Required provision concerning effect of benefits under other valid group coverage; subrogation; prohibited act

1. Every policy of group health insurance must contain a provision which reduces the insurer's liability because of benefits under other valid group coverage. To the extent authorized by the Commissioner, such a provision may include subrogation.

2. A provision for subrogation may include a lien upon any recovery by an insured from a third person for the cost of medical benefits paid by the insurer for injuries incurred as a result of the actions of the third person. The lien may not exceed the amount paid by the insurer.

3. An insurer may not deny payment for services because of the inclusion of a provision required by this section.