(1) A health insurance policy that provides coverage on an expense-incurred basis for a member of the family of the insured or subscriber shall, as to the family member’s coverage, also provide that the health insurance benefits applicable for children will be payable with respect to a newborn child of the insured or subscriber, or covered family member of the insured or subscriber, from the moment of birth. However, with respect to a newborn child of a covered family member other than the spouse of the insured or subscriber, the coverage for the newborn child terminates 18 months after the birth of the newborn child.
(2) The coverage for newborn children required by this section consists of coverage for injury or sickness, including the necessary care or treatment of medically diagnosed congenital defects, birth abnormalities, or prematurity, and transportation costs of the newborn to and from the nearest available facility appropriately staffed and equipped to treat the newborn’s condition, when such transportation is certified by the attending physician as necessary to protect the health and safety of the newborn child. The coverage of such transportation costs may not exceed the usual and customary charges, up to $1,000.
(3) This section does not apply to disability income or hospital indemnity policies or to normal maternity policy provisions applicable to the mother.
(4) A policy may require the insured, subscriber, or covered family member to notify the insurer of the birth of a child within a time period, as specified in the policy, of not less than 30 days after the birth. If timely notice is given, the insurer may not charge an additional premium for coverage of the newborn child for the duration of the notice period. If timely notice is not given, the insurer may charge an additional premium from the date of birth. The insurer may not deny coverage for a child due to the failure of the insured to timely notify the insurer of the birth of the child.
(5) If the policy does not require the insured to notify the insurer of the birth of a child within a specified time period, the insurer may not deny coverage for such child or retroactively charge the insured an additional premium for such child. However, the insurer may prospectively charge the insured an additional premium for the child if the insurer provides at least 45 days’ notice of the additional premium required.
History.—s. 1, ch. 72-82; s. 1, ch. 74-8; s. 3, ch. 76-168; s. 1, ch. 77-174; s. 1, ch. 77-457; s. 1, ch. 80-177; ss. 2, 3, ch. 81-318; ss. 490, 497, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 1, ch. 84-202; ss. 123, 149, ch. 92-33; s. 114, ch. 92-318.
Structure Florida Statutes
Chapter 627 - Insurance Rates and Contracts
Part VI - Health Insurance Policies (Ss. 627.601-627.64995)
627.6011 - Mandated coverages.
627.602 - Scope, format of policy.
627.604 - Nonresident insured.
627.6041 - Children with disabilities; continuation of coverage.
627.6043 - Notification of cancellation, nonrenewal, or change in rates.
627.6044 - Use of a specific methodology for payment of claims.
627.6045 - Preexisting condition.
627.6046 - Limit on preexisting conditions.
627.605 - Required provisions; captions, omissions, substitutions.
627.6056 - Coverage for ambulatory surgical center service.
627.606 - Entire contract; changes.
627.607 - Time limit on certain defenses.
627.613 - Time of payment of claims.
627.615 - Physical examination, autopsy.
627.617 - Change of beneficiary.
627.618 - Optional policy provisions.
627.619 - Change of occupation.
627.620 - Misstatement of age or sex.
627.621 - Other insurance with this insurer.
627.622 - Insurance with other insurers.
627.623 - Insurance with other insurers; other benefits.
627.624 - Relation of earnings to insurance.
627.6265 - Cancellation or nonrenewal prohibited.
627.627 - Conformity with statutes.
627.629 - Intoxicants and narcotics.
627.630 - Order of certain provisions.
627.631 - Third-party ownership.
627.632 - Requirements of other jurisdictions.
627.633 - Other policy provisions.
627.636 - Industrial health insurance.
627.637 - Construction of noncomplying contracts.
627.638 - Direct payment for hospital, medical services.
627.6385 - Disclosures to policyholders; calculations of cost sharing.
627.6387 - Shared savings incentive program.
627.639 - Application signed by agent.
627.640 - Filing of classifications and rates.
627.6401 - Refunds for persons age 64.
627.6402 - Insurance rebates for healthy lifestyles.
627.64025 - Advanced practice registered nurse services.
627.6403 - Payment of acupuncture benefits to certified acupuncturists.
627.6405 - Decreasing inappropriate utilization of emergency care.
627.6408 - Diabetes treatment services.
627.6409 - Coverage for osteoporosis screening, diagnosis, treatment, and management.
627.641 - Coverage for newborn children.
627.6416 - Coverage for child health supervision services.
627.6417 - Coverage for surgical procedures and devices incident to mastectomy.
627.64171 - Coverage for length of stay and outpatient postsurgical care.
627.64172 - Requirements with respect to breast cancer and routine followup care.
627.6418 - Coverage for mammograms.
627.6419 - Requirements with respect to breast cancer.
627.64193 - Required coverage for cleft lip and cleft palate.
627.64195 - Requirements for opioid coverage.
627.64196 - Medication synchronization.
627.64197 - Coverage for organ transplants.
627.642 - Outline of coverage.
627.6425 - Renewability of individual coverage.
627.6426 - Short-term health insurance.
627.643 - Uniform minimum standards.
627.644 - Discrimination against handicapped prohibited.
627.645 - Denial of health insurance claims restricted.
627.646 - Conversion on termination of eligibility.
627.647 - Standard health claim form.
627.6471 - Contracts for reduced rates of payment; limitations; coinsurance and deductibles.
627.6472 - Exclusive provider organizations.
627.6473 - Combined preferred provider and exclusive provider policies.
627.64731 - Leasing, renting, or granting access to a participating provider.
627.6474 - Provider contracts.
627.64741 - Pharmacy benefit manager contracts.
627.6475 - Individual reinsurance pool.
627.6487 - Guaranteed availability of individual health insurance coverage to eligible individuals.
627.64995 - Restrictions on use of state and federal funds for state exchanges.