{"data":{"id":"us-ky/krs-304.17a-150","jurisdiction":"us-ky","citation":"KRS 304.17A-150","heading":"Unfair trade practices -- Penalties.","body":"(1) On and after July 15, 1995, it is an unfair trade practice for an insurer, agent, broker,\nor any other person in the business of marketing and selling health plans, to commit\nor perform any of the following acts:\n(a) Encourage individuals or groups to refr ain from filing an application for\ncoverage with the insurer because of the individual's or group's health status,\nclaims experience, industry, occupation, or geographic location; or\n(b) Encourage or direct individuals or groups to seek coverage from anoth er\ninsurer because of the individual's or group's health status, claims experience,\nindustry, occupation, or geographic location; or\n(c) Encourage an employer to exclude an employee from coverage.\nThe provisions of this subsection shall not apply to infor mation provided regarding\nthe established geographic service area of an insurer.\n(2) It is an unfair trade practice for an insurer to compensate an agent, broker, or any\nother person in the business of marketing and selling health plans on the basis of the\nhealth status, claims experience, industry, occupation, or geographic location of the\ninsured or prospective insured, except as provided in KRS 304.17B -001 to\n304.17B-031.\n(3) It shall constitute an unfair trade practice for any insurer, insurance agent, or third-\nparty administrator to refer an individual to Kentucky Access, or to arrange for an\nindividual to apply to Kentucky Access, for the purpose of separating an individual\nfrom group health insurance coverage.\n(4) It is an unfair trade practice for an insurer that offers multiple health benefit plans to\nrequire a health care provider, as a condition of participation in a health benefit plan\nof the insurer, to participate in any of the insurer's other health benefit plans. In\naddition to the proceedings  and penalties provided in this chapter for violation of\nthis provision, a contract provision violating this subsection is void.\n(5) It is an unfair trade practice for an insurer not to compute an insured's coinsurance\nor cost sharing on the basis of the a mount actually received by a health -care\nprovider from the insurer.\n(6) The commissioner may suspend or revoke, after notice and hearing, the certificate\nof authority to transact insurance in this state of any insurer that fails to pay an\nassessment under KRS 304.17B-021. As an alternative, the commissioner may levy\na civil penalty on any member insurer that fails to pay the assessment when due.\nThe civil penalty shall not exceed five percent (5%) of the unpaid assessment per\nmonth, but no civil penalty shall be less than one hundred dollars ($100) per month.\n(7) The remedy provided by KRS 304.12 -120 shall be available for conduct proscribed\nby this section.\n(8) It is an unfair claims settlement practice for any person to make claims payments to\ninsureds or beneficiaries not accompanied by a statement setting forth the coverage\nunder which the payments are being made in instances in which the insured has a\nliability under the policy beyond his or her copayment or deductible.\n(9) It is an unfair trade practice  to impose requirements in a provider contract or\nagreement with a doctor of chiropractic licensed pursuant to KRS Chapter 312 that\nrestrict, reduce, or negate the benefits that are otherwise provided to a person\ncovered under a health benefit plan. Nothing in this subsection shall be construed to\nprevent an insurer from performing a utilization review in accordance with KRS\n304.17A-600 to 304.17A-633.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=40554","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:46Z","sha256":"bc7fcecc3eced1b6965ab28e75e33cb351463ea04d134345774ff38746d99c58","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-149","next":"us-ky/krs-304.17a-155"},"notice":"GroundRules: Original legal text. Not legal advice."}