California Family Code Section 3751.5
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California Laws > Family Code > California Family Code Section 3751.5
3751.5. (a) Notwithstanding any other provision of law, an employer
or insurer shall not deny enrollment of a child under the health
insurance coverage of a child's parent on any of the following
(1) The child was born out of wedlock.
(2) The child is not claimed as a dependent on the parent's
federal income tax return.
(3) The child does not reside with the parent or within the
insurer's service area.
(b) Notwithstanding any other provision of law, in any case in
which a parent is required by a court or administrative order to
provide health insurance coverage for a child and the parent is
eligible for family health coverage through an employer or an
insurer, the employer or insurer shall do all of the following, as
(1) Permit the parent to enroll under health insurance coverage
any child who is otherwise eligible to enroll for that coverage,
without regard to any enrollment period restrictions.
(2) If the parent is enrolled in health insurance coverage but
fails to apply to obtain coverage of the child, enroll that child
under the health coverage upon presentation of the court order or
request by the local child support agency, the other parent or person
having custody of the child, or the Medi-Cal program.
(3) The employer or insurer shall not disenroll or eliminate
coverage of a child unless either of the following applies:
(A) The employer has eliminated family health insurance coverage
for all of the employer's employees.
(B) The employer or insurer is provided with satisfactory written
evidence that either of the following apply:
(i) The court order or administrative order is no longer in effect
or is terminated pursuant to Section 3770.
(ii) The child is or will be enrolled in comparable health
insurance coverage through another insurer that will take effect not
later than the effective date of the child's disenrollment.
(c) In any case in which health insurance coverage is provided for
a child pursuant to a court or administrative order, the insurer
shall do all of the following:
(1) Provide any information, including, but not limited to, the
health insurance membership or identification card regarding the
child, the evidence of coverage and disclosure form, and any other
information provided to the covered parent about the child's health
care coverage to the noncovered parent having custody of the child or
any other person having custody of the child and to the local child
support agency when requested by the local child support agency.
(2) Permit the noncovered parent or person having custody of the
child, or a provider with the approval of the noncovered parent or
person having custody, to submit claims for covered services without
the approval of the covered parent.
(3) Make payment on claims submitted in accordance with
subparagraph (2) directly to the noncovered parent or person having
custody, the provider, or to the Medi-Cal program. Payment on claims
for services provided to the child shall be made to the covered
parent for claims submitted or paid by the covered parent.
(d) For purposes of this section, "insurer" includes every health
care service plan, self-insured welfare benefit plan, including those
regulated pursuant to the Employee Retirement Income Security Act of
1974 (29 U.S.C. Sec. 1001, et seq.), self-funded employer plan,
disability insurer, nonprofit hospital service plan, labor union
trust fund, employer, and any other similar plan, insurer, or entity
offering a health coverage plan.
(e) For purposes of this section, "person having custody of the
child" is defined as a legal guardian, a caregiver who is authorized
to enroll the child in school or to authorize medical care for the
child pursuant to Section 6550, or a person with whom the child
(f) For purposes of this section, "employer" has the meaning
provided in Section 5210.
(g) For purposes of this section, the insurer shall notify the
covered parent and noncovered parent having custody of the child or
any other person having custody of the child in writing at any time
that health insurance for the child is terminated.
(h) The requirements of subdivision (g) shall not apply unless the
court, employer, or person having custody of the child provides the
insurer with one of the following:
(1) A qualified medical child support order that meets the
requirements of subdivision (a) of Section 1169 of Title 29 of the
United States Code.
(2) A health insurance coverage assignment or assignment order
made pursuant to Section 3761.
(3) A national medical support notice made pursuant to Section
(i) The noncovered parent or person having custody of the child
may contact the insurer, by telephone or in writing, and request
information about the health insurance coverage for the child. Upon
request of the noncovered parent or person having custody of the
child, the insurer shall provide the requested information that is
specific to the health insurance coverage for the child.
Last modified: February 22, 2013