Company: North Carolina General Assembly

North Carolina Attorney General Opinion

§ 58‑3‑177.  Uniform prescription drug identification cards.
(a)	Every health benefit plan that provides coverage for prescription drugs or devices and that issues a prescription drug card, shall issue to its insureds a uniform prescription drug identification card. The uniform prescription drug identification card shall contain the information listed in subdivisions (1) through (7) of this subsection in the following order beginning at the top left margin of the card:
(1)	The health benefit plan's name and/or logo.
(2)	The American National Standards Institute assigned Issuer Identification Number.
(3)	The processor control number.
(4)	The insured's group number.
(5)	The health benefit plan's card issuer identifier.
(6)	The insured's identification number.
(7)	The insured's name.
(b)	In addition to the information required under subsection (a), the uniform prescription drug card shall contain, in one of the lower‑most elements on the back side of the card, the following information:
(1)	The health benefit plan's claims submission name and address.
(2)	The health benefit plan's help desk telephone number and name.
Nothing in this section shall require a health benefit plan to violate a contractual agreement, service mark agreement, or trademark agreement.
(c)	A new uniform prescription drug identification card as required under subsection (a) of this section shall be issued annually by a health benefit plan if there has been any change in the insured's coverage in the previous 12 months. A change in the insured's coverage shall include, but is not limited to, the addition or deletion of a dependent of the insured covered by a health benefit plan.
(d)	Not later than January 1, 2003, the uniform prescription drug identification card provided under subsection (a) of this section shall contain one of the following mediums capable of the processing or adjudicating of a claim through electronic verification:
(1)	A magnetic strip.
(2)	A bar code.
(3)	Any new technology available that is capable of processing or adjudicating a claim by electronic verification.
(e)	As used in this section, "health benefit plan" means an accident and health insurance policy or certificate; a nonprofit hospital or medical service corporation contract; a health maintenance organization subscriber contract; a plan provided by a multiple employer welfare arrangement; or a plan provided by another benefit arrangement, to the extent permitted by the Employee Retirement Income Security Act of 1974, as amended, or by any waiver of or other exception to that Act provided under federal law or regulation. "Health benefit plan" does not mean any of the following kinds of insurance:
(1)	Accident.
(2)	Credit.
(3)	Disability income.
(4)	Long‑term or nursing home care.
(5)	Medicare supplement.
(6)	Specified disease.
(7)	Dental or vision.
(8)	Coverage issued as a supplement to liability insurance.
(9)	Workers' compensation.
(10)	Medical payments under automobile or homeowners.
(11)	Insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability policy or equivalent self‑insurance.
(12)	Hospital income or indemnity.
(f)	This section shall not apply to an entity that has its own facility and employs or contracts with physicians, pharmacists, nurses, and other health care personnel, to the extent that the entity dispenses prescription drugs or devices from its own pharmacies to its employees and to enrollees of its health benefit plan. This section does not apply to a health benefit plan that issues a single identification card to its insureds for all services covered under the plan. (1999‑343, s. 1.)

G.S. 58-3-177		Page