Health Insurance Policy Offering Dependent Coverage; Required Provisions; Denial Prohibited; Grounds.

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Sec. 3403.

(1) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy that offers dependent coverage shall include both of the following provisions in the policy:

(a) That the health insurance benefits applicable for children are payable with respect to a newly born child of the insured from the moment of birth.

(b) That the coverage for newly born children consists of coverage of injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities.

(2) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy that offers dependent coverage shall not deny enrollment to an insured's child on any of the following grounds:

(a) The child was born out of wedlock.

(b) The child is not claimed as a dependent on the insured's federal income tax return.

(c) The child does not reside with the insured or in the insurer's service area.

History: Add. 1975, Act 20, Imd. Eff. Apr. 3, 1975 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Compiler's Notes: Section 2 of Act 20 of 1975 provides: “The requirements of this act shall apply to all insurance policies delivered or issued for delivery in this state more than 120 days after the effective date of the act.”
Popular Name: Act 218


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