Statement of principal claims practices

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    (a)    Each nonprofit health service plan that provides hospital benefits shall furnish a statement of the plan’s principal claims practices as part of the certificate form or booklet describing the coverage to be afforded.

    (b)    The statement shall include practices for payment for:

        (1)    surgical procedures performed by two or more surgeons;

        (2)    services provided in-area by nonparticipating providers; and

        (3)    services provided out-of-area by affiliated plans and affiliated providers.


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