§ 27-18-59 - Termination of children's benefits.
SECTION 27-18-59
§ 27-18-59 Termination of children'sbenefits. – (a) Every individual health insurance contract, plan, or policy delivered,issued for delivery, or renewed in this state and every group health insurancecontract, plan, or policy delivered, issued for delivery or renewed in thisstate which provides medical coverage for dependent children that includescoverage for physician services in a physician's office, and every policy whichprovides major medical or similar comprehensive type coverage, except forsupplemental policies which only provide coverage for specified diseases andother supplemental policies, shall provide coverage of an unmarried child underthe age of nineteen (19) years, an unmarried child who is a student under theage of twenty-five (25) years and who is financially dependent upon the parentand an unmarried child of any age who is financially dependent upon the parentand medically determined to have a physical or mental impairment which can beexpected to result in death or which has lasted or can be expected to last fora continuous period of not less than twelve (12) months. Such contract, plan orpolicy shall also include a provision that policyholders shall receive no lessthan thirty (30) days notice from the accident and sickness insurer that achild covered as a dependent by the policy holder is about to lose his or hercoverage as a result of reaching the maximum age for a dependent child, andthat the child will only continue to be covered upon documentation beingprovided of current full or part-time enrollment in a post-secondaryeducational institution or that the child may purchase a conversion policy ifhe or she is not an eligible student. Nothing in this section prohibits anaccident and sickness insurer from requiring a policyholder to annually provideproof of a child's current full or part-time enrollment in a post-secondaryeducational institution in order to maintain the child's coverage. Provided,nothing in this section requires coverage inconsistent with the membershipcriteria in effect under the policyholder's health benefits coverage.
(b) This section does not apply to insurance coverageproviding benefits for: (1) hospital confinement indemnity; (2) disabilityincome; (3) accident only; (4) long term care; (5) Medicare supplement; (6)limited benefit health; (7) specified diseased indemnity; or (8) other limitedbenefit policies.