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State of South Dakota
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SEVENTY-SIXTH
SESSION
LEGISLATIVE ASSEMBLY, 2001 |
| 400E0310 |
SENATE BILL
NO.
38
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| Introduced by: The Committee on Commerce at the request of the Department of Commerce and Regulation |
FOR AN ACT ENTITLED, An Act to
revise health plan coverage requirements for newborns
and newly adopted children.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA:
Section 1. That § 58-17-30.3 be amended to read as follows:
58-17-30.3. The coverage for a newly born child from the moment of birth or for a newly adopted child, from the beginning of the six-month adoption bonding period, shall consist of coverage of injury or sickness including the necessary care and treatment of premature birth and medically diagnosed congenital defects and birth abnormalities. The coverage required by this section applies to any subsequent health benefit plan that is purchased providing coverage for that newly born or newly adopted child. The provisions of § § 58-17-30.2 to 58-17-30.4, inclusive, apply to any individually written health benefit plan issued or renewed by any health insurer, health carrier, health maintenance organization, fraternal benefit society, nonprofit medical and surgical plan, nonprofit hospital service plan, or other entity providing coverage through a health benefit plan subject to the provisions of this title.
Section 2. That § 58-18-33 be amended to read as follows:
58-18-33. The coverage for a newly born child from the moment of birth or for a newly adopted child, from the beginning of the six-month adoption bonding period, shall consist of coverage of injury or sickness including the necessary care and treatment of premature birth and medically diagnosed congenital defects and birth abnormalities. The coverage required by this section applies to any subsequent health benefit plan that is purchased providing coverage for that newly born or newly adopted child. The provisions of § § 58-18-32 to 58-18-34, inclusive, apply to any group health benefit plan issued or renewed by any health insurer, health carrier, health maintenance organization, fraternal benefit society, nonprofit medical and surgical plan, nonprofit hospital service plan, or other entity providing coverage through a health benefit plan subject to the provisions of this title.
Section 3. That § 58-33-85 be amended to read as follows:
58-33-85. Any insurer subject to this chapter, including any group health plan, as defined in section 607(1) of the Employee Retirement Income Security Act of 1974, as amended to January 1, 1994, who are engaged in the business of health insurance is prohibited from denying enrollment of a dependent child
, as defined by subdivision 25-7A-1(7),
under the health insurance
coverage of either the child's natural, adoptive, or stepparents for any of the following reasons:
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA:
Section 1. That § 58-17-30.3 be amended to read as follows:
58-17-30.3. The coverage for a newly born child from the moment of birth or for a newly adopted child, from the beginning of the six-month adoption bonding period, shall consist of coverage of injury or sickness including the necessary care and treatment of premature birth and medically diagnosed congenital defects and birth abnormalities. The coverage required by this section applies to any subsequent health benefit plan that is purchased providing coverage for that newly born or newly adopted child. The provisions of § § 58-17-30.2 to 58-17-30.4, inclusive, apply to any individually written health benefit plan issued or renewed by any health insurer, health carrier, health maintenance organization, fraternal benefit society, nonprofit medical and surgical plan, nonprofit hospital service plan, or other entity providing coverage through a health benefit plan subject to the provisions of this title.
Section 2. That § 58-18-33 be amended to read as follows:
58-18-33. The coverage for a newly born child from the moment of birth or for a newly adopted child, from the beginning of the six-month adoption bonding period, shall consist of coverage of injury or sickness including the necessary care and treatment of premature birth and medically diagnosed congenital defects and birth abnormalities. The coverage required by this section applies to any subsequent health benefit plan that is purchased providing coverage for that newly born or newly adopted child. The provisions of § § 58-18-32 to 58-18-34, inclusive, apply to any group health benefit plan issued or renewed by any health insurer, health carrier, health maintenance organization, fraternal benefit society, nonprofit medical and surgical plan, nonprofit hospital service plan, or other entity providing coverage through a health benefit plan subject to the provisions of this title.
Section 3. That § 58-33-85 be amended to read as follows:
58-33-85. Any insurer subject to this chapter, including any group health plan, as defined in section 607(1) of the Employee Retirement Income Security Act of 1974, as amended to January 1, 1994, who are engaged in the business of health insurance is prohibited from denying enrollment of a dependent child
(1)
The child was born out of wedlock; or
(2)
The child is not claimed as a dependent on the parent's federal income tax return; or
(3)
The child does not reside with the parent or in the insurer's service area.
Section 4. That § 58-38-11.7 be repealed.
58-38-11.7.
Any health insurance policy or indemnity type contract issued by a nonprofit
medical and surgical service plan corporation which offers coverage for a family member of an
insured or subscriber shall provide that the health insurance benefits applicable for children are
payable with respect to a newly born child of the insured or subscriber from the moment of birth
Section 5. That § 58-38-11.8 be repealed.
58-38-11.8.
The coverage for a newly born child from the moment of birth or for a newly
adopted child, from the beginning of the six-month adoption bonding period, shall consist of
coverage of injury or sickness including the necessary care and treatment of premature birth and
medically diagnosed congenital defects and birth abnormalities.
Section 6. That § 58-38-11.9 be repealed.
58-38-11.9.
An insurer may require notice that a newly born or newly adopted child is to be
added to the policy or that coverage is to be changed from single or spousal coverage to family
coverage. However, the insurer may not require notification sooner than the birth of the child
or the start of the adoption bonding period. If the child is added or coverage changed to family
coverage before the birth of the child or the start of the adoption bonding period, no additional
premium may be charged by the insurer until the birth of the child or the start of the adoption
bonding period. The insurer shall take reasonable steps to provide adequate notice to insureds
of the need to alter coverage to ensure newborn or adopted children are covered and of the lack
of premium adjustment until the birth of the child or the start of the adoption bonding period. An
insurer is considered to have taken reasonable steps if prominent disclosure of the requirements
of this section are included in a certificate, subscriber contract, evidence of coverage, or
Section 4. That § 58-38-11.7 be repealed.
or to a newly adopted child of the insured or subscriber from the beginning of the six-month adoption bonding period. The newly born or newly adopted child shall be added to the policy without underwriting and without the imposition of any preexisting waiting period. Any policy or contract issued before July 1, 1984, shall, upon its next anniversary date, also provide that the health insurance benefits applicable for children are payable with respect to a newly born child of the insured or subscriber from the moment of birth or to a newly adopted child of the insured or subscriber from the beginning of the six-month adoption bonding period.
Section 5. That § 58-38-11.8 be repealed.
Section 6. That § 58-38-11.9 be repealed.
employee handbook if such are provided to all insureds.
If payment of a specific premium or subscription fee is required to provide coverage for a
child, the policy or contract may require that notification of birth of a newly born child or
notification of the start of the six-month adoption bonding period for an adopted child and
payment of the required premium or fees be furnished to the nonprofit medical and surgical
service plan corporation within thirty-one days after the date of birth or start of the bonding
period in order to have the coverage continued beyond the thirty-one day period.
Section 7. That § 58-40-10.7 be repealed.
58-40-10.7.
Any health insurance policy or indemnity type contract issued by a nonprofit
hospital service plan corporation which offers coverage for a family member of an insured or
subscriber shall provide that the health insurance benefits applicable for children are payable with
respect to a newly born child of the insured or subscriber from the moment of birth or to a newly
adopted child of the insured or subscriber from the beginning of the six-month adoption bonding
period. The newly born or newly adopted child shall be added to the policy without underwriting
and without the imposition of any preexisting waiting period. Any policy or contract issued
before July 1, 1984, shall, upon its next anniversary date, also provide that the health insurance
benefits applicable for children are payable with respect to a newly born child of the insured or
subscriber from the moment of birth or to a newly adopted child of the insured or subscriber
from the beginning of the six-month adoption bonding period.
Section 8. That § 58-40-10.8 be repealed.
58-40-10.8.
The coverage for a newly born child from the moment of birth or for a newly
adopted child, from the beginning of the six-month adoption bonding period, shall consist of
coverage of injury or sickness including the necessary care and treatment of premature birth and
medically diagnosed congenital defects and birth abnormalities.
Section 9. That § 58-40-10.9 be repealed.
58-40-10.9.
An insurer may require notice that a newly born or newly adopted child is to be
added to the policy or that coverage is to be changed from single or spousal coverage to family
coverage. However, the insurer may not require notification sooner than the birth of the child
or the start of the adoption bonding period. If the child is added or coverage changed to family
coverage before the birth of the child or the start of the adoption bonding period, no additional
premium may be charged by the insurer until the birth of the child or the start of the adoption
bonding period. The insurer shall take reasonable steps to provide adequate notice to insureds
of the need to alter coverage to ensure newborn or adopted children are covered and of the lack
of premium adjustment until the birth of the child or the start of the adoption bonding period. An
insurer is considered to have taken reasonable steps if prominent disclosure of the requirements
of this section are included in a certificate, subscriber contract, evidence of coverage, or
employee handbook if such are provided to all insureds.
Section 7. That § 58-40-10.7 be repealed.
Section 8. That § 58-40-10.8 be repealed.
Section 9. That § 58-40-10.9 be repealed.
If payment of a specific premium or subscription fee is required to provide coverage for a
child, the policy or contract may require that notification of birth of a newly born child or
notification of the start of the six-month adoption bonding period for an adopted child and
payment of the required premium or fees be furnished to the nonprofit medical and surgical
service plan corporation within thirty-one days after the date of birth or start of the bonding
period in order to have the coverage continued beyond the thirty-one day period.
Section 10. That § 58-41-35.2 be repealed.
58-41-35.2.
Any health insurance policy or indemnity type contract issued by a health
maintenance organization which offers coverage for a family member of an insured or subscriber
shall provide that the health insurance benefits applicable for children are payable with respect
to a newly born child of the insured or subscriber from the moment of birth or to a newly
Section 11. That § 58-41-35.3 be repealed.
58-41-35.3.
The coverage for a newly born child from the moment of birth or for a newly
adopted child, from the beginning of the six-month adoption bonding period, shall consist of
coverage of injury or sickness including the necessary care and treatment of premature birth and
medically diagnosed congenital defects and birth abnormalities.
Section 12. That § 58-41-35.4 be repealed.
58-41-35.4.
An insurer may require notice that a newly born or newly adopted child is to be
added to the policy or that coverage is to be changed from single or spousal coverage to family
coverage. However, the insurer may not require notification sooner than the birth of the child
or the start of the adoption bonding period. If the child is added or coverage changed to family
coverage before the birth of the child or the start of the adoption bonding period, no additional
premium may be charged by the insurer until the birth of the child or the start of the adoption
bonding period. The insurer shall take reasonable steps to provide adequate notice to insureds
of the need to alter coverage to ensure newborn or adopted children are covered and of the lack
of premium adjustment until the birth of the child or the start of the adoption bonding period. An
insurer is considered to have taken reasonable steps if prominent disclosure of the requirements
of this section are included in a certificate, subscriber contract, evidence of coverage, or
Section 10. That § 58-41-35.2 be repealed.
adopted child of the insured or subscriber from the beginning of the six-month adoption bonding period. The newly born or newly adopted child shall be added to the policy without underwriting and without the imposition of any preexisting waiting period. Any policy or contract issued before July 1, 1984, shall, upon its next anniversary date, also provide that the health insurance benefits applicable for children are payable with respect to a newly born child of the insured or subscriber from the moment of birth or to a newly adopted child of the insured or subscriber from the beginning of the six-month adoption bonding period.
Section 11. That § 58-41-35.3 be repealed.
Section 12. That § 58-41-35.4 be repealed.
employee handbook if such are provided to all insureds.
If payment of a specific premium or subscription fee is required to provide coverage for a
child, the policy or contract may require that notification of birth of a newly born child or
notification of the start of the six-month adoption bonding period for an adopted child and
payment of the required premium or fees be furnished to the nonprofit medical and surgical
service plan corporation within thirty-one days after the date of birth or start of the bonding
period in order to have the coverage continued beyond the thirty-one day period.
