Last Updated July 23, 2012
Enactments through the 2012 Extraordinary Session
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Terms & Conditions
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KRS Chapter 304.38
Terms & Conditions
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.030 Definitions for subtitle.
.035 Certificate required for health maintenance organization.
.040 Establishment of health maintenance organizations.
.050 Evidence of coverages and charges for health care service -- Exception.
.060 Issuance of certificate of authority.
.065 Repealed, 2002.
.070 Requirements for protection against insolvency -- Risk-based capital requirements.
.073 Deposit of cash or securities for performance of obligations to enrollees.
.075 Requirements for transfer of risk to provider -- Additional reserves may be required.
.077 Repealed, 2002.
.080 Information to enrollees.
.090 Annual report.
.095 Application of KRS 304.2-205.
.098 Compliance with KRS 304.18-124 to 304.18-127.
.110 Agent of health maintenance organization -- Licensing -- Continuing education -- Appointment.
.120 Financial condition, market conduct, and business practices subject to examination.
.130 Revocation or suspension of certificate of authority.
.140 Rehabilitation, liquidation, or conservation of health maintenance organization.
.150 Rules and regulations.
.160 Repealed, 1982.
.170 Public documents -- Statutory construction.
.180 Prohibited practices.
.185 Coordination of benefits.
.190 Powers of insurers.
.191 Conversion and continuation rights upon termination of group coverage.
.192 Repealed, 1986.
.193 Coverage for treatment for mental illness.
.1933 Coverage for services of licensed psychologist or licensed clinical social worker.
.1934 Coverage for medical and surgical benefits with respect to mastectomy, diagnosis and treatment of endometrioses and endometritis, and bone density testing -- Duties of health maintenance organization.
.1935 Coverage for mammograms.
.1936 Coverage for treatment of breast cancer.
.1937 Coverage for treatment of temporomandibular joint disorders and craniomandibular jaw disorders.
.194 Pooling of claims experience required.
.195 Policy covering services performed by dentist deemed to cover such services performed by physician.
.1955 Construction of provisions for services by licensed optometrist or licensed ophthalmic dispenser to include same services from licensed physician.
.196 Indemnity payable for services performed by chiropractors, physicians, osteopaths, or podiatrists.
.197 Coverage for treatment of alcoholism.
.198 Optional nursery care coverage for a well newly born child.
.199 Coverage for newly-born child.
.200 Application of other subtitles.
.205 Medicare supplement coverage for persons not eligible for Medicare by reason of age.
.210 Health maintenance organizations as insurers to offer home health care coverage -- Conditions.
.220 Long-term health care benefits.
.225 Requirements for health maintenance organization that provides hospital benefits coverage and requires utilization review of benefits.
.230 Funding of benefits by employer or group contract holder.
Health Discount Plans
.500 Repealed, 2002.
.505 Repealed, 2002.
.510 Repealed, 2002.