- (1) Each HMO shall comply with the requirements of Section 641.31(9), F.S. If the HMO does not require pre-enrollment for newborns, newborn coverage will commence from the moment of birth in accordance with the subscriber contract.
- (2) If the HMO does have a pre-enrollment requirement, the subscriber must be allowed to pre-enroll the newborn up to the moment of birth. The HMO must notify the subscriber of any pre-enrollment requirement, both in the subscriber contract and handbook. Additionally, the HMO should emphasize the pre-enrollment requirements after the subscriber or covered family member is known by the HMO to be pregnant.
- (3) Failure to comply with pre-enrollment procedures shall require the newborn to be enrolled during the subscriber’s next open enrollment period.
- (4) Coverage for adopted children shall be provided pursuant to the requirements enumerated in Section 641.31(17), F.S.
Rulemaking Authority 641.36 FS. Law Implemented 641.31(9), (17) FS. History–New 2-22-88, Amended 10-25-89, Formerly 4-31.045, Amended 5-28-92, Formerly 4-191.045.