§ 58-3-247. Insurance identification card. - North Carolina Statutes

§ 58‑3‑247. Insurance identification card.

(a)        Every insureroffering a health benefit plan as defined under G.S. 58‑3‑167,including the State Health Plan, shall provide the health benefit plansubscriber or members with an insurance identification card. The card shallcontain at a minimum:

(1)        The subscriber'sname and identification number.

(2)        The member's nameand identification number, if applicable and different from the subscriber'sname and identification number.

(3)        The group number.

(4)        The name of theorganization issuing the policy, the name of the organization administering thepolicy, and the name of the network, whichever applies.

(5)        The effective dateof health benefits plan coverage or the date the card is issued if it is afterthe effective date.

(6)        The address whereclaims are to be filed and, if applicable, the electronic claims filing payoridentification number.

(7)        The policyholder'sobligations with regard to co‑payments, if applicable, for at least thefollowing:

a.         Primary care officevisit.

b.         Specialty careoffice visit.

c.         Urgent care visit.

d.         Emergency roomvisit.

(8)        The phone number orWeb site address whereby the subscriber, member, or service provider, incompliance with privacy rules under the Health Insurance Portability andAccountability Act may readily obtain the following:

a.         Confirmation ofeligibility.

b.         Benefitsverification in order to estimate patient financial responsibility.

c.         Prior authorizationfor services and procedures.

d.         The list ofparticipating providers in the network.

e.         The employer groupnumber.

f.          Special mentalhealth medical benefits under the health plan, if applicable.

(b)        The insuranceidentification card must be designed such that if the card is photocopied orelectronically scanned, the resulting image is clearly legible. Theidentification card must present the information in a readily identifiablemanner or, alternatively, the information may be embedded on the card andavailable through magnetic stripe or smart card. The information may also beprovided through other electronic technology. (2007‑362, s. 2.)