Coverage for newly born and adopted children and children placed for adoption.
1. Any policy which provides coverage for a dependent of a member must provide that benefits for children are payable for a member’s newly born child, adopted child or child placed with the member for the purpose of adoption to the same extent that the coverage applies to other dependents.
2. The policy may require that to have coverage for the newly born child, adopted child or child placed for adoption continued beyond 31 days after the child’s birth, adoption or placement, the member must notify the organization for dental care within 31 days after the birth, adoption or placement.
3. For covered services provided to the child, the organization for dental care shall reimburse noncontracted providers of health care to an amount equal to the average amount of payment for which the organization has agreements, contracts or arrangements for those covered services.
Last modified: February 27, 2006