58-17-85.1 Health carrier to offer additional deductible options.
Health carrier to offer additional deductible options.
Any health carrier with any
in force individual health benefit plan issued in accordance with § 58-17-85 prior to August 1, 2003,
shall offer, at the option of the insured, additional deductible options of the following:
One thousand dollars with a four thousand dollar out-of-pocket coinsurance maximum;
Three thousand dollars with a two thousand dollar out-of-pocket coinsurance maximum;
Five thousand dollars with no more than a twenty-five percent coinsurance; and
Ten thousand dollars with a twelve thousand two hundred fifty dollar out-of-pocket
maximum, including the deductible.
Any additional deductible option, with the exception of the five thousand dollar option, may not
require that the insured be responsible for more than a fifty percent coinsurance. If the policy is a
family policy, the health carrier may satisfy the options listed above by offering amounts that are
twice the amounts provided in subdivisions (1) to (4), inclusive. The premium rates for these benefit
plans shall be adjusted based upon the actuarial difference in benefits. A health carrier is not required
to offer a deductible option if that option would decrease the insured's deductible or out-of-pocket
maximum. The director may approve alternatives to those deductible options specified in this section
if the alternatives are consistent with the offering of increased deductible options to insureds and at
least one of the alternatives is consistent with the formation of a health savings account as provided
for by 26 U.S.C. § 223.
Source: SL 2004, ch 302, § 1.