41-4203. STANDARDS FOR POLICY PROVISIONS. (1) The director shall issue rules, subject to chapter 52, title 67, Idaho Code, to establish specific standards, including standards of full and fair disclosure, that set forth the manner, content, and required disclosure for the sale of individual policies of disability insurance, group supplemental policies of disability insurance, nongroup subscriber contracts of nonprofit hospital, medical and dental service associations and nongroup subscriber contracts of managed care organizations which shall be in addition to and in accordance with applicable laws of this state, which may cover but shall not be limited to:

(a) Terms or renewability;

(b) Initial and subsequent conditions of eligibility;

(c) Nonduplication of coverage provisions;

(d) Coverage of dependents;

(e) Pre-existing conditions;

(f) Termination of insurance;

(g) Probationary periods;

(h) Limitations;

(i) Exceptions;

(j) Reductions;

(k) Elimination periods;

(l) Requirements for replacement;

(m) Recurrent conditions; and

(n) The definition of terms including but not limited to the following: hospital, accident, sickness, injury, physician, accidental means, total disability, partial disability, nervous disorder, guaranteed renewable and noncancelable.

(2) The director may issue rules that specify prohibited policy provisions not otherwise specifically authorized by statute which in the opinion of the director are unjust, unfair, or unfairly discriminatory to the policyholder, any person insured under the policy, or beneficiary.

History:

[41-4203, added 1975, ch. 205, sec. 3, p. 569; am. 2009, ch. 66, sec. 3, p. 188.]