{"data":{"id":"us-ky/krs-304.17a-846","jurisdiction":"us-ky","citation":"KRS 304.17A-846","heading":"Providing of requested information on insureds by group health","body":"benefit plan insurers -- Confidentiality -- Additional information to be\nprovided to large groups.\n(1) Any insurer issuing or delivering group health benefit plans in the Commonwealth\nshall provide to an employer-organized association health benefit plan, within thirty\n(30) calendar days after a written request, the information relating to its health\nbenefit plan that has been requested, including but not limited to the following\ninformation for the previous three (3) years or for the entire period of coverage,\nwhichever is shorter:\n(a) Aggregate claims experience by month, including claims experience for\npharmacy benefits;\n(b) Total premiums paid by month;\n(c) Total number of insureds on a monthly basis by coverage tier; and\n(d) Sufficient detailed claims information to permit the employer -organized\nassociation to verify eligibility and participation of the groups and individuals\nparticipating in the employer-organized association program.\nThe department shall, by July 15, 2005, promulgate administrative regulations to\nimplement the provisions of this section and define the extent that individual\ninformation shall be provided.\n(2) This section shall not require the insurer to disclose an y nonpublic personal health\ninformation without the written consent of the individual who is the subject of the\ninformation, as required by administrative regulations promulgated by the\ncommissioner. However, nonpublic personal health information may be pr ovided to\nthe employer -organized association health benefit plan and large group health\nbenefit plan with fifty -one (51) or more enrolled employees as a covered entity to\ncover entity transfer under the Federal Health Insurance Portability and\nAccountability Act of 1996 (HIPAA), 42 U.S.C. sec. 300gg et seq., provided that\nthe health benefit plan certifies to the insurer that it has adopted HIPAA -required\nsafeguards and will treat the nonpublic personal health information in accordance\nwith HIPAA standards.\n(3) Any insurer issuing or delivering group health benefit plans in the Commonwealth\nshall provide to a large group health benefit plan with fifty -one (51) or more\nenrolled employees, within thirty (30) calendar days after receipt of a written\nrequest, the following information relating to its health benefit plan:\n(a) Total premiums paid by month;\n(b) Total number of insureds on a monthly basis by coverage tier; and\n(c) Additional utilization data to help the employer measure costs in the following\nareas:\n1. Detailed prescription drug utilization information, including generic\nversus brand utilization;\n2. Number of office visits to primary care providers and specialists;\n3. Number of emergency room visits;\n4. Number of inpatient and outpatient hospitalizations;\n5. Number of members utilizing deductible and out -of-pocket expenses by\ncost level; and\n6. A list of the most prevalent disease categories.\n(4) Insurers shall not be required to produce reports requested  pursuant to subsection\n(3) of this section more than twice annually.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29384","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:48Z","sha256":"10b92d581ce196cf3960719a8b237130c3d6feaa94b37debf25e9dec82fe2431","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-844","next":"us-ky/krs-304.17b-001"},"notice":"GroundRules: Original legal text. Not legal advice."}