1. A. Notwithstanding any other provision of law, an insurer shall not deny enrollment of a child under the health plan of the child's parent on the grounds that:

   1. 1. The child was born out of wedlock;
   2. 2. The child is not claimed as a dependent on the parent's federal tax return; or
   3. 3. The child does not reside with the parent or in the insurer's service area.

2. B. Where a child has health coverage through an insurer of a noncustodial parent the insurer shall:

   1. 1. Upon request , provide complete information to the custodial person, the designated agency administering the State Medicaid Program, the state agency administering the provisions of 42 U.S.C., Sections 5 through 669, or the Child Support Enforcement Program, regarding any insurance benefits to which the child is entitled, and any forms, publications or documents necessary to apply for or to utilize the benefits available through that coverage;
   2. 2. Permit the custodial person, the designated agency administering the State Medicaid Program, or the provider with approval, to submit claims for covered services without the approval of the noncustodial parent; and
   3. 3. Make payments on claims submitted in accordance with paragraph 2 of this subsection directly to the custodial person, the provider, or the designated agency administering the State Medicaid Program.

3. C. Where a parent is required by a court or administrative order to provide health coverage for a child, and the parent is eligible for family health coverage, the insurer shall be required:

   1. 1. To permit the parent to enroll, under the family coverage, a child who is otherwise eligible for the coverage without regard to any enrollment season restrictions;
   2. 2. If the parent is enrolled but fails to make application to obtain coverage for the child, to enroll the child under family coverage and deduct the cost of the coverage from the employee's wages, upon application of the child's custodial person, the designated agency administering the State Medicaid Program, or the state agency administering the provisions of 42 U.S.C., Sections 5 to 669, the Child Support Enforcement Program; and

   3. 3. Not to disenroll, or eliminate coverage for the child unless the insurer is provided satisfactory written evidence that:

      1. a. the court or administrative order is no longer in effect, or
      2. b. the child is or will be enrolled in comparable health coverage through another insurer which will take effect not later than the effective date of disenrollment.
4. D. An insurer may not impose requirements on a state agency, which has been assigned the rights of an individual eligible for medical assistance under Medicaid and covered for health benefits from the insurer, that are different from requirements applicable to an agent or assignee of any other individual so covered.
5. E. As used in this section, "insurer" includes a licensed insurance company, not-for-profit hospital service or medical indemnity corporation, a fraternal benefit society, a health maintenance organization, a prepaid plan, a preferred provider organization, a multiple employer welfare arrangement, a self-insured, the State and Education Employees Group Insurance Board, or any other entity providing a plan of health insurance or health benefits in this state.

Laws 1994, SB 1187, c. 27, § 1, emerg. eff. April 7, 1994; Amended by Laws 1998, SB 1342, c. 323, § 6, eff. October 1, 1998 (superseded document available)