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AN ACT relating to the application of health insurance subtitles. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 304.17-020 is amended to read as follows: 3
(1) As used in this section: 4
(a) "Health insurance" includes any policy, certificate, plan, or contract that 5
provides coverage or benefits in this state for medical, surgical, 6
chiropractic, physical therapy, speech pathology, audiology, professional 7
mental health, dental, hospital, optometric, pharmaceutical, or other health-8
related expenses: 9
1. By direct payment, reimbursement, or otherwise; and 10
2. On a fully insured or self-insured basis or any combination thereof; 11
(b) "Individual market" means the market for health insurance offered to 12
individuals or groups, other than in connection with the following: 13
1. Group health insurance, as defined in KRS 304.18-020; or 14
2. Blanket health insurance, as defined in KRS 304.18-060; 15
(c) "Most recent effective date" means the most recent effective date of the 16
section, as set forth in: 17
1. The official version of the Kentucky Revised Statutes maintained by 18
the Legislative Research Commission in accordance with KRS 7.131 19
and made available to the public pursuant to KRS 7.500; or 20
2. Except as otherwise provided in KRS 7.138(2)(b), any certified version 21
of the Kentucky Revised Statutes designated by the Legislative 22
Research Commission in accordance with KRS 7.132; and 23
(d) "Otherwise specifically indicated or provided" means that the section or 24
another section of the Kentucky Revised Statutes: 25
1. Expressly states that the section is applicable to; and 26
2. Specifically refers to; 27 UNOFFICIAL COPY 25 RS BR 153
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a type of insurance, coverage, or benefits that is excluded under subsection 1
(2) of this section. 2
(2) Unless otherwise specifically indicated or provided: 3
(a) The sections of this subtitle apply only to health insurance offered in the 4
individual market; 5
(b) If a section of this subtitle has a most recent effective date that is prior to 6
the effective date of this Act, the section shall not apply to or affect any of 7
the following[Nothing in this subtitle shall apply to or affect]: 8
1.[(1)] [Any policy of ]Liability or workers' compensation insurance with 9
or without supplementary expense coverage therein;[. 10
(2) Any group or blanket policy.] 11
2.[(3)] Life insurance, endowment or annuity contracts, or contracts 12
supplemental thereto which contain only such provisions relating to 13
health insurance as: 14
a.[(a)] Provide additional benefits in case of death or 15
dismemberment or loss of sight by accident or accidental 16
means;[,] or 17
b.[(b)] Operate to safeguard such contracts against lapse, or to give 18
a special surrender value or special benefit or an annuity in the 19
event that the insured or annuitant becomes totally and 20
permanently disabled, as defined by the contract or supplemental 21
contract;[.] 22
3.[(4)] Reinsurance;[.] 23
4.[(5)] A[Any] contract made or issued prior to June 18, 1970, together 24
with any extensions, renewals, reinstatements or modifications thereof 25
or amendments thereto, whenever made; or 26
5. Other types of similar or limited insurance, coverage, or benefits, to 27 UNOFFICIAL COPY 25 RS BR 153
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the extent specified by the commissioner in an administrative 1
regulation promulgated in accordance with KRS Chapter 13A; and 2
(c) If a section of this subtitle has a most recent effective date that is on or after 3
the effective date of this Act, the section shall not apply to or affect any of 4
the following: 5
1. Health insurance covering only accident, credit, dental, vision, or 6
specified disease, illness, or condition; 7
2. Disability income insurance; 8
3. Paid family leave insurance; 9
4. Long-term care insurance; 10
5. Short-term nursing home insurance; 11
6. Medicare supplement insurance; 12
7. Hospital indemnity or other fixed indemnity health insurance; 13
8. Coverage provided under a limited health service benefit plan, as 14
defined in KRS 304.17C-010, including a limited health service 15
contract, as defined in KRS 304.38A-010; 16
9. Coverage under which benefits for medical expenses are: 17
a. Contained in, or included as a rider, amendment, or 18
supplemental policy provision to, any liability insurance policy or 19
contract or equivalent self-insurance; or 20
b. Supplemental to other insurance or equivalent self-insurance 21
benefits, including the following: 22
i. Automobile medical-payment insurance; and 23
ii. Life insurance or endowment or annuity contracts; 24
10. Medical expense reimbursement coverage that is: 25
a. Specifically designed to supplement, or fill gaps in, primary 26
health insurance coverage; and 27 UNOFFICIAL COPY 25 RS BR 153
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b. Provided under a policy, plan, certificate, or contract that is 1
separate from the primary health insurance coverage; 2
11. Coverage or benefits provided under: 3
a. KRS Chapter 205 or 342; or 4
b. Any other statutory-based public assistance or compensation 5
program; 6
12. Coverage or benefits for on-site medical clinics; 7
13. Coverage or benefits provided under a health flexible spending 8
arrangement; or 9
14. Other types of similar or limited insurance, coverage, or benefits, to 10
the extent specified by the commissioner in an administrative 11
regulation promulgated in accordance with KRS Chapter 13A. 12
SECTION 2. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 13
IS CREATED TO READ AS FOLLOWS: 14
(1) As used in this section, "otherwise specifically indicated or provided" means that 15
the section or another section of the Kentucky Revised Statutes: 16
(a) Expressly states that the section is applicable to; and 17
(b) Specifically refers to; 18
a type of insurance, coverage, or benefits that is excluded under subsection (2) of 19
this section. 20
(2) Unless otherwise specifically indicated or provided, the sections of this subtitle 21
shall not apply to or affect any of the following: 22
(a) Policies, plans, certificates, or contracts covering only accident, credit, 23
dental, vision, or specified disease, illness, or condition; 24
(b) Disability income insurance; 25
(c) Paid family leave insurance; 26
(d) Long-term care insurance; 27 UNOFFICIAL COPY 25 RS BR 153
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(e) Short-term nursing home insurance; 1
(f) Medicare supplement insurance; 2
(g) Hospital indemnity or other fixed indemnity insurance; 3
(h) Coverage provided under a limited health service benefit plan, as defined in 4
KRS 304.17C-010, including a limited health service contract, as defined in 5
KRS 304.38A-010; 6
(i) Coverage under which benefits for medical expenses are: 7
1. Contained in, or included as a rider, amendment, or supplemental 8
policy provision to, any liability insurance policy or contract or 9
equivalent self-insurance; or 10
2. Supplemental to other insurance or equivalent self-insurance benefits, 11
including the following: 12
a. Automobile medical-payment insurance; and 13
b. Life insurance or endowment or annuity contracts; 14
(j) Medical expense reimbursement coverage that is: 15
1. Specifically designed to supplement, or fill gaps in, primary health 16
insurance coverage; and 17
2. Provided under a policy, plan, certificate, or contract that is separate 18
from the primary health insurance coverage; 19
(k) Coverage or benefits provided under: 20
1. KRS Chapter 205 or 342; or 21
2. Any other statutory-based public assistance or compensation program; 22
(l) Coverage or benefits for on-site medical clinics; 23
(m) Coverage or benefits provided under a health flexible spending 24
arrangement; or 25
(n) Other types of similar or limited insurance, coverage, or benefits, to the 26
extent specified by the commissioner in an administrative regulation 27 UNOFFICIAL COPY 25 RS BR 153
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promulgated in accordance with KRS Chapter 13A. 1
Section 3. KRS 304.18-010 is amended to read as follows: 2
(1) As used in this section: 3
(a) "Group health insurance" and "blanket health insurance": 4
1. Have the same meanings as in KRS 304.18-020 and 304.18-060, 5
respectively; and 6
2. Include any policy, certificate, plan, or contract that provides coverage 7
or benefits in this state for medical, surgical, chiropractic, physical 8
therapy, speech pathology, audiology, professional mental health, 9
dental, hospital, optometric, pharmaceutical, or other health-related 10
expenses: 11
a. By direct payment, reimbursement, or otherwise; and 12
b. On a fully insured or self-insured basis or any combination 13
thereof; 14
(b) "Most recent effective date" means the most recent effective date of the 15
section, as set forth in: 16
1. The official version of the Kentucky Revised Statutes maintained by 17
the Legislative Research Commission in accordance with KRS 7.131 18
and made available to the public pursuant to KRS 7.500; or 19
2. Except as otherwise provided in KRS 7.138(2)(b), any certified version 20
of the Kentucky Revised Statutes designated by the Legislative 21
Research Commission in accordance with KRS 7.132; and 22
(c) "Otherwise specifically indicated or provided" means that the section or 23
another section of the Kentucky Revised Statutes: 24
1. Expressly states that the section is applicable to; and 25
2. Specifically refers to; 26
a type of insurance, coverage, or benefits that is excluded under subsection 27 UNOFFICIAL COPY 25 RS BR 153
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(3) of this section. 1
(2) This subtitle may be cited as the Group or Blanket Health Insurance Law. 2
(3)[(2)] Unless otherwise specifically indicated or provided: 3
(a) The sections of this subtitle apply[This subtitle applies] only to group health 4
insurance[ contracts] and to blanket health insurance; 5
(b) If a section of this subtitle has a most recent effective date that is prior to 6
the effective date of this Act, the section shall not apply to or affect any of 7
the following[contracts, except]: 8
1.[(a)] Disability income insurance;[ and] 9
2.[(b)] Paid family leave insurance; or 10
3. Other types of similar or limited insurance, coverage, or benefits, to 11
the extent specified by the commissioner in an administrative 12
regulation promulgated in accordance with KRS Chapter 13A; and 13
(c) If a section of this subtitle has a most recent effective date that is on or after 14
the effective date of this Act, the section shall not apply to or affect any of 15
the of following: 16
1. Group health insurance or blanket health insurance covering only 17
accident, credit, dental, vision, or specified disease, illness, or 18
condition; 19
2. Disability income insurance; 20
3. Paid family leave insurance; 21
4. Long-term care insurance; 22
5. Short-term nursing home insurance; 23
6. Medicare supplement insurance; 24
7. Hospital indemnity or other fixed indemnity health insurance; 25
8. Coverage provided under a limited health service benefit plan, as 26
defined in KRS 304.17C-010, including a limited health service 27 UNOFFICIAL COPY 25 RS BR 153
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contract, as defined in KRS 304.38A-010; 1
9. Coverage under which benefits for medical expenses are: 2
a. Contained in, or included as a rider, amendment, or 3
supplemental policy provision to, any liability insurance policy or 4
contract or equivalent self-insurance; or 5
b. Supplemental to other insurance or equivalent self-insurance 6
benefits, including the following: 7
i. Automobile medical-payment insurance; and 8
ii. Life insurance or endowment or annuity contracts; 9
10. Medical expense reimbursement coverage that is: 10
a. Specifically designed to supplement, or fill gaps in, primary 11
health insurance coverage; and 12
b. Provided under a policy, plan, certificate, or contract that is 13
separate from the primary health insurance coverage; 14
11. Coverage or benefits provided under: 15
a. KRS Chapter 205 or 342; or 16
b. Any other statutory-based public assistance or compensation 17
program; 18
12. Coverage or benefits for on-site medical clinics; 19
13. Coverage or benefits provided under a health flexible spending 20
arrangement; or 21
14. Other types of similar or limited insurance, coverage, or benefits, to 22
the extent specified by the commissioner in an administrative 23
regulation promulgated in accordance with KRS Chapter 13A. 24