Syfert Injury Law Firm

Scope of this part.

Mandated coverages.

Scope, format of policy.

Death benefits.

Nonresident insured.

Children with disabilities; continuation of coverage.

Notification of cancellation, nonrenewal, or change in rates.

Use of a specific methodology for payment of claims.

Preexisting condition.

Limit on preexisting conditions.

Required provisions; captions, omissions, substitutions.

Coverage for ambulatory surgical center service.

Entire contract; changes.

Time limit on certain defenses.

Grace period.

Reinstatement.

Notice of claim.

Claim forms.

Proof of loss.

Time of payment of claims.

Payment of claims.

Payment of claims.

Denial of claims.

Physical examination, autopsy.

Legal actions.

Change of beneficiary.

Optional policy provisions.

Change of occupation.

Misstatement of age or sex.

Other insurance with this insurer.

Insurance with other insurers.

Insurance with other insurers; other benefits.

Relation of earnings to insurance.

Unpaid premiums.

Cancellation or nonrenewal prohibited.

Conformity with statutes.

Illegal occupation.

Intoxicants and narcotics.

Order of certain provisions.

Third-party ownership.

Requirements of other jurisdictions.

Other policy provisions.

Age limit.

Excess insurance.

Industrial health insurance.

Construction of noncomplying contracts.

Direct payment for hospital, medical services.

Disclosures to policyholders; calculations of cost sharing.

Shared savings incentive program.

Application signed by agent.

Filing of classifications and rates.

Refunds for persons age 64.

Insurance rebates for healthy lifestyles.

Advanced practice registered nurse services.

Payment of acupuncture benefits to certified acupuncturists.

Decreasing inappropriate utilization of emergency care.

Maternity care.

Massage.

Diabetes treatment services.

Coverage for osteoporosis screening, diagnosis, treatment, and management.

Coverage for newborn children.

Coverage for natural-born, adopted, and foster children; children in insured’s custodial care.

Coverage for child health supervision services.

Coverage for surgical procedures and devices incident to mastectomy.

Coverage for length of stay and outpatient postsurgical care.

Requirements with respect to breast cancer and routine followup care.

Coverage for mammograms.

Requirements with respect to breast cancer.

Required coverage for cleft lip and cleft palate.

Coverage requirements for services provided by nonparticipating providers; payment collection limitations.

Requirements for opioid coverage.

Medication synchronization.

Coverage for organ transplants.

Outline of coverage.

Renewability of individual coverage.

Short-term health insurance.

Uniform minimum standards.

Discrimination against handicapped prohibited.

Denial of health insurance claims restricted.

Conversion on termination of eligibility.

Standard health claim form.

Contracts for reduced rates of payment; limitations; coinsurance and deductibles.

Exclusive provider organizations.

Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.

Combined preferred provider and exclusive provider policies.

Leasing, renting, or granting access to a participating provider.

Provider contracts.

Pharmacy benefit manager contracts.

Individual reinsurance pool.

Guaranteed availability of individual health insurance coverage to eligible individuals.

Restrictions on use of state and federal funds for state exchanges.