insurance under this section is responsible for paying both the
employer and the employee share of the cost of the coverage.
(f) The group health insurance program required under subsections
(b) through (e) and subsection (k) must be equal to that offered active
employees. The retired employee may participate in the group health
insurance program if the retired employee:
(1) except as provided in subsection (l), pays an amount equal
to the employer's and the employee's premium for the group
health insurance for an active employee; and if the retired
employee
(2) within ninety (90) days after the employee's retirement date
files a written request for insurance coverage with the employer.
However, the employer may elect to pay any part of the retired
employee's premium with respect to insurance coverage under this
chapter.
(g) Except as provided in subsection (j), a retired employee's
eligibility to continue insurance under this section ends when the
employee becomes eligible for Medicare coverage as prescribed by 42
U.S.C. 1395 et seq., or when the employer terminates the health
insurance program. A retired employee who is eligible for insurance
coverage under this section may elect to have the employee's spouse
covered under the health insurance program at the time the employee
retires. If a retired employee's spouse pays the amount the retired
employee would have been required to pay for coverage selected by the
spouse, the spouse's subsequent eligibility to continue insurance under
this section is not affected by the death of the retired employee. The
surviving spouse's eligibility ends on the earliest of the following:
(1) When the spouse becomes eligible for Medicare coverage as
prescribed by 42 U.S.C. 1395 et seq.
(2) When the employer terminates the health insurance program.
(3) Two (2) years after the date of the employee's death.
(4) The date of the spouse's remarriage.
(h) This subsection does not apply to an employee who is entitled
to group insurance coverage under IC 20-28-10-2(b). An employee
who is on leave without pay is entitled to participate for ninety (90)
days in any health insurance program maintained by the employer for
active employees if the employee pays an amount equal to the total of
the employer's and the employee's premiums for the insurance.
(i) An employer may provide group health insurance for retired
employees or their spouses not covered by this section and may provide
group health insurance that contains provisions more favorable to
retired employees and their spouses than required by this section. A
public employer may provide group health insurance to an employee
who is on leave without pay for a longer period than required by
subsection (h).
(j) An employer may elect to permit former employees and their
spouses, including surviving spouses, to continue to participate in a
group health insurance program under this chapter after the former
employee (who is otherwise qualified under this chapter to participate
in a group insurance program) or spouse has become eligible for
Medicare coverage as prescribed by 42 U.S.C. 1395 et seq. An
employer who makes an election under this section may require a
person who continues coverage under this subsection to participate in
a retiree health benefit plan developed under section 8.3 of this chapter.
(k) The state shall provide a group health insurance program to each
retired employee:
(1) who was employed as a teacher in a state institution under:
(A) IC 11-10-5;
(B) IC 12-24-3;
(C) IC 16-33-3;
(D) IC 16-33-4;
(E) IC 20-21-2-1; or
(F) IC 20-22-2-1;
(2) who is at least fifty-five (55) years of age on or before the
employee's retirement date;
(3) who is not eligible for Medicare coverage as prescribed by 42
U.S.C. 1395 et seq.; and
(4) who:
(A) has at least fifteen (15) years of service credit as a
participant in the retirement fund of which the employee is a
member on or before the employee's retirement date; or
(B) completes at least ten (10) years of service credit as a
participant in the retirement fund of which the employee is a
member immediately before the employee's retirement.
(l) The state shall pay at least fifty percent (50%) of the
premium for any insurance coverage provided under this section
for a retired employee who:
(1) retires after June 30, 2007;
(2) has at least twenty (20) years of creditable employment
with the state on the employee's retirement date; and
(3) otherwise meets the requirements for participation in
group health insurance under this section.
(m) The state shall provide, and pay at least fifty percent (50%)
of the premium for, coverage under a Medicare supplement policy
for a retired employee who:
(1) retires after June 30, 2007; and
(2) meets the requirements for participation in group health
insurance under this section, except that the retired employee
is eligible for and participates in Medicare coverage (42
U.S.C. 1395 et seq.).".
FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 34.1. (a) No policy of
wholesale, franchise, or employee life insurance, as defined in this
section, shall be issued or delivered in this state unless it conforms to
the requirements of this section.
(b) Wholesale, franchise, or employee life insurance is defined as
a term life insurance plan under which a number of individual term
insurance policies are issued at special rates to a selected group. A
special rate is any rate lower than the rate shown in the issuing
insurance company's manual for individually issued policies of the
same type and to insureds of the same class.
(c) Wholesale, franchise, or employee life insurance may be issued
to:
(1) three (3) or more employees of any corporation, copartnership,
or individual employer, or any governmental corporation, agency,
or department thereof; or
(2) ten (10) or more members, employees, or employees of
members of any trade or professional association, or of a labor
union, or of any association of members in the same or related
occupations, profession, or industry having been in existence for
at least two (2) years, where such association or union has a
constitution or bylaws and is formed in good faith for purposes
other than that of obtaining insurance. Evidence of individual
insurability satisfactory to the insurer may be required by the
insurer as a condition to coverage.
(d) The premiums on such policies may be paid to the insurer
periodically by the employer, with or without payroll deductions, or by
the insured or association or union for its members, or by some
designated person acting on behalf of such employer, association, or
union. The term "employees" as used in this chapter refers to officers,
managers, employees, and retired employees of the employer and the
individual proprietor or partners if the employer is an individual or
partnership.
(e) Each policy issued under this section shall provide for the
following:
(1) That, if the insured person ceases to qualify for the policy he
the insured person may convert the policy, without evidence of
insurability, to an individual policy of life insurance, provided
application for such conversion is made within thirty-one (31)
days of the date the insured person ceases to qualify for coverage
under this section. The individual policy shall be issued on any
one (1) of the forms, except term insurance, then customarily
issued by the insurer at the age and in the amount applied for. The
premium on this individual policy is to be at the insurer's then
customary rate applicable to the form and amount of such
individual policy, the class of risk to which the insured person
then belongs, and his the insured person's age attained on the
effective date of such individual policy.
(2) That, if the insured person under a policy of employee life
insurance:
(A) is covered under a policy of employee life insurance
purchased by the state as described in IC 5-10-8-7(a)(1);
(B) terminates employment;
(C) applies for continuation of the coverage within
thirty-one (31) days of the date of termination; and
(D) pays both the employer and employee shares of the
premium that would be paid for coverage of an active
employee;
the insured person may, without evidence of insurability,
continue coverage under the employee term life insurance
policy or under an equivalent individual term life insurance
policy at the same rate as the rate that would be paid for
coverage under the employee term life insurance policy.
by the insured person.
However, a provision under this subdivision may not preclude the
assertion at any time of defenses based upon provisions in the
policy that relate to eligibility for coverage.
(3) A provision that a copy of the application, if any, of the
policyholder must be attached to the policy when issued, that all
statements made by the policyholder or by the persons insured are
to be deemed representations and not warranties, and that no
statement made by any person insured may be used in any contest
unless a copy of the instrument containing the statement is or has
been furnished to the insured person or, in the event of death or
incapacity of the insured person, to the insured person's
beneficiary or personal representative.
(4) A provision setting forth the conditions, if any, under which
the insurer reserves the right to require a person eligible for
insurance to furnish evidence of individual insurability
satisfactory to the insurer as a condition to part or all of the
person's coverage.
(5) A provision specifying an equitable adjustment of premiums,
benefits, or both to be made in the event the age of a person
insured has been misstated. A provision under this subdivision
must contain a clear statement of the method of adjustment to be
made.
(6) A provision that any sum becoming due by reason of the death
of the person insured must be payable to the beneficiary
designated by the person insured. However, if a policy contains
conditions pertaining to family status, the beneficiary may be the
family member specified by the policy terms, subject to the
provisions of the policy in the event there is no designated
beneficiary, as to all or any part of the sum, living at the death of
the person insured, and subject to any right reserved by the
insurer in the policy and set forth in the certificate to pay at its
option a part of the sum not exceeding two thousand dollars
($2,000) to any person appearing to the insurer to be equitably
entitled to that payment by reason of having incurred funeral or
other expenses incident to the last illness or death of the person
insured.
(7) A provision that the insurer will issue to the policyholder, for
delivery to each person insured, a certificate setting forth a
statement that:
(A) explains the insurance protection to which the person
insured is entitled;
(B) indicates to whom the insurance benefits are payable;
(C) explains any dependent's coverage included in the
certificate; and
(D) sets forth the rights and conditions that apply to the person
under subdivisions (8), (9), (10), and (11).
(8) A provision that if the insurance, or any portion of it, on a
person covered under the policy, or on the dependent of a person
covered, ceases because of termination of employment or
termination of membership in the class or classes eligible for
coverage under the policy, the person or dependent is entitled,
without evidence of insurability, to the following:
(A) An individual policy of life insurance issued to the person
or dependent by the insurer without disability or other
supplementary benefits, provided that an application for the
individual policy is made and that the first premium is paid to
the insurer within thirty-one (31) days after the termination,
and provided further that:
(A) (i) the individual policy must, at the option of the person
or dependent, be on any one (1) of the forms then
customarily issued by the insurer at the age and for the
amount applied for, except that the group policy may
exclude the option to elect term insurance;
(B) (ii) the individual policy must be in an amount not in
excess of the amount of life insurance that ceases because of
the termination, less the amount of any life insurance for
which the person or dependent becomes eligible under the
same policy or any other group policy within thirty-one (31)
days after the termination (however, any amount of
insurance that has matured on or before the date of the
termination as an endowment payable to the person insured,
whether in one (1) sum, in installments, or in the form of an
annuity, may not, for the purposes of this clause, be included
in the amount of insurance that is considered to cease
because of the termination); and
(C) (iii) the premium on the individual policy must be at the
insurer's then customary rate applicable to the form and
amount of the individual policy, to the class of risk to which
the person or dependent then belongs, and to the individual
age attained by the person or dependent on the effective date
of the individual policy.
Subject to the conditions set forth in this subdivision, clause,
the conversion privilege created by this subdivision clause
must be available to a surviving dependent of a person covered
under a group policy, with respect to the coverage under the
group policy that terminates by reason of the death of the
person covered, and to the dependent of an employee or
member after termination of the coverage of the dependent
because the dependent ceases to be a qualified family member
under the group policy, while the employee or member
remains insured under the group policy.
coverage under this subdivision on a premium paying basis must
extend for a period of six (6) months from the date on which the
total disability started, but not beyond the earlier of:
(A) the date of approval by the insurer of continuation of the
coverage under any disability provision that the group
insurance policy may contain; or
(B) the date of discontinuance of the group insurance policy.
(12) In the case of a policy insuring the lives of debtors, a
provision that the insurer will furnish to the policyholder, for
delivery to each debtor insured under the policy, a certificate of
insurance describing the coverage and specifying that the death
benefit will first be applied to reduce or extinguish the
indebtedness.
(c) Subsections (b)(6) through (b)(11) do not apply to policies
insuring the lives of debtors. The standard provisions required under
IC 27-1-12 for individual life insurance policies do not apply to group
life insurance policies.
(d) If a group life insurance policy is on a plan of insurance other
than the group plan, it must contain a nonforfeiture provision that, in
the opinion of the commissioner, is equitable to the insured persons
and to the policyholder. However, group life insurance policies need
not contain the same nonforfeiture provisions as are required for
individual life insurance policies under IC 27-1-12.