" defined -- Eligible groups and benefits.
(1)
"Group health insurance" is hereby declared to be that form of health insurance
covering groups of persons as defined in this section, with or without one (1) or
more members of their families or one (1) or more of their dependents, or
covering one (1) or more members of the families or one (1) or more
dependents of such groups of persons, and issued upon the following basis:
(a) Under a policy issued to an employer or trustees of a fund established by
an employer, who shall be deemed the policyholder, insuring employees
of such employer for the benefit of persons other than the employer
(except as to policies insuring only against aviation or transportation
hazards). The term "employees" as used in this paragraph shall be
deemed to include the officers, directors, managers and employees of the
employer, the individual proprietor or partner if the employer is an
individual proprietor or partnership, the officers, directors, managers and
employees of subsidiary or affiliated corporations, the individual
proprietors, partners and employees of individuals and firms, if the
business of the employer and such individual or firm is under common
control through stock ownership, contract or otherwise. The term
"employees" as used in this paragraph may include retired employees. A
policy issued to insure employees of a public body may provide that the
term "employees" shall include elected or appointed officers. The policy
may provide that the term "employees" shall include the trustees or their
employees, or both, if their duties are principally connected with such
trusteeship;
(b) Under a policy issued to an association, including a labor union, which
shall have a constitution and bylaws and which has been organized and is
maintained in good faith for purposes other than that of obtaining
insurance, insuring members, employees, or employees of members of
the association for the benefit of persons other than the association or its
officers or trustees. The term "employees" as used in this paragraph may
include directors of corporate members and retired employees;
(c) Under a policy issued to the trustees of a fund established by two (2) or
more employers in the same or related industry or by one (1) or more
labor unions or by one (1) or more employers and one (1) or more labor
unions or by an association as defined in paragraph (b), which trustees
shall be deemed the policyholder, to insure employees of the employers
or members of the unions or of such association, or employees of
members of such association, for the benefit of persons other than the
employers or the unions or such association. The term "employees" as
used in this paragraph may include the officers, directors, managers, and
employees of the employer, and the individual proprietor or partners if the
employer is an individual proprietor or partnership. The term "employees"
as used in this paragraph may include retired employees. The policy may
provide that the term "employees" shall include the trustees or their
employees, or both, if their duties are principally connected with such
trusteeship;
(d) Under a policy issued to a creditor insuring a group of debtors, as defined
(2)
in KRS 304.16-040, and under the same conditions and limitations as
specified in such section, but the amount in indemnity payable with
respect to any person insured thereunder shall not at any time exceed the
aggregate of the periodic scheduled unpaid installments;
(e) Under a policy issued to any other person or organization to which a
policy of group life insurance may be issued or delivered in this state to
insure any class or classes of individuals that could be insured under
such group life policy; and
(f) Under a policy issued to cover any other substantially similar group
which, in the discretion of the commissioner, may be subject to the
issuance of a group health policy or contract.
Any group health policy which contains provisions for the payment by the
insurer of benefits for expenses incurred on account of hospital, nursing,
medical, or surgical services for members of the family or dependents of a
person in the insured group may provide for the continuation of such benefit
provisions, or any part or parts thereof, after the death of the person in the
insured group.
Effective:July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1292, effective July 15, 2010. -Amended 1998 Ky. Acts ch. 496, sec. 58, effective April 10, 1998. -- Created
1970 Ky. Acts ch. 301, subtit. 18, sec. 2, effective June 18, 1970.
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