§ 58-51-120. Coverage of children.
§58‑51‑120. Coverage of children.
(a) No health insurershall deny enrollment of a child under the health benefit plan of the child'sparent on any of the following grounds:
(1) The child was bornout of wedlock.
(2) The child is notclaimed as a dependent on the parent's federal income tax return.
(3) The child does notreside with the parent or in the insurer's service area.
(b) If a parent isrequired by a court or administrative order to provide health benefit plancoverage for a child, and the parent is eligible for family health benefit plancoverage through a health insurer, the health insurer:
(1) Must allow theparent to enroll, under the family coverage, a child who is otherwise eligiblefor the coverage without regard to any enrollment season restrictions.
(2) Must enroll thechild under family coverage upon application of the child's other parent or theDepartment of Health and Human Services in connection with its administrationof the Medical Assistance or Child Support Enforcement Program if the parent isenrolled but fails to make application to obtain coverage for the child.
(3) May not disenroll oreliminate coverage of the child unless the health insurer is providedsatisfactory written evidence that:
a. The court oradministrative order is no longer in effect; or
b. The child is or willbe enrolled in comparable health benefit plan coverage through another healthinsurer, which coverage will take effect not later than the effective date ofdisenrollment.
(c) If a child hashealth benefit plan coverage through the health insurer of a noncustodialparent, that health insurer shall do all of the following:
(1) Provide suchinformation to the custodial parent as may be necessary for the child to obtainbenefits through that coverage.
(2) Permit the custodialparent (or the health care provider, with the custodial parent's approval) tosubmit claims for covered services without the approval of the noncustodialparent.
(3) Make payments onclaims submitted in accordance with subdivision (2) of this subsection directlyto the custodial parent, the provider, or the Department of Health and HumanServices.
(d) No health insurermay impose requirements on any State agency that has been assigned the rightsof an individual eligible for medical assistance under Medicaid and covered forhealth benefits from the insurer that are different from requirementsapplicable to an agent or assignee of any other individual so covered. (1993(Reg. Sess., 1994), c. 644, s. 1; 1997‑443, s. 11A.118(a).)