Nebraska Statutes 44-4226. Major medical expense coverage required;considerations
(1) The pool shall offer major medical expense coverage to every eligible individual. The pool coverage, its schedule of benefits, and exclusions and other limitations shall be established through rules and regulations adopted and promulgated by the director taking into consideration the advice and recommendations of the members.
Terms Used In Nebraska Statutes 44-4226
- Director: means the Director of Insurance. See Nebraska Statutes 44-4208
- Health insurance: means any hospital, surgical, or medical expense-incurred policy or health maintenance organization contract. See Nebraska Statutes 44-4209
- Pool: means the Comprehensive Health Insurance Pool. See Nebraska Statutes 44-4215
- State: when applied to different states of the United States shall be construed to extend to and include the District of Columbia and the several territories organized by Congress. See Nebraska Statutes 49-801
(2) In establishing the pool coverage, the director shall take into consideration the levels of individual health insurance coverage provided in the state and such medical economic factors as may be deemed appropriate and shall determine benefit levels, deductibles, coinsurance and stop-loss factors, exclusions, and limitations determined to be generally reflective of and commensurate with individual health insurance coverage provided by the ten insurers writing the largest amount of individual health insurance coverage in the state.
(3) Pool coverage established under this section shall provide both an appropriate high and low deductible to be selected by the pool applicant. The deductibles and coinsurance and stop-loss factors may be adjusted annually according to the medical component of the Consumer Price Index.