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Indiana - Compensation & Benefit Legislation

INDIANA - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

INDIANA - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted child is included in state's newborn health care mandate.

 

Preventive care for children: No.

 

(Indiana Code Sections 27-8-5.6-2, 27-8-5-18, 27-8-5-19, 27-8-5-21, 27-8-5-41 et seq.)

 

INDIANA - ALCOHOLISM & DRUG ABUSE

State reports no statutory requirements.

 

INDIANA - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: No. Follows FUTA.

 

INDIANA - CONTINUATION OF COVERAGE CONVERSIONS

State reports no statutory requirements.

 

INDIANA - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits (effective July 1, 1988). Includes joint custody and COBRA provisions. Based on 1987 National Association of Insurance Commissioner Rules model. (Indiana Admin. Code tit. 760 R. 1-38.1)

 

INDIANA - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

INDIANA - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

Who is Covered by Statute: Any individual performing services for an employer. An employer is any person engaged in an industry affecting commerce that has at least 15 employees for each working day in the last 20 calendar weeks. Corporations wholly owned by the government are exempt.

 

Applicant Testing: Applicant testing is allowed but not encouraged, prohibited, or restricted.

 

Employee Testing: Applicant testing is allowed but not encouraged, prohibited, or restricted.

 

How Test Results are Used: Results can be used to remove persons from safety-sensitive duties.

 

Enforcement of Statutes: State has no statutory requirements.

 

Employee Remedies: State has no statutory requirements.

 

Employer Penalties: State has no statutory requirements.

 

Who Pays for Testing: State has no statutory requirements.

 

Employee Assistance Benefits: State has no statutory requirements.

 

Other Requirements: State has no statutory requirements.

 

(Indiana Code Ann. Sections 22-9-5-9, 22-9-5-9, 22-9-5-10, 22-9-5-24.)

 

INDIANA - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Policies providing family coverage must cover adopted children as of the date of placement or judgment granting custody. (Indiana Code Ann. Section 27-8-5-21.)

 

Diabetes: Effective 1/1/98, health care insurers (HMOs included) must provide coverage for the medically necessary treatment of diabetes, including supplies and equipment as ordered in writing by a licensed physician. Diabetes self-management training must be conducted by a health care professional who is licensed, registered, or certified and who has specialized training in the management of diabetes. Individuals who are treated for diabetes conditions must not be required to pay annual deductibles for co-payments which are greater than payments required to be made for other similar coverages. (S184, 1997) (Indiana Code Ann. Section 27-8-14.5.)

 

Disclosure of Information: Health care providers (including HMOs) must not be prohibited from disclosing to patients all treatment options available, including those not covered under their policies. Also, providers must not be penalized financially or in any other manner for disclosure of information to patients. (S392, 1996) (Indiana Code Ann. Sections 27-8-11-4.5, 27-8-24.7, 27-13-15-1.)

 

Domestic Violence: Health care providers, including HMOs and PPOs, may not refuse coverage to an individual by otherwise terminating or restricting benefits because an individual is a victim of domestic abuse. (S306, 1996) (Indiana Code Ann. Section 27-4-1-4, 27-8-24.3.)

 

Genetic Information: Effective 1/1/98, genetic screening or testing results must not be obtained by an insurance company other than a life insurance company without written consent from an individual. Insurers (HMOs included) must not require an individual to submit to genetic screening or testing, must not inquire about genetic testing results, must not base decisions which are adverse to an applicant on genetic testing results, and must not cancel, refuse to issue or to renew health coverage based on results of genetic testing. Insurers may, however, consider genetic testing results of an individual who voluntarily submits the findings. (H1684, 1997) (Indiana Code Ann. Section 16-39-5-2, 27-4-1-4, 28-5-26.)

 

Handicapped Dependents. Coverage for dependent children cannot be terminated while a person is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Indiana Code Ann. Section 27-8-5-19(16).)

 

Health Maintenance Organizations: HMOs must provide insured individuals with information on how and where services can be obtained, how to file a grievance, and how HMOs may be contacted without cost. (H1663, 1997) (Indiana Code Ann. Sections 27-13-1-12, 27-13-8-2, 27-13-9-4, 27-13-10, 27-13-34-12.)

 

Mammography Screening: An insurer must offer one baseline mammography screening if the insured is the least 35 but less than 40 years of age, one mammography screening every two years if the insured is at least 40 but less than 50 years of age and not a woman at risk (personal history of breast cancer or breast disease proven benign, immediate relative who has had breast cancer or at least 30 years of age and has not given birth), every year if in this age range and a woman at risk or if at least 50 years of age whether or not at risk. Reimbursement must be at least as high as the limit established in 42 CFR 405.534(b)(3) according to the Medicare Economic Index at the time of screening or the rate negotiated by the contract provider, whichever is lower. Dollar limits, deductibles, and coinsurance may not be less favorable than those applying to physical illness generally. (Indiana Code Ann. Section 27-8-14.) Public Employees: A self-insured program established to provide health care coverage must provide coverage for breast cancer diagnostic services, breast cancer outpatient treatment services, and breast cancer rehabilitative services. The coverage must provide reimbursement for breast cancer screening mammography at a level at least as high as the limitation for payment for screening mammography services established in 42 CFT 4005.534(b)(3) according to the Medicare Economic Index at the time the breast cancer screening mammography is performed, or the rate negotiated by a contract provider according to the provisions of the insurance policy, whichever is lower. The costs of the coverage may be paid by the state or by the employee or by a combination of the state and the employee. A contract with a prepaid health care delivery plan must provide covered individuals with breast cancer diagnostic services, breast cancer outpatient treatment services, and breast cancer rehabilitative services. (Indiana Code Ann. Section 5-10-8-7.2(h), ( i).)

 

Mastectomy: Health care policies (HMOs included) which provide coverage for mastectomies must also provide for prosthetic devices, reconstructive surgery of the affected breast, and reconstructive surgery of the other breast to produce symmetry; these procedures may be done in a manner determined appropriate by an an attending physician and a patient. Coverage for prosthetic devices and for reconstructive breast surgery may be limited to 2 years following a mastectomy in which no evidence of malignancy is found. (H1684, 1997) (Indiana Code Ann. Sections 15-39-5-2, 27-4-1-4, 27-8-5-26, 27-13-7-14.)

 

Medical Records: Effective 1/1/98, health care insurers may obtain written consent from individuals to secure their health records; consent may be secured at the time of application for insurance or at any other time. (H1684, 1997) (Indiana Code Ann. Sections 16-39-5-1, 27-4-1-4, 27-8-5-26.)

 

Mental Health: Community mental health centers and licensed psychiatric hospitals: Policies that cover inpatient treatment of mental illness or substance abuse must include treatment rendered by such centers or hospitals. (Indiana Code Ann. Section 27-8-5-15.5.) Group health policies (in effect for HMOs after 6/30/98) are not required to provide mental health care benefits. Under policies which provide mental health benefits, coverage must not include services for the treatment of substance abuse or chemical dependency. Group policies must not impose aggregate lifetime limits or annual limits on benefits provided for mental health services if similar limitations are not imposed on services provided for coverage of other conditions. (H1400, 1997) (Indiana Code Ann. Section 25-8-5-15.6.)

 

Newborns: Accident and sickness policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness, including treatment of medically diagnosed congenital defects and birth abnormalities and including inpatient or outpatient expenses arising from medical and dental treatments (orthodontic or oral surgery treatments included) involved in the management of cleft lip and cleft palate. Coverage of an insured individual's newborn child is not required if the pregnancy which lead to the birth of the child was a condition which existed prior to the issuance of a policy; such newborn coverage , however, is subject to practices followed by an insurer. (S225, 1997) (Indiana Code Ann. Section 27-8-5.6-2.)

 

Policies for Small Employers: A small employer is one which employed at least 3 but not more than 50 workers on at least 50 percent of the working days during the preceding calendar year with the majority of the workers employed within Indiana. Late Enrollee: A late enrollee is an eligible employee or dependent of an eligible employee who did not request enrollment in a small employer health insurance plan during the initial enrollment period. (S117, 1996) (Indiana Code Ann. Sections 27-8-5-2.5, 27-8-5-2.6, 27-8-15-10.5, 27-8-15-14, 27-8-15-24, 27-8-15-28.)

 

Pre-existing Conditions: Effective January 1, 1998, individual health policies must not exclude, limit, or deny benefits to a person for more than 12 months after the effective date of the coverage due to a pre-existing condition. Insurers, however, may reduce the period of time during which an individual's benefits are disallowed due to a pre-existing condition by the amount of time the individual continuously was covered under another policy which expired not more than 30 days prior to an individual's application for new coverage. Policies for Small Employers: Expiring January 1, 1998, small employer insurers, under certain conditions, must waive exclusion or limitation periods during which eligible employees, eligible dependents or eligible employees previously covered by another plan may not receive particular services due to pre-existing conditions (S117, 1996) (Indiana Code Ann. Sections 27-8-5-2.5, 27-8-5-2.6, 27-8-15-10.5, 27-8-15-24, 27-8-15-28.)

 

Providers: Dentists, psychologists, podiatrists, osteopaths, optometrists, and chiropractors: Costs for treatment must be covered if the provider is licensed, such treatment is within the provider's scope of services, and the service is covered by the policy. (Indiana Code Ann. Section 27-8-6-1.) Nurse anesthetists: Accident and sickness insurance must cover services provided by a certified registered nurse anesthetist. (S618, 1995.)

 

Substance Abuse: Policies including substance abuse must include treatment at a community mental health center or licensed psychiatric hospital. (Indiana Code Ann. Section 27-8-5-15.5.)

 

INDIANA - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

INDIANA - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: 100%.

 

Minimum number of employees in group plan: No statutory requirements.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Indiana Code Sections 27-1-12-37, 27-1-12-41)

 

INDIANA - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Lincoln's Birthday, Columbus Day (or 2nd Monday in October), Thanksgiving, Sunday. Other: If holiday falls on a Sunday, following Monday is a holiday; if holiday falls on a Saturday, preceding Friday is a holiday. (Indiana Code. Ann. Sections 1-1-9-1, 1-1-10-1, 1-1-11-1, 1-1-12.5-1 through 1-1-14-1)

 

INDIANA - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

INDIANA - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator is guilty of class B misdemeanor.

 

Other Requirements: None reported. (Indiana Code Ann. Section 35-44-3-10.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: Violator is guilty of a class B misdemeanor.

 

Other Requirements: None reported.

 

INDIANA - LEAVES OF ABSENCE

State reports no statutory requirements.

 

See U.S. Federal Family and Medical Leave Act

 

INDIANA - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

INDIANA - MANDATED PROVIDERS

Optometrists, chiropractors, dentists, psychologists, and podiatrists. Mandatory coverage for osteopaths and nurse anesthetists. (Indiana Code Sections 27-8-6-1, 27-8-6-5, 27-8-24.7-5)

 

INDIANA - MENTAL HEALTH CARE

State reports no statutory requirements.

 

INDIANA - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain professionals, agriculture workers, outside sales, students, and handicapped workers in special environments. (Indiana Code Ann. Sections 22-2-2-3, 22-2-2-4)

 

See U.S. Minimum Wage

 

INDIANA - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: New employees.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 form or at the employer’s option, its equivalent.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and federal tax identification number.

 

Employee information to be included: Name, address, and SSN.

 

Penalty for failure to report: $500 if intentional.

 

(Indiana Code Section 22-4.1 through 4.2)

 

INDIANA - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: No. (Indiana Code Sections 27-8-5.6-2, 27-8-5-18, 27-8-5-19, 27-8-5-21, 27-8-s4-1 et seq.)

 

INDIANA - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

INDIANA - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, benefits may not be excluded or limited for more than 9 months. (Indiana Stat. Ann. Sections 27-8-15-1 et seq.)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

INDIANA - PROTECTED CLASSIFICATIONS

Age:   Yes, between 40 and 70.

Race:   Yes.

Color:   Yes.

National Origin: Yes.

Ancestry:  Yes.

Religion:  Yes.

Sex:  Yes.

Pregnancy:  No specific law. State has expressed policy against discrimination.

Sexual Harassment:  No specific law. State has expressed policy against discrimination.

 

(Ind. Code Sections 22-9-1-2, 22-9-1-3, 22-9-1-6, 22-9-1-13, 22-9-2-1, 22-9-2-2.)

 

INDIANA - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

INDIANA - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

INDIANA - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Payday.

 

Date due if employee resigns: Payday.

 

Wages: Yes.

 

Vacation Pay: Yes. (Case law requires payment of vacation pay on termination if that is employer's policy.)

 

Holiday: No.

 

Sick leave: No.

 

Severance: No.

 

(Indiana Code Sections 22-2-5-1, 22-2-9-2. See Olser Inst., Inc. v. Inglert, 569 N.E.2d 636 (Ind. 1991))

 

INDIANA - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes. Within 30 Days of notice and before expiration of 120 days of beginning of year.

 

(Indiana Code Ann. Sections 22-4-10-5, 22-4-11-2, 22-4-11-3.)

 

INDIANA - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

INDIANA - VOTING TIME OFF

State reports no statutory requirements.

 

INDIANA - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments including corporate officers. Elective as to partners and sole proprietors.

 

Public Employers: Mandatory as to state, municipal corporations, and political sub-divisions; includes state legislators, and elected and appointed officials. Volunteers working as authorized emergency management workers, volunteers working for hazardous materials response teams and police reserves may be covered.

 

Exceptions: Farm labor, domestic servants, casual workers, railroad workers, and licensed real estate professionals. (Note: Elective officer of a charitable, religious, educational or non-profit.)

 

Special Coverage Provisions: Mandatory as to coal mining and for students in cooperative education.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)