Ind. Code § 27-1-15.6-13.5
This is the official text of Ind. Code § 27-1-15.6-13.5, part of Indiana’s Code — part of the compiled statutory law of Indiana, published by the state as "Code." Browse the sections below, each linked to its official government source.
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Applicability; disclosure to policyholder or subscriber; acknowledgment; submission to all payer claims data base; examination
Official statutory text
Sec. 13.5. (a) This section applies only to the following:
(1) An individual, group, franchise, or blanket policy of accident and sickness insurance, as defined in IC 27-8-5-1. However, this section does not apply to the types of insurance and coverage described in IC 27-8-5-2.5(a).
(2) An individual or group health maintenance organization contract entered into under IC 27-13.
(b) As used in this section, "third party administrator" means a person who:
(1) is licensed under IC 27-1-25; and
(2) administers a policy of accident and sickness insurance described in subsection (a)(1) or a health maintenance organization contract described in subsection (a)(2).
(c) Except as provided in subsection (f), an insurer that issues an insurance policy, a health maintenance organization that enters into a health maintenance organization contract, or a third party administrator shall disclose to the policyholder or subscriber in a separate written notification:
(1) any commission, service fee, or brokerage fee that has been or will be paid to an insurance producer for selling, soliciting, or negotiating the policy or contract; and
(2) whether the amount disclosed under subdivision (1) is based on a percentage of total plan premiums or a flat per member fee.
(d) An insurer, a health maintenance organization, or a third party administrator shall provide a copy of the written notification described in subsection (c) to the policyholder or subscriber:
(1) when the insurance policy is issued or the contract is entered into; and
(2) each time the insurance policy or contract is renewed.
(e) Each copy of a written notification described in subsection (c) must include a signature line on which the policyholder may sign to acknowledge receiving the written notification.
(f) This section does not require the disclosure to the policyholder of a commission, service fee, or brokerage fee in connection with the issuance of an insurance policy if a federal law or regulation requires disclosure of the commission, service fee, or brokerage fee to the policyholder.
(g) An insurer, a health maintenance organization, and a third party administrator shall submit the information described in subsection (c) to the executive director of the all payer claims data base established under IC 27-1-44.5 for inclusion in the data base.
(h) The department shall perform an examination under IC 27-1-3.1 for any alleged violation of this section.
As added by P.L.50-2020, SEC.4. Amended by P.L.216-2025, SEC.38.
(1) An individual, group, franchise, or blanket policy of accident and sickness insurance, as defined in IC 27-8-5-1. However, this section does not apply to the types of insurance and coverage described in IC 27-8-5-2.5(a).
(2) An individual or group health maintenance organization contract entered into under IC 27-13.
(b) As used in this section, "third party administrator" means a person who:
(1) is licensed under IC 27-1-25; and
(2) administers a policy of accident and sickness insurance described in subsection (a)(1) or a health maintenance organization contract described in subsection (a)(2).
(c) Except as provided in subsection (f), an insurer that issues an insurance policy, a health maintenance organization that enters into a health maintenance organization contract, or a third party administrator shall disclose to the policyholder or subscriber in a separate written notification:
(1) any commission, service fee, or brokerage fee that has been or will be paid to an insurance producer for selling, soliciting, or negotiating the policy or contract; and
(2) whether the amount disclosed under subdivision (1) is based on a percentage of total plan premiums or a flat per member fee.
(d) An insurer, a health maintenance organization, or a third party administrator shall provide a copy of the written notification described in subsection (c) to the policyholder or subscriber:
(1) when the insurance policy is issued or the contract is entered into; and
(2) each time the insurance policy or contract is renewed.
(e) Each copy of a written notification described in subsection (c) must include a signature line on which the policyholder may sign to acknowledge receiving the written notification.
(f) This section does not require the disclosure to the policyholder of a commission, service fee, or brokerage fee in connection with the issuance of an insurance policy if a federal law or regulation requires disclosure of the commission, service fee, or brokerage fee to the policyholder.
(g) An insurer, a health maintenance organization, and a third party administrator shall submit the information described in subsection (c) to the executive director of the all payer claims data base established under IC 27-1-44.5 for inclusion in the data base.
(h) The department shall perform an examination under IC 27-1-3.1 for any alleged violation of this section.
As added by P.L.50-2020, SEC.4. Amended by P.L.216-2025, SEC.38.
Status: in_force · Read it on the official government site
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