(1) Coverage for all usual, customary, and reasonable charges related to medically necessary services rendered, as defined by the small employer carrier includes as follows:
- (a) The benefits provided shall be coordinated pursuant to ARM 6.6.2401 through 6.6.2405.
- (b) Coverage for all statutory mandated benefits, including, but not limited to those mandated by 33-22-132 , MCA, (mammography examinations) ; 33-22-512 , MCA, 33-30-1014 , MCA (well child care) ; 33-22-703 , MCA (mental illness, and chemical dependency) ; 33-22-114 , MCA, (services of physician's assistants - certified) ; 33-22-125 , MCA, (independent chiropractic examination and review) ; 33-22-130 , MCA, (treatment of adopted children) ; 33-22-131 , MCA, (phenylketonuria treatment) ; 33-22-301 , MCA, 33-22-504 , MCA, and 33-30-1001 , MCA, (newborns) ; 33-22-304 , MCA, 33-22-506 , MCA, and 33-30-1004 , MCA, (continuation of coverage for the handicapped) ; 33-22-305 through 33-22-311 , MCA (the Individual Family Disability Insurance Continuation of Coverage Act) ; 33-22-503 , MCA (regarding continuation of benefits to dependents) ; 33-22-507 , MCA (regarding continuing group coverage after reduction of work schedule) ; 33-22-508 , MCA (regarding conversion on termination of eligibility) ; 33-22-509 , MCA (regarding imposition of pre-existing conditions to a converted policy covered by a group contract) ; and 33-22-510 , MCA (insured family-conversion entitlement) .
- (c) Standard plans must comply with 49-2-309 , MCA.
- (2) Small employer carriers may offer a standard plan above the minimum coverage and benefit levels.
Authorizing statute(s): Sec. 33-1-313 and 33-22-1822, MCA
Implementing statute(s): Sec. 33-22-1802, 33-22-1812, and 33-22-1828, MCA
History: NEW, 1994 MAR p. 1528, Eff. 6/10/94; AMD, 1994 MAR p. 2926, Eff. 11/11/94; AMD, 1995 MAR p. 2127, Eff. 10/13/95; AMD, 1998 MAR p. 2020, Eff. 6/26/98.