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Current as of January 02, 2024 | Updated by Findlaw Staff
Sec. 13.5. (a) This section applies only to the following:
(1) An individual, group, franchise, or blanket policy of accident and sickness insurance, as defined in IC 27-8-5-1. However, this section does not apply to the types of insurance and coverage described in IC 27-8-5-2.5(a).
(2) An individual or group health maintenance organization contract entered into under IC 27-13.
(b) As used in this section, “third party administrator” means a person who:
(1) is licensed under IC 27-1-25; and
(2) administers a policy of accident and sickness insurance described in subsection (a)(1) or a health maintenance organization contract described in subsection (a)(2).
(c) Except as provided in subsection (f), an insurer that issues an insurance policy, a health maintenance organization that enters into a health maintenance organization contract, or a third party administrator shall disclose to the policyholder or subscriber in a separate written notification:
(1) any commission, service fee, or brokerage fee that has been or will be paid to an insurance producer for selling, soliciting, or negotiating the policy or contract; and
(2) whether the amount disclosed under subdivision (1) is based on a percentage of total plan premiums or a flat per member fee.
(d) An insurer, a health maintenance organization, or a third party administrator shall provide a copy of the written notification described in subsection (c) to the policyholder or subscriber:
(1) when the insurance policy is issued or the contract is entered into; and
(2) each time the insurance policy or contract is renewed.
(e) Each copy of a written notification described in subsection (c) must include a signature line on which the policyholder may sign to acknowledge receiving the written notification.
(f) This section does not require the disclosure to the policyholder of a commission, service fee, or brokerage fee in connection with the issuance of an insurance policy if a federal law or regulation requires disclosure of the commission, service fee, or brokerage fee to the policyholder.
(g) An insurer, a health maintenance organization, and a third party administrator shall submit the information described in subsection (c) to the executive director of the all payer claims data base established under IC 27-1-44.5 for inclusion in the data base.
(h) The department shall perform an examination under IC 27-1-3.1 for any alleged violation of this section.
Cite this article: FindLaw.com - Indiana Code Title 27. Insurance § 27-1-15.6-13.5 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-27-insurance/in-code-sect-27-1-15-6-13-5/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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