6.6.5008    COVERED SERVICES OF POLICIES UNDER STANDARD PLAN

(1) Coverage for all usual, customary, and reasonable charges related to medically necessary services rendered, as defined by the small employer carrier includes as follows:

(a) The benefits provided shall be coordinated pursuant to ARM 6.6.2401 through 6.6.2405.

(b) Coverage for all statutory mandated benefits, including, but not limited to those mandated by 33-22-132 , MCA, (mammography examinations) ; 33-22-512 , MCA, 33-30-1014 , MCA (well child care) ; 33-22-703 , MCA (mental illness, and chemical dependency) ; 33-22-114 , MCA, (services of physician's assistants - certified) ; 33-22-125 , MCA, (independent chiropractic examination and review) ; 33-22-130 , MCA, (treatment of adopted children) ; 33-22-131 , MCA, (phenylketonuria treatment) ; 33-22-301 , MCA, 33-22-504 , MCA, and 33-30-1001 , MCA, (newborns) ; 33-22-304 , MCA, 33-22-506 , MCA, and 33-30-1004 , MCA, (continuation of coverage for the handicapped) ; 33-22-305 through 33-22-311 , MCA (the Individual Family Disability Insurance Continuation of Coverage Act) ; 33-22-503 , MCA (regarding continuation of benefits to dependents) ; 33-22-507 , MCA (regarding continuing group coverage after reduction of work schedule) ; 33-22-508 , MCA (regarding conversion on termination of eligibility) ; 33-22-509 , MCA (regarding imposition of pre-existing conditions to a converted policy covered by a group contract) ; and 33-22-510 , MCA (insured family-conversion entitlement) .

(c) Standard plans must comply with 49-2-309 , MCA.

(2) Small employer carriers may offer a standard plan above the minimum coverage and benefit levels.

History: Sec. 33-1-313 and 33-22-1822, MCA; IMP, Sec. 33-22-1802, 33-22-1812, and 33-22-1828, MCA; NEW, 1994 MAR p. 1528, Eff. 6/10/94; AMD, 1994 MAR p. 2926, Eff. 11/11/94; AMD, 1995 MAR p. 2127, Eff. 10/13/95; AMD, 1998 MAR p. 2020, Eff. 6/26/98.