44-4113. Use of nonpreferred providers; effect.

Insurers and participants in insurance arrangements shall provide for payment for services rendered by nonpreferred providers or providers who have not negotiated a contract with the insurer or participants in the insurance arrangement. Insureds under an insurance arrangement shall use the preferred providers who have contracted with the group to obtain coverage under the plan at the least direct expense to the insured. Insureds selecting nonpreferred providers may be held financially responsible for the difference between the benefits available under a preferred provider contract and the charges of the nonpreferred provider and may be subject to larger coinsurance or deductible provisions. Under a prepaid dental service plan as defined in section 44-3802, a participant's premium contribution for health services provided by nonpreferred providers to an insured shall be an amount equal to the participant's contribution pursuant to a preferred provider contract.

Source:Laws 1984, LB 902, ยง 13.