Chapter 27-18. Accident and Sickness Insurance Policies
Section
27-18-1“Policy of accident and sickness insurance” construed.27-18-1.1Definitions.27-18-2Form of policy.27-18-2.1Uniform explanation of benefits and coverage.27-18-3Required provisions.27-18-3.1Alternative coverage by employer.27-18-3.2Rules and regulations.27-18-3.3Penalties.27-18-3.4Judicial review.27-18-3.5Non-applicability.27-18-4Optional provisions.27-18-5Inapplicable or inconsistent provisions.27-18-6Sequence of provisions.27-18-7Third-party ownership.27-18-8Filing of accident and sickness insurance policy forms.27-18-8.1Waiting period — Effective date of filings.27-18-8.2Notice of disapproval.27-18-8.3Withdrawal of approval.27-18-8.4Rules as to filing.27-18-9Policies of foreign insurers.27-18-10Compliance by domestic insurer with laws of other states.27-18-11Application of provisions to policy issued to nonresident.27-18-12Less favorable provisions prohibited.27-18-13Effect of policies inconsistent with chapter.27-18-14Copies of applications.27-18-15Alteration of application.27-18-16False statements in application.27-18-17Acts not constituting waiver of insurer’s defenses.27-18-18Acceptance of premiums after effective period of policy.27-18-19Insurance exempt from chapter.27-18-20Penalties for violations.27-18-21Appeals from commissioner.27-18-22Effect on other law.27-18-23Severability.27-18-24Immunity of benefits from process.27-18-25Unfair discrimination prohibited.27-18-26Physical examinations by insurance company.27-18-27Adoptive children.27-18-28[Repealed.]27-18-29Changing coverage.27-18-30Health insurance contracts — Infertility.27-18-31Insurance coverage for services of licensed midwives.27-18-32Discontinuance of coverage — Chronic disabilities.27-18-33Drug coverage.27-18-33.1Insurance coverage for postpartum hospital stays.27-18-33.2Pharmacy benefit manager requirements with respect to multi-source generic pricing updates to pharmacies.27-18-33.3Patient choice in dispensing of clinician-administered drugs.27-18-34Health insurance contracts — Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists.27-18-35Certified counselors in mental health and therapists in marriage and family practice.27-18-36[Repealed.]27-18-36.1[Repealed.]27-18-36.2[Repealed.]27-18-36.3[Repealed.]27-18-37[Repealed.]27-18-38Diabetes treatment.27-18-39Mastectomy treatment.27-18-40Insurance coverage for mastectomy hospital stays.27-18-41Mammograms and pap smears — Coverage mandated.27-18-42Mammograms — Quality assurance standards.27-18-43Pap smears — Quality assurance standards.27-18-44Primary and preventive obstetric and gynecological care.27-18-44.1Hysterectomy or myomectomy treatment.27-18-45Whistleblowers protection.27-18-46Penalties and remedies.27-18-47Additional relief and damages — Reinstatement.27-18-48Third-party reimbursement for services of certain healthcare workers.27-18-48.1Third-party reimbursement for services of registered nurse first assistants.27-18-49Human leukocyte antigen testing.27-18-50Drug coverage.27-18-50.1Medication synchronization.27-18-50.2Specialty drugs.27-18-51Restricted annual rate payments prohibited.27-18-52Genetic testing.27-18-52.1Genetic information.27-18-53Magnetic resonance imaging — Quality assurance standards.27-18-54Health insurance rates.27-18-55Acupuncture services.27-18-56Prohibition against dentists being required to indemnify provider.27-18-57FDA approved prescription contraceptive drugs and devices.27-18-58Prostate and colorectal examinations — Coverage mandated — The Maryellen Goodwin Colorectal Cancer Screening Act.27-18-59Eligibility for children’s benefits.27-18-60Hearing aids.27-18-61Prompt processing of claims.27-18-62Mandatory coverage for certain lyme disease treatments.27-18-63Dental insurance assignment of benefits.27-18-64Coverage for early intervention services.27-18-65Post-payment audits.27-18-66Tobacco cessation programs.27-18-67Reimbursement for orthotic and prosthetic services.27-18-68Mandatory coverage for scalp hair prosthesis.27-18-69Licensed ambulance service.27-18-70Enteral nutrition products.27-18-71Prohibition on preexisting condition exclusions.27-18-72Prohibition on rescission of coverage.27-18-73Prohibition on annual and lifetime limits.27-18-74Coverage for individuals participating in approved clinical trials.27-18-75Medical loss ratio reporting and rebates.27-18-76Emergency services.27-18-77Internal and external appeal of adverse benefit determinations.27-18-78Primary care provider designation requirement.27-18-79Discretionary clauses.27-18-80Orally administered anticancer medication — Cost-sharing requirement.27-18-81Consumer notification.27-18-82Opioid antagonists.27-18-83Healthcare provider credentialing.27-18-84Health insurance contracts — Full year coverage for contraception.27-18-85Prohibition on discrimination in organ transplants.27-18-86Health insurance contracts — Copayments exemption for COVID-19 related services.27-18-87Perinatal doulas.27-18-88Gender rating.27-18-89Coverage for biomarker testing.27-18-90Mandatory coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome.27-18-91Coverage for treatment of pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) to prevent HIV infection.27-18-92[Repealed.]27-18-93Dispensing and administration of HIV PrEP or PEP drugs.27-18-94Epinephrine injectors.27-18-95Acute mental health crisis mobile response and stabilization services. [Effective January 1, 2026.]