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Laws of North Carolina (Last Updated: May 12, 2015) |
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Chapter58. Insurance. |
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Article50. General Accident and Health Insurance Regulations |
| Part 1. Miscellaneous Provisions |
| § 58-50-1. Waiver by insurer |
| § 58-50-5. Application |
| § 58-50-10. Repealed by Session Laws 1993, c. 529, s. 4.1 |
| § 58-50-15. Conforming to statute |
| § 58-50-20. Age limit |
| § 58-50-25. Nurses' services |
| § 58-50-26. Physician services provided by physician assistants |
| § 58-50-30. Right to choose services of certain providers |
| § 58-50-35. Notice of nonpayment of premium required before forfeiture |
| § 58-50-40. Willful failure to pay group insurance premiums; willful termination of a group health plan; notice to persons insured; penalty; restitution; examination of insurance transactions |
| § 58-50-45. Group health or life insurers to notify insurance fiduciaries of obligations |
| § 58-50-46. Recodified as G.S. 108A-55.4 by Session Laws 2006-221, s. 9(a), effective January 1, 2007 |
| Part 2. PPOs, Utilization Review and Grievances |
| § 58-50-50. Repealed by Session Laws, 1997-519, s. 3.17 |
| § 58-50-55. Repealed by Session Laws 1997-519, s. 3.17 |
| § 58-50-56. Insurers, preferred provider organizations, and preferred provider benefit plans |
| § 58-50-57. Offsets against provider reimbursement for workers' compensation payments forbidden |
| § 58-50-58. Reserved for future codification purposes |
| § 58-50-59. Reserved for future codification purposes |
| § 58-50-60. Repealed by Session Laws 1997-519, s. 4.4 |
| § 58-50-61. Utilization review |
| § 58-50-62. Insurer grievance procedures |
| § 58-50-63. Expired pursuant to Session Laws 2005-453, s. 3, effective July 1, 2005 |
| § 58-50-64. Reserved for future codification purposes |
| Part 3. Scope and Sanctions |
| § 58-50-65. Certain policies of insurance not affected |
| § 58-50-70. Punishment for violation |
| Part 4. Health Benefit Plan External Review |
| § 58-50-75. Purpose, scope, and definitions |
| § 58-50-76. Reserved for future codification purposes |
| § 58-50-77. Notice of right to external review |
| § 58-50-78. Reserved for future codification purposes |
| § 58-50-79. Exhaustion of internal grievance process |
| § 58-50-80. Standard external review |
| § 58-50-81. Reserved for future codification purposes |
| § 58-50-82. Expedited external review |
| § 58-50-83. Reserved for future codification purposes |
| § 58-50-84. Binding nature of external review decision |
| § 58-50-85. Approval of independent review organizations |
| § 58-50-86. Reserved for future codification purposes |
| § 58-50-87. Minimum qualifications for independent review organizations |
| § 58-50-88. Reserved for future codification purposes |
| § 58-50-89. Hold harmless for Commissioner, medical professionals, and independent review organizations |
| § 58-50-90. External review reporting requirements |
| § 58-50-91. Reserved for future codification purposes |
| § 58-50-92. Funding of external review |
| § 58-50-93. Disclosure requirements |
| § 58-50-94. Selection of independent review organizations |
| § 58-50-95. Report by Commissioner |
| Part 5. Small Employer Group Health Insurance Reform |
| § 58-50-100. Title and reference |
| § 58-50-105. Purpose and intent |
| § 58-50-110. Definitions |
| § 58-50-112. Affiliated companies; HMOs |
| § 58-50-113. Repealed by Session Laws 1993, c. 529, s. 3.4 |
| § 58-50-115. Health benefit plans subject to Act |
| § 58-50-120. Repealed by Session Laws 2006-154, s. 9, effective July 23, 2006 |
| § 58-50-125. Health care plans; formation; approval; offerings |
| §§ 58-50-126, 58-50-127. Repealed by Session Laws 2013-357, s. 2(a), effective January 1, 2014 |
| § 58-50-130. Required health care plan provisions |
| § 58-50-131. Premium rates for health benefit plans; approval authority; hearing |
| § 58-50-135. Repealed by Session Laws 2013-357, s. 2(a), effective January 1, 2014 |
| § 58-50-140. Repealed by Session Laws 2006-154, s. 9, effective July 23, 2006 |
| § 58-50-145. Repealed by Session Laws 2006-154, s. 9, effective July 23, 2006 |
| § 58-50-149. Limit on cessions to the Reinsurance Pool |
| § 58-50-150. North Carolina Small Employer Health Reinsurance Pool |
| § 58-50-151. (Recodified as § 58-51-116 effective July 1, 2002) ERISA plans may not require Medicaid to pay first |
| §§ 58-50-155, 58-50-156. Repealed by Session Laws 2013-357, s. 2(a), effective January 1, 2014 |
| Part 6. North Carolina Health Insurance Risk Pool |
| § 58-50-175. (Repealed effective January 1, 2017 - see note) Definitions |
| § 58-50-180. (Repealed effective January 1, 2017 - see note) Risk Pool established; board of directors; plan of operation |
| § 58-50-185. (Repealed effective January 1, 2017 - see note) Administrator |
| § 58-50-190. (Repealed effective January 1, 2017 - see note) Risk Pool rates and policy forms |
| § 58-50-195. (Repealed effective January 1, 2017 - see note) Eligibility for Pool coverage |
| § 58-50-200. (Repealed effective January 1, 2017 - see note) Unfair referral to Pool |
| § 58-50-205. (Repealed effective January 1, 2017 - note) Minimum Pool benefits |
| § 58-50-210. (Repealed effective January 1, 2017 - see note) Preexisting conditions |
| § 58-50-215. (Repealed effective January 1, 2017 - see note) Nonduplication of benefits |
| § 58-50-220. Reserved for future codification purposes |
| § 58-50-225. (Repealed effective January 1, 2017 - see note) North Carolina Health Insurance Risk Pool Fund |
| § 58-50-230. (Repealed effective January 1, 2017 - see note) Complaint procedures |
| § 58-50-235. (Repealed effective January 1, 2017 - see note) Audit |
| § 58-50-240. (Repealed effective January 1, 2017 - see note) Taxation |
| § 58-50-245. (Repealed effective January 1, 2017 - see note) Rules |
| § 58-50-250. (Repealed effective January 1, 2017 - see note) Collective action |
| § 58-50-255. (Repealed effective January 1, 2017 - see note) Pool financing; Board reporting |
| § 58-50-260. (Repealed effective January 1, 2017 - see note) Dissolution of Pool |
| § 58-50-261. Reserved for future codification purposes |
| § 58-50-262. Reserved for future codification purposes |
| § 58-50-263. Reserved for future codification purposes |
| § 58-50-264. Reserved for future codification purposes |
| § 58-50-265. Reserved for future codification purposes |
| Part 7. Contracts Between Health Benefit Plans and Health Care Providers |
| § 58-50-270. Definitions |
| § 58-50-275. Notice contact provisions |
| § 58-50-280. Contract amendments |
| § 58-50-285. Policies and procedures |
| § 58-50-290. Health benefit plans or insurers contracting for provision of dental services; no limitation on fees for noncovered services |
| § 58-50-295. Prohibited contract provisions related to reimbursement rates |
| § 58-50-300. Health benefit plans or insurers contracting for provision of vision services or materials; no limitation on fees for noncovered services or materials |