Miss. Code Ann. § 83-61-13: Written disclosure by the carrier; written statement by eligible individual; services and costs information.

(1) Upon offering coverage under a minimum benefits or basic coverage contract issued in accordance with this chapter, the approved carrier shall provide the eligible individual with a written disclosure containing at least the following:

(a) An explanation that this is a minimum benefits or basic insurance coverage contract and that benefits otherwise mandated by state law are not covered in the minimum benefits contracts;

(b) An explanation of the benefits mandated by state law;

(c) An explanation of the cost control features of the minimum benefits or basic coverage contract; and

(d) A list of applicable addresses and telephone numbers for use by the eligible individual to obtain information on and authorization for participation in the program.

(2) Before issuing a minimum benefits or basic insurance coverage contract in accordance with this chapter, the approved carrier shall obtain from the eligible individual a signed written statement in which the individual:

(a) Certifies his or her eligibility for coverage under a minimum benefits or basic coverage contract in accordance with Section 83-61-7;

(b) Acknowledges the limited benefits provided under the basic coverage insurance contract.

(3) The State Health Department shall furnish information to approved carriers concerning the services, and the costs of such services, if any, available from the county and state health departments, and such information shall be included in contracts of insurance coverage.

(4) The carriers shall furnish information to their policyholders concerning the federal government’s earned income credit for health insurance, and such information shall be included in contracts of insurance coverage issued under this chapter.