§36-6981. Policy of coverage — Issuance to enrollees — Filing and
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approval — Requirements.
A. Every enrollee of a prepaid vision plan shall be issued a coverage policy by the prepaid vision plan organization. No policy for coverage or amendment to the policy shall be issued or delivered to any person in this state until a copy of the policy for coverage or amendment to the policy has been filed with and approved by the Insurance Commissioner.
B. A policy for coverage shall contain a statement of:
1. The prepaid vision services or other benefits to which the enrollee is entitled under the prepaid vision plan;
2. Any limitations of the services or benefits to which the enrollee is entitled under the prepaid vision plan;
3. Information as to how services may be obtained; and
4. The obligation of the enrollee for charges for the prepaid vision plan.
C. The Commissioner shall approve any policy of coverage if the requirements of this section are complied with and the prepaid vision plan, in the judgment of the Commissioner, is able to meet its financial obligations for the membership coverage. It shall be unlawful for a prepaid vision plan organization to issue a policy until it is approved by the Commissioner.
D. 1. If the Commissioner does not disapprove any policy within thirty
(30)days after filing, the policy shall be deemed approved.
2. If the Commissioner disapproves a policy of membership coverage, the Commissioner shall notify the prepaid vision plan organization, specifying the reasons for disapproval. The Commissioner shall grant a hearing on any disapproval within thirty
(30)days after a request in writing for a hearing is received by the Commissioner from the prepaid vision plan organization. Added by Laws 2024, c. 360, § 10, emerg. eff. May 30, 2024.