2015 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)
(2)
Under a policy issued to a creditor insuring a group of debtors, as defined 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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