R590-277-2. Purpose and Scope

  (1) The purpose of this rule is to provide reasonable standardization and simplification of terms and coverages of a managed care health benefit plan policy in order to:

  (a) facilitate public understanding and comparison;

  (b) prohibit provisions which may be misleading or confusing in connection either with the purchase of such coverages or with the settlement of claims; and

  (c) provide for full disclosure.

  (2) This rule applies to any health benefit plan issued by a managed care organization to an individual or group, including policies issued to an association, trust, discretionary group, or other similar group.

  (3) This rule does not apply to short-term limited duration health insurance that complies with both R590-85, Individual Accident and Health Insurance and Individual and Group Medicare Supplement rates, and R590-126, Accident and Health Insurance Standards.