(1) A health insurance policy or health maintenance organization contract:

1. (a) shall provide, at a minimum, coverage of emergency services as required in 29 C.F.R. Sec. 2590.715-2719A; and

2. (b) may not:

   1. (i) require any form of preauthorization for treatment of an emergency medical condition until after the insured's condition has been stabilized; or
   2. (ii) deny a claim for any covered evaluation, covered diagnostic test, or other covered treatment considered medically necessary to stabilize the emergency medical condition of an insured.

(3) For purposes of this section:

1. (a) "emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that a prudent layperson, who possesses an average knowledge of medicine and health, would reasonably expect the absence of immediate medical attention at a hospital emergency department to result in:

   1. (i) placing the insured's health, or with respect to a pregnant woman, the health of the woman or her unborn child, in serious jeopardy;
   2. (ii) serious impairment to bodily functions; or
   3. (iii) serious dysfunction of any bodily organ or part; and
2. (b) "hospital emergency department" means that area of a hospital in which emergency services are provided on a 24-hour-a-day basis.

(4) Nothing in this section may be construed as:

1. (a) altering the level or type of benefits that are provided under the terms of a contract or policy; or
2. (b) restricting a policy or contract from providing enhanced benefits for certain emergency medical conditions that are identified in the policy or contract.

(5) Notwithstanding Section 31A-2-308, if the commissioner finds an insurer has violated this section, the commissioner may:

1. (a) work with the insurer to improve the insurer's compliance with this section; or

2. (b) impose the following fines:

   1. (i) not more than $5,000; or
   2. (ii) twice the amount of any profit gained from violations of this section.