514C.1 Supplemental coverage for adopted or newly born children.
1. Any policy of individual or group accident and sickness insurance providing coverage on an expense incurred basis, and any individual or group hospital or medical service contracts issued pursuant to chapters 509, 514, and 514A, which provide coverage for a family member of the insured or subscriber shall also provide that the health insurance benefits applicable for children shall, subject to the enrollment requirements of this section, be payable with respect to a newly born child of the insured or subscriber from the moment of birth, or, in the situation of a newly adopted child of a covered person, such child shall be covered from the earlier of any of the following:
a. The date of placement of the child for the purpose of adoption and continuing in the same manner as for other dependents of the covered person, unless the placement is disrupted prior to legal adoption and the child is removed from placement.
b. The date of entry of an order granting the covered person custody of the child for purposes of adoption.
c. The effective date of adoption.
2. The coverage for adopted or newly born children shall consist of coverage for injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities and is not subject to any preexisting condition exclusion.
3. If payment of a specific premium or subscription fee is required to provide coverage for a newly born child, the policy or contract may require that notification of birth of a newly born child and payment of the required premium or fees must be furnished to the insurer or nonprofit service or indemnity corporation within sixty days after the date of birth.
4. If payment of a specific premium or subscription fee is not required to provide coverage for a newly born child, the policy or contract may require that notification of birth of a newly born child must be furnished to the insurer or nonprofit service or indemnity corporation within sixty days after the date of birth in order for coverage to be provided for the child from the date of birth.
5. a. If payment of a specific premium or subscription fee is required to provide coverage for a newly adopted child or child placed for adoption, the policy or contract may require that notification of the adoption or placement for adoption and payment of the required premium or fees must be furnished to the insurer or nonprofit service or indemnity corporation within sixty days after the coverage is required to begin under this section.
b. If payment of a specific premium or subscription fee is not required to provide coverage for a newly adopted child or child placed for adoption, the policy or contract may require that notification of the adoption or placement for adoption must be furnished to the insurer or nonprofit service or indemnity corporation within sixty days after the coverage is required to begin under this section.
c. If a covered person fails to provide the required notice or to make payment of premium or subscription fees within the sixty-day period required in this subsection, the newly adopted child or child placed for adoption shall be treated no less favorably by a health carrier than other dependents of the covered person, other than newly born children, who seek coverage under a policy or contract at a time other than the time when the dependent is first eligible to apply for coverage.
[C75, 77, 79, 81, §514C.1]
2006 Acts, ch 1117, §62
Referred to in §514E.7
Structure Iowa Code
Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES
Section 514C.1 - Supplemental coverage for adopted or newly born children.
Section 514C.2 - Skilled nursing care covered in hospitals.
Section 514C.3 - Dentist’s services under accident and sickness insurance policies.
Section 514C.3A - Disclosures relating to dental coverage reimbursement rates.
Section 514C.3B - Dental coverage — fee schedules.
Section 514C.4 - Mandated coverage for mammography.
Section 514C.5 - Prescription drug benefit restrictions.
Section 514C.6 - Uniformity of treatment — employee welfare benefit plans.
Section 514C.8 - Coordination of health care benefits with state medical assistance.
Section 514C.9 - Medical support — insurance requirements.
Section 514C.10 - Coverage for adopted child.
Section 514C.12 - Postdelivery benefits and care.
Section 514C.14 - Continuity of care — pregnancy.
Section 514C.15 - Treatment options.
Section 514C.16 - Emergency room services.
Section 514C.17 - Continuity of care — terminal illness.
Section 514C.18 - Diabetes coverage.
Section 514C.19 - Prescription contraceptive coverage.
Section 514C.20 - Mandated coverage for dental care — anesthesia and certain hospital charges.
Section 514C.21 - Coverage for immunizations — mercury.
Section 514C.22 - Biologically based mental illness coverage.
Section 514C.23 - Human papilloma virus vaccinations — coverage.
Section 514C.24 - Cancer treatment — coverage.
Section 514C.25 - Coverage for prosthetic devices.
Section 514C.26 - Approved cancer clinical trials coverage.
Section 514C.27 - Mental illness and substance abuse treatment coverage for veterans.
Section 514C.28 - Autism spectrum disorders coverage.
Section 514C.29 - Services provided by a doctor of chiropractic.
Section 514C.31 - Applied behavior analysis for treatment of autism spectrum disorder — coverage.
Section 514C.33 - Services provided by provisionally licensed psychologists.
Section 514C.34 - Health care services delivered by telehealth — coverage.
Section 514C.35 - Behavioral health services provided in a school — coverage.