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Private Insurance Data Requirements in Idaho

 

Private Insurance Data Requirements in Idaho

Subtopic Statute/Regulation Description
Disclosure of information held by health plan, including notice requirements Idaho Admin. Code r. 18.04.01.020, Notice of Right to External Review Requires health carriers to provide covered persons with notice of their external review procedures. Permits such notice to accompany the policy,...
Idaho Admin. Code r. 18.04.01.021, Request for External Review Requires the Department of Insurance to make an external review request form available on the Department’s website. Requires covered persons to...
Idaho Admin. Code r. 18.04.01.022, Health Carrier Notice of an Initial Determination of an External Review Requires health carriers to send notice of an initial determination of an external review using a from that complies with the language in Appendix C...
Idaho Code Ann. § 41-5916, Disclosure Requirements Specifies the information about external review procedures that health carriers must include in policies, certificates, and other evidences of...
Grievance procedures Idaho Admin. Code r. 18.04.01.020, Notice of Right to External Review Requires health carriers to provide covered persons with notice of their external review procedures. Permits such notice to accompany the policy,...
Idaho Admin. Code r. 18.04.01.021, Request for External Review Requires the Department of Insurance to make an external review request form available on the Department’s website. Requires covered persons to...
Idaho Admin. Code r. 18.04.01.022, Health Carrier Notice of an Initial Determination of an External Review Requires health carriers to send notice of an initial determination of an external review using a from that complies with the language in Appendix C...
Idaho Code Ann. § 41-3918, Grievance System Requires Managed Care Organizations (MCOs) to implement a grievance system that has received approval from the Insurance Director. Requires MCOs to...
Idaho Code Ann. § 41-3930, Utilization Management Program Requirements Establishes requirements for utilization management programs conducted by Managed Care Organizations (MCOs) or their contractors. Requires MCO...
Idaho Code Ann. § 41-5916, Disclosure Requirements Specifies the information about external review procedures that health carriers must include in policies, certificates, and other evidences of...
Cost reporting by insurance companies (Cross reference Provider Resource Use) Idaho Admin. Code r. 18.04.04.014, Annual Report to the Director Requires managed care organizations to annually file a financial report with the Insurance Director. Requires the report to be prepared using...
Idaho Code Ann. § 41-3910, Reports to the Director Requires Managed Care Organizations to file financial reports to the Insurance Director by June 1 of every year.
Preexisting condition information: How the insurer may use preexisting condition information Idaho Admin. Code r. 18.04.10.082, Prohibition Against Use of Genetic Information and Requests for Genetic Testing Prohibits insurance carriers that issue Medicare supplement coverage from using an individual’s genetic information as the basis to deny or...
Required testing by insurance company(genetic and HIV/STD) Idaho Admin. Code r. 18.04.10.082, Prohibition Against Use of Genetic Information and Requests for Genetic Testing Prohibits insurance carriers that issue Medicare supplement coverage from using an individual’s genetic information as the basis to deny or...
Health plan required reporting Idaho Code Ann. § 41-5914, External Review Reporting Requirements Requires independent review organizations to maintain records of requested and assigned external reviews. Specifies the data that such organizations...