KRS 304.17A-150: Unfair trade practices -- Penalties.

(1) On and after July 15, 1995, it is an unfair trade practice for an insurer, agent, broker,

or any other person in the business of marketing and selling health plans, to commit

or perform any of the following acts:

(a) Encourage individuals or groups to refr ain from filing an application for

coverage with the insurer because of the individual's or group's health status,

claims experience, industry, occupation, or geographic location; or

(b) Encourage or direct individuals or groups to seek coverage from anoth er

insurer because of the individual's or group's health status, claims experience,

industry, occupation, or geographic location; or

(c) Encourage an employer to exclude an employee from coverage.

The provisions of this subsection shall not apply to infor mation provided regarding

the established geographic service area of an insurer.

(2) It is an unfair trade practice for an insurer to compensate an agent, broker, or any

other person in the business of marketing and selling health plans on the basis of the

health status, claims experience, industry, occupation, or geographic location of the

insured or prospective insured, except as provided in KRS 304.17B -001 to

304.17B-031.

(3) It shall constitute an unfair trade practice for any insurer, insurance agent, or third-

party administrator to refer an individual to Kentucky Access, or to arrange for an

individual to apply to Kentucky Access, for the purpose of separating an individual

from group health insurance coverage.

(4) It is an unfair trade practice for an insurer that offers multiple health benefit plans to

require a health care provider, as a condition of participation in a health benefit plan

of the insurer, to participate in any of the insurer's other health benefit plans. In

addition to the proceedings and penalties provided in this chapter for violation of

this provision, a contract provision violating this subsection is void.

(5) It is an unfair trade practice for an insurer not to compute an insured's coinsurance

or cost sharing on the basis of the a mount actually received by a health -care

provider from the insurer.

(6) The commissioner may suspend or revoke, after notice and hearing, the certificate

of authority to transact insurance in this state of any insurer that fails to pay an

assessment under KRS 304.17B-021. As an alternative, the commissioner may levy

a civil penalty on any member insurer that fails to pay the assessment when due.

The civil penalty shall not exceed five percent (5%) of the unpaid assessment per

month, but no civil penalty shall be less than one hundred dollars ($100) per month.

(7) The remedy provided by KRS 304.12 -120 shall be available for conduct proscribed

by this section.

(8) It is an unfair claims settlement practice for any person to make claims payments to

insureds or beneficiaries not accompanied by a statement setting forth the coverage

under which the payments are being made in instances in which the insured has a

liability under the policy beyond his or her copayment or deductible.

(9) It is an unfair trade practice to impose requirements in a provider contract or

agreement with a doctor of chiropractic licensed pursuant to KRS Chapter 312 that

restrict, reduce, or negate the benefits that are otherwise provided to a person

covered under a health benefit plan. Nothing in this subsection shall be construed to

prevent an insurer from performing a utilization review in accordance with KRS

304.17A-600 to 304.17A-633.