IC 27-1-41-9: Certificate of coverage; notice

Sec. 9. (a) A certificate that is issued under a group insurance policy to an individual participating group member must include the following information:

(1) The full name and address of the insurer.

(2) The policy number of the master policy.

(3) The full name, address, and telephone number of the group administrator that holds the master policy.

(4) A description of the coverage provided under the certificate, including the amount and term of the coverage.

(5) The amount of premium charged to the individual participating group member for the coverage.

(6) Coverage limits that specifically apply under the individual participating group member's certificate.

(7) Unless:

(A) the master policy is incorporated by reference in the certificate; and

(B) a copy of the master policy accompanies the certificate;

all material terms and conditions of coverage under the certificate.

(b) An insurer shall provide to each individual participating group member separate notice that provides instructions on claim submission procedures.

(c) An insurer or group administrator shall deliver to each individual participating group member a certificate, an amended certificate, or an endorsement to a certificate if any of the following occurs:

(1) A change in coverage limits.

(2) A change in the type of coverage provided.

(3) An addition to, reduction in, or elimination of coverage provided.

(4) An addition of an exclusion of coverage.