(a) (1) No contract of individual or group healthcare coverage sold, delivered, issued for delivery, renewed, or offered for sale in this state by any insurer, health maintenance organization, self-funded group, multiple-employer welfare arrangement, or hospital or medical services corporation shall, directly or indirectly, restrict or deny healthcare coverage due to the fact that the minor child does not reside with the noncustodial parent or that the parent-child relationship was established through a paternity action or that the minor child is covered through the state-administered Medicaid program or that the minor child is not claimed as a dependent on the noncustodial parent's federal or state income tax return.
(2) (A) Furthermore, no insurer, health maintenance organization, self-funded group, multiple-employer welfare arrangement, or hospital or medical services corporation shall, directly or indirectly, restrict or deny benefits to a minor child because the child lives outside of its service area.
(B) Benefits provided outside the service area shall be in accordance with the terms and conditions of the healthcare plan.
(b) (1) Each contract of individual or group healthcare coverage sold, delivered, issued for delivery, renewed, or offered for sale in this state by any insurer, health maintenance organization, self-funded group, multiple-employer welfare arrangement, or hospital or medical services corporation shall provide for the immediate enrollment of the minor child or children.
(2) The minor child shall be enrolled immediately in the noncustodial parent's healthcare plan upon submission of the notice as provided in § 9-14-511 or, in cases being enforced under Title IV-D of the Social Security Act, 42 U.S.C. § 651 et seq., by the Office of Child Support Enforcement of the Revenue Division of the Department of Finance and Administration, as required in § 9-14-516.
(c) Except for nonpayment of premium, no contract of individual or group healthcare coverage sold, delivered, issued for delivery, renewed, or offered for sale in this state by any insurer, health maintenance organization, self-funded group, multiple-employer welfare arrangement, or hospital or medical services corporation shall permit, directly or indirectly, the removal of a minor child from enrollment for coverage unless the insurer has received evidence in writing that the court or administrative order providing for the healthcare coverage is no longer in effect or that the child is or will be enrolled in comparable healthcare coverage through another insurer that will take effect not later than the effective date of such disenrollment.
(d) No contract of individual or group healthcare coverage sold, delivered, issued for delivery, renewed, or offered for sale in this state by any insurer, health maintenance organization, self-funded group, multiple-employer welfare arrangement, or hospital or medical services corporation shall, directly or indirectly, impose requirements on the office that are any different from those applicable to any other agent or assignee assigned the rights of a person eligible for medical assistance under this section and covered for health benefits from the insurer.
(e) Any insurance policy provision that would deny or restrict coverage to a minor child under such circumstances shall be void as against public policy.
Section: Previous 9-14-502 9-14-503 9-14-504 9-14-505 9-14-506 9-14-507 9-14-508 9-14-509 9-14-510 9-14-511 9-14-512 9-14-513 9-14-514 9-14-515 NextLast modified: November 15, 2016