Hawaii Health Insurance Laws
The state of Hawaii has strict laws governing the provision of health insurance in the state. Many of the laws that regulate health insurance provisions and health insurance policies are contained in chapter 431:10A of the Hawaii Revised Statutes, and contain regulations stating the exact form that a policy must take, provisions that must be included in every policy, and how family policies must cover newborn children.
Form of Policy
Section 431:10A-104 of the Hawaii Revised Statutes contains the form that all health insurance policies offered in Hawaii must conform to. A health insurance policy must include the total amount of money that the purchaser is expected to pay, and the exact times when the policy begins and ends. The policy must be designed in such a way that no prominence is given to any part of the text, and the text of the policy must not be printed using a font size smaller than 10 point. All policies must include a form-number on the bottom left hand corner of the first page, and policies must not contain provisions stating that the rules, charter or constitution of the insurance provider form part of the policy, unless they are expressly included in the details of the policy and written in full. The publication of insurance rates, or the classification of risks may be included in the policy information.
Required Provisions
All health insurance policies offered in Hawaii must contain certain provisions by law. These provisions are contained in section 431:10A-105 of the Hawaii Revised Statutes, and must be included in health insurance policies, using the exact words used in this section. Insurers may use their own wording for the required provisions, provided that they have been approved by the state commissioner. Only customized provisions that are at least as favorable to the policy beneficiary as the provisions set out in the revised statutes are allowed.
Provisions that must be included in all health insurance policies include a time limit on misstatements of three years. The provision limits insurance providers to three years in which a misstatement on a policy may be used to deny a claim, unless the misstatement can be shown to have been made deliberately, as a fraudulent act. All policies must include a payment grace period, which comes into force following the first payment. This means that the policy must remain in force even if the insured person is late in paying the premium, provided that it is paid by the end of the grace period.
Newborn Children
In Hawaii, all health insurance policies that provide cover for families, must provide insurance cover for the newborn infants of the insured family from the moment that the infant is born. Coverage in this instance is governed by section 431:10A-115 of the Hawaii Revised Statutes, which states that coverage of newborn infants can be limited to the treatment and care of birth abnormalities or congenital defects. Wherever a policy requires a separate premium to be paid for each child, the insurance provider must be notified of the birth within 31 days for coverage to continue and apply to the newborn child.
Tags: health insurance policies, insurance policies, policy must, Hawaii Revised, Hawaii Revised Statutes
