Indiana § 27-1-25-16 - Presumption of control

§ 27-1-25-16. Presumption of control

Sec. 16. (a) A presumption of control arising under section 1(e) of this chapter may be rebutted by a showing made in the manner provided under IC 27-1-23-3(k) that control does not exist in fact.

(b) In the absence of a presumption that control exists in fact, the commissioner may determine that control exists in fact after:

(1) providing notice and an opportunity to be heard under IC 4-21.5 to all interested parties; and

(2) making specific findings of fact to support the determination.

As added by P.L.160-2003, SEC.21.

IC 27-1-25.1Chapter 25.1. Certain Insurer Responsibilities

27-1-25.1-1"Affiliate" 27-1-25.1-2"Insurer" 27-1-25.1-3"Person" 27-1-25.1-4Insurer responsibility for actions of affiliate

IC 27-1-25.1-1"Affiliate" Sec. 1. As used in this chapter, "affiliate" has the meaning set forth in IC 27-1-25-1(b).

As added by P.L.160-2003, SEC.22.

IC 27-1-25.1-2"Insurer" Sec. 2. As used in this chapter, "insurer" has the meaning set forth in IC 27-1-25-1(l).

As added by P.L.160-2003, SEC.22.

IC 27-1-25.1-3"Person" Sec. 3. As used in this chapter, "person" refers to a person described in IC 27-1-25-1(a)(15).

As added by P.L.160-2003, SEC.22.

IC 27-1-25.1-4Insurer responsibility for actions of affiliate Sec. 4. The insurer with which a person is affiliated is responsible for:

(1) the acts of the person; and

(2) providing the person's books and records to the commissioner.

As added by P.L.160-2003, SEC.22.

IC 27-1-25.5Chapter 25.5. Fiduciary Duties

27-1-25.5-1"Fiduciary duty" 27-1-25.5-2"Health insurance coverage" 27-1-25.5-3"Insurer" 27-1-25.5-4"Pharmacy benefit manager" 27-1-25.5-5"Plan sponsor" 27-1-25.5-6Fiduciary duty to plan sponsor

IC 27-1-25.5-1"Fiduciary duty" Sec. 1. As used in this chapter, "fiduciary duty" includes the duty to:

(1) act with loyalty and care in the best interest of the plan sponsor;

(2) ensure that all fees, costs, and commissions are reasonably and fully disclosed;

(3) avoid self-dealing and conflicts of interest; and

(4) maintain transparency in all financial and contractual arrangements related to the plan sponsor's health insurance coverage, including prescription drug benefits.

As added by P.L.69-2025, SEC.1.

IC 27-1-25.5-2"Health insurance coverage" Sec. 2. As used in this chapter, "health insurance coverage" includes:

(1) a group policy of accident and sickness insurance (as defined in IC 27-8-5-1);

(2) a group contract (as defined in IC 27-13-1-16) that provides coverage for basic health care services (as defined in IC 27-13-1-4); and

(3) any other group health plan that limits eligibility to members of a specific group.

The term includes coverage of a dependent of the covered individual under a group policy or contract described in subdivisions (1) through (3).

As added by P.L.69-2025, SEC.1.

IC 27-1-25.5-3"Insurer" Sec. 3. As used in this chapter, "insurer" means an insurer that provides health insurance coverage to a covered individual.

As added by P.L.69-2025, SEC.1.

IC 27-1-25.5-4"Pharmacy benefit manager" Sec. 4. As used in this chapter, "pharmacy benefit manager" has the meaning set forth in IC 27-1-24.5-12.

As added by P.L.69-2025, SEC.1.

IC 27-1-25.5-5"Plan sponsor" Sec. 5. As used in this chapter, "plan sponsor" means an employer or organization that offers health insurance coverage to its employees or members through an insurer or a self-funded health benefit plan.

As added by P.L.69-2025, SEC.1.

IC 27-1-25.5-6Fiduciary duty to plan sponsor Sec. 6. Any:

(1) third party administrator; or

(2) pharmacy benefit manager;

acting on behalf of a plan sponsor owes a fiduciary duty to the plan sponsor.

As added by P.L.69-2025, SEC.1.

IC 27-1-26Chapter 26. Policy Language Simplification

27-1-26-1Definitions 27-1-26-2Policies and forms not subject to chapter 27-1-26-3Minimum requirements 27-1-26-4Non-English language policies 27-1-26-5Flesch reading ease score; procedure to determine; rules of construction 27-1-26-6Reading ease; alternative tests 27-1-26-7Certificate of insurer to accompany policy filed with department; contents; additional information 27-1-26-8Separate test scores permitted for riders, endorsements, applications, and other forms 27-1-26-9Policies with failing scores; issuance for delivery authorized upon certain findings 27-1-26-10Compliance with other laws 27-1-26-11Regulations 27-1-26-12Application of chapter