Ambulance membership plan requirements

(1) An ambulance membership organization may assess a one-time application processing fee to the ambulance membership organization's members that may not exceed $25. (2) If an ambulance membership organization cancels an ambulance membership plan for any reason other than nonpayment of charges by a member, the ambulance membership organization shall issue a pro rata refund of all periodic charges and membership fees to the member. (3) An ambulance membership organization, or a person that sells an ambulance membership plan for an ambulance membership organization, shall disclose each charge and fee for each ambulance membership plan to each prospective member. (4) An ambulance membership organization shall provide the terms and conditions of an ambulance membership plan to each prospective enrollee before the day on which the prospective enrollee enters into the ambulance membership plan. (5) An ambulance membership organization shall file a copy of each ambulance membership plan with the commissioner before the ambulance membership plan goes into effect. (6) An ambulance membership plan described in Subsection (5) shall: (a) identify the ambulance membership organization, including the ambulance membership organization's: (i) physical address; (ii) website address; and (iii) toll-free phone number; (b) conspicuously state: (i) the total purchase price of the ambulance membership plan, including any membership fees; and (ii) that the ambulance membership plan is not an insurance contract; (c) state: (i) the terms under which the ambulance membership plan is to be paid; (ii) any cost sharing requirements; (iii) the services the ambulance membership organization shall provide under the ambulance membership plan, and any limitation, exception, or exclusion; (iv) any term, restriction, or condition that governs the cancellation of the ambulance membership plan by either the enrollee or the ambulance membership organization; (v) that if the enrollee cancels the ambulance membership plan within 30 days after the day on which the enrollee purchases the ambulance membership plan, the ambulance membership organization shall refund to the enrollee: (A) any one-time charge the enrollee pays that exceeds $25; and (B) each periodic charge and membership fee the enrollee pays; and (vi) what constitutes acceptable insurance coverage if eligibility for the ambulance membership plan is conditioned on the member's current and continuing health insurance coverage; and (d) define "medical necessity," if membership coverage of a transport is conditioned on a finding of medical necessity.