342.352 Voluntary programs for integrated management of employer's worker
357 words·~2 min read·
/ky/342-352A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
compensation and group health insurance claims -- Twenty-four hour
coverage.
(1)The commissioner may establish one
(1)or more programs for interested employers
of integrated management of an employer's workers' compensation and group health
insurance claims by an insurer authorized to do business in the Commonwealth and
may promulgate any administrative regulations necessary to implement the
provisions of this subsection. The integrated management of such claims shall in no
event affect any benefits, rights, or coverage established pursuant to a workers'
compensation insurance policy. Treatment for work-related conditions shall not be
subject to either copayments or deductibles. The commissioner shall make a report
comparing the results of each program to the expected results under traditional
workers' compensation insurance and traditional workers' compensation with a
managed care program. The program shall serve as a tentative model for future
experiments.
(2)No policy for twenty-four
(24)hour coverage shall become effective until it is
reviewed and approved by the commissioner, in consultation with the commissioner
of the Department of Insurance.
(3)The purchase of a twenty-four
(24)hour health policy shall not constitute an
exemption from statutory provisions which require other nonmedical insurance
coverage. However, an insurance carrier shall reduce its premium for insurance
coverage written without the medical or health care component. Notwithstanding
the provisions of Subtitle 13 of KRS Chapter 304, the premium reduction required
in this subsection shall be subject to the approval of the commissioner of the
Department of Insurance.
(4)If an employer obtains a twenty-four
(24)hour health insurance policy, pursuant to
this section, to secure payment of compensation for medical care and treatment
under this chapter, the employer shall also procure an insurance policy which shall
provide indemnity benefits to ensure that the total coverage afforded by both the
twenty-four
(24)hour insurance policy and the policy providing indemnity benefits
shall provide the total compensation required by this chapter.
(5)The participants in a project for twenty-four
(24)hour health coverage shall comply
with periodic reporting requirements of the commission.
(6)Each agency of state government shall cooperate with the commissioner if
requested to provide information for the purposes of this section.