Nebraska Statutes 44-32,131. Subscriber; receive evidence of coverage; contents
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Every subscriber shall receive an evidence of coverage from the group contract holder or the health maintenance organization. The evidence of coverage shall not contain provisions or statements which are unfair, unjust, inequitable, misleading, or deceptive or which encourage misrepresentation as described by section 44-1525. The evidence of coverage shall contain a clear statement of the provisions required in subdivisions (1) through (17) of section 44-32,129.
Terms Used In Nebraska Statutes 44-32,131
- Contract: A legal written agreement that becomes binding when signed.
- 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.
- Evidence of coverage: shall mean a statement of the essential features and services of the health maintenance organization coverage which is given to the subscriber by the health maintenance organization or by the group contract holder. See Nebraska Statutes 44-32,100
- Health maintenance organization: shall mean any person who undertakes to provide or arrange for the delivery of basic health care services to enrollees on a prepaid basis except for enrollee responsibility for copayments or deductibles. See Nebraska Statutes 44-32,105
- Subscriber: shall mean an individual whose employment or other status, except family dependency, is the basis for eligibility for enrollment in the health maintenance organization or, in the case of an individual contract, the individual in whose name the contract is issued. See Nebraska Statutes 44-32,113