58-3-290. Nondependent child coverage defined; open enrollment.
(a) As used in this section, the following definitions apply:
(1) "Health benefit plan" has the same meaning as G.S. 58-3-167(a)(1).
(2) "Individual market" has the same meaning as G.S. 58-68-25(a)(9).
(3) "Insurer" has the same meaning as G.S. 58-3-167(a)(2).
(4) "Nondependent child coverage" or "nondependent child policy" means an individual health benefit plan which provides coverage to an individual under age 19. This shall not include health benefit plans that cover children under age 19 as dependents.
(5) "Open enrollment" means, with respect to "nondependent child coverage," the period of time during which any individual under age 19 has the opportunity to apply for coverage under a health benefit plan offered by an insurer and shall not be denied eligibility for coverage under the plan due to factors relating to the individual's health status.
(b) An insurer who offers nondependent child coverage shall offer open enrollment either continuously throughout the year or for the months of January and July of each year. Coverage issued under this section shall be issued without any riders based on the health status of the child. Nothing in this section shall require an insurer to offer nondependent child coverage or maternity coverage within an offer of nondependent child coverage.
(c) The Commissioner shall adopt rules as necessary or proper to implement the provisions of this section.
(d) Nothing in this section shall prohibit an insurer from adjusting the initial premium charged an individual afforded coverage under this section based upon medical underwriting to the extent that such an adjustment is in compliance with the applicable product's current rate filing approved by the Commissioner. (2011-196, s. 5.)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 3 - General Regulations for Insurance.
§ 58-3-1 - State law governs insurance contracts.
§ 58-3-5 - No insurance contracts except under Articles 1 through 64 of this Chapter.
§ 58-3-6 - Charitable gift annuities.
§ 58-3-7 - Certain accountable care organizations not subject to this Chapter.
§ 58-3-8 - Medical direct primary care agreements not subject to this Chapter.
§ 58-3-10 - Statements in application not warranties.
§ 58-3-15 - Additional or coinsurance clause.
§ 58-3-20 - Group plans other than life, annuity or accident and health.
§ 58-3-25 - Discriminatory practices prohibited.
§ 58-3-30 - Meaning of terms "accident", "accidental injury", and "accidental means".
§ 58-3-33 - Insurer conditionally required to provide information.
§ 58-3-35 - Stipulations as to jurisdiction and limitation of actions.
§ 58-3-40 - Proof of loss forms required to be furnished.
§ 58-3-45 - Insurance as security for a loan by the company.
§ 58-3-50 - Companies must do business in own name; emblems, insignias, etc.
§ 58-3-55 - Must not pay death benefits in services.
§ 58-3-60 - Publication of assets and liabilities; penalty for failure.
§ 58-3-65 - Publication of financial information.
§ 58-3-71 - Unearned premium reserves.
§ 58-3-72 - Premium deficiency reserves.
§ 58-3-75 - Loss and loss expense reserves of fire and marine insurance companies.
§ 58-3-81 - Loss and loss expense reserves of casualty insurance and surety companies.
§ 58-3-100 - Insurance company licensing provisions.
§ 58-3-105 - Limitation of risk.
§ 58-3-110 - Limitation of liability assumed.
§ 58-3-115 - Twisting with respect to insurance policies; penalties.
§ 58-3-120 - Discrimination forbidden.
§ 58-3-121 - Discrimination against coverage of certain bones and joints prohibited.
§ 58-3-135 - Certain insurance activities by lenders with customers prohibited.
§ 58-3-137 - Prohibition on provisions relating to replacement cost estimators.
§ 58-3-140 - Temporary contracts of insurance permitted.
§ 58-3-145 - Solicitation, negotiation or payment of premiums on insurance policies.
§ 58-3-147 - Credit card guaranty or collateral prohibited.
§ 58-3-149 - Certificates of insurance.
§ 58-3-150 - Forms to be approved by Commissioner.
§ 58-3-151 - Deemer provisions.
§ 58-3-152 - Excess liability policies; uninsured and underinsured motorist coverages.
§ 58-3-155 - Business transacted with insurer-controlled brokers.
§ 58-3-160 - Sale of company or major reorganization; license to be restricted.
§ 58-3-165 - Business transacted with producer-controlled property or casualty insurers.
§ 58-3-167 - Applicability of acts of the General Assembly to health benefit plans.
§ 58-3-168 - Coverage for postmastectomy inpatient care.
§ 58-3-169 - Required coverage for minimum hospital stay following birth.
§ 58-3-170 - Requirements for maternity coverage.
§ 58-3-171 - Uniform claim forms.
§ 58-3-172 - Notice of claim denied.
§ 58-3-175 - Direct payment to government agencies.
§ 58-3-176 - Treatment discussions not limited.
§ 58-3-177 - Uniform prescription drug identification cards.
§ 58-3-179 - Coverage for colorectal cancer screening.
§ 58-3-180 - Motor vehicle repairs; selection by claimant.
§ 58-3-181 - Synchronization of prescription refills.
§ 58-3-185 - Lien created for payment of past-due child support obligations.
§ 58-3-190 - Coverage required for emergency care.
§ 58-3-191 - Managed care reporting and disclosure requirements.
§ 58-3-192 - Coverage for autism spectrum disorder.
§ 58-3-200 - Miscellaneous insurance and managed care coverage and network provisions.
§ 58-3-215 - Genetic information in health insurance.
§ 58-3-220 - Mental illness benefits coverage.
§ 58-3-221 - Access to nonformulary and restricted access prescription drugs.
§ 58-3-223 - Managed care access to specialist care.
§ 58-3-225 - Prompt claim payments under health benefit plans.
§ 58-3-227 - Health plans fee schedules.
§ 58-3-228 - Coverage for extra prescriptions during a state of emergency or disaster.
§ 58-3-230 - Uniform provider credentialing.
§ 58-3-231 - Payment under locum tenens arrangements.
§ 58-3-235 - Selection of specialist as primary care provider.
§ 58-3-240 - Direct access to pediatrician for minors.
§ 58-3-245 - Provider directories; cost tools for insured.
§ 58-3-247 - Insurance identification card.
§ 58-3-250 - Payment obligations for covered services.
§ 58-3-255 - Coverage of clinical trials.
§ 58-3-256 - Coverage related to organ transplants.
§ 58-3-260 - Insurance coverage for newborn hearing screening mandated.
§ 58-3-265 - Prohibition on managed care provider incentives.
§ 58-3-270 - Coverage for surveillance tests for women at risk for ovarian cancer.
§ 58-3-275 - Closure of a block of business.
§ 58-3-280 - Coverage for the diagnosis and treatment of lymphedema.
§ 58-3-285 - Coverage for hearing aids.
§ 58-3-290 - Nondependent child coverage defined; open enrollment.
§ 58-3-300 - Health insurance issuers subject to certain requirements of federal law.