Arizona Laws 20-1079. Individual health insurance policies; mandatory coverage exemption; definitions
A. A health care services organization may issue an evidence of coverage to an uninsured individual that is not subject to the requirements of any of the following:
Terms Used In Arizona Laws 20-1079
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Dependent: A person dependent for support upon another.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Health care plan: means any contractual arrangement whereby any health care services organization undertakes to provide directly or to arrange for all or a portion of contractually covered health care services and to pay or make reimbursement for any remaining portion of the health care services on a prepaid basis through insurance or otherwise. See Arizona Laws 20-1051
- Health care services: means services for the purpose of diagnosing, preventing, alleviating, curing or healing human illness or injury. See Arizona Laws 20-1051
- Health care services organization: means any person that undertakes to conduct one or more health care plans. See Arizona Laws 20-1051
- Person: means any natural or artificial person including individuals, partnerships, associations, providers of health care, trusts, insurers, hospital or medical service corporations or other corporations, prepaid group practice plans, foundations for medical care and health maintenance organizations. See Arizona Laws 20-1051
- United States: includes the District of Columbia and the territories. See Arizona Laws 1-215
1. Section 20-1057, subsections C, K, L, Y, Z, AA and BB.
2. Sections 20-1057.01, 20-1057.03, 20-1057.04 and 20-1057.05.
3. Section 20-1057.02, subsections B and E.
B. For the purposes of this section:
1. "Health insurance coverage":
(a) Means a health care plan or arrangement that pays for or furnishes medical or health services and that is issued by a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or medical, hospital, dental and optometric service corporation or a similar entity in another state.
(b) Includes a self-insured or self-funded employee benefit plan or multiemployer employee benefit plan created pursuant to 29 United States Code § 186(c) if the regulation of that plan is preempted by section 514(b) of the employee retirement insurance security act of 1974 (29 United States Code § 1144(b)).
(c) Does not include limited benefit coverage as defined in section 20-1137.
2. "Uninsured individual" means a person who has either:
(a) Not had health insurance coverage for the ninety days immediately before the effective date of coverage issued pursuant to this section, except that this requirement does not apply at the renewal of coverage pursuant to this section.
(b) Lost health insurance coverage in one of the following ways within ninety days immediately before the effective date of coverage issued pursuant to this section:
(i) The individual left a job that provided health insurance coverage.
(ii) The individual’s employer discontinued offering health insurance coverage.
(iii) The individual exhausted continuation coverage under a COBRA continuation provision as defined in section 20-2301.
(iv) The individual’s family health insurance coverage was discontinued due to the death of a spouse or a divorce.
(v) The individual attained the maximum age for dependent coverage under a health insurance policy.
(vi) The individual’s participation in a public health care program was discontinued.