58-51-25. Policy coverage to continue as to children with an intellectual or physical disability; or dependent students on medically necessary leave of absence.
(a) An individual or group accident and health insurance policy, hospital service plan policy, or medical service plan policy that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy or contract, shall also provide in substance that attainment of the limiting age shall not operate or terminate the coverage of the child while the child is and continues to be (i) incapable of self-sustaining employment by reason of an intellectual or physical disability; and (ii) chiefly dependent upon the policyholder or subscriber for support and maintenance. The proof of such incapacity and dependency shall be furnished to the insurer, hospital service plan corporation, or medical service plan corporation by the policyholder or subscriber within 31 days of the child's attainment of the limiting age and subsequently as may be required by the insurer or corporation, but not more frequently than annually after the child's attainment of the limiting age.
(b) All health benefit plans, as defined in G.S. 58-3-167, that provide that coverage of a dependent child shall terminate upon a change in enrollment of the child in a postsecondary educational institution shall provide for the continued eligibility of the dependent child during a medically necessary leave of absence from the postsecondary educational institution in accordance with all applicable requirements of Public Law 110-381, known as Michelle's Law. (1969, c. 745, s. 1; 1971, c. 1126, s. 1; 2009-382, s. 17; 2018-47, s. 7(a).)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 51 - Nature of Policies.
§ 58-51-1 - Form, classification and rates to be approved by Commissioner.
§ 58-51-10 - Right to return policy and have premium refunded.
§ 58-51-15 - Accident and health policy provisions.
§ 58-51-16 - Intoxicants and narcotics.
§ 58-51-17 - Portability for accident and health insurance.
§ 58-51-30 - Policies to cover newborn infants, foster children, and adopted children.
§ 58-51-37 - Pharmacy of choice.
§ 58-51-37.1 - Lock-in program for certain controlled substances.
§ 58-51-38 - Direct access to obstetrician-gynecologists.
§ 58-51-50 - Coverage for chemical dependency treatment.
§ 58-51-55 - No discrimination against mentally ill or chemically dependent individuals.
§ 58-51-57 - Coverage for mammograms and cervical cancer screening.
§ 58-51-58 - Coverage for prostate-specific antigen (PSA) tests.
§ 58-51-59 - Coverage of certain prescribed drugs for cancer treatment.
§ 58-51-60 - Meaning of term "preexisting conditions" in certain policies.
§ 58-51-61 - Coverage for certain treatment for diabetes.
§ 58-51-62 - Coverage for reconstructive breast surgery following mastectomy.
§ 58-51-63 - Coverage for abortions not allowed in plans offered through Exchange.
§ 58-51-65 - Industrial sick benefit insurance defined.
§ 58-51-70 - Industrial sick benefit insurance; provisions.
§ 58-51-75 - Blanket accident and health insurance defined.
§ 58-51-80 - Group accident and health insurance defined.
§ 58-51-81 - Group accident and health insurance for public school students.
§ 58-51-85 - Group or blanket accident and health insurance; approval of forms and filing of rates.
§ 58-51-90 - Definition of franchise accident and health insurance.
§ 58-51-95 - Approval by Commissioner of forms, classification and rates; hearing; exceptions.
§ 58-51-100 - Credit accident and health insurance.
§ 58-51-105 - Hospitalization insurance defined.
§ 58-51-110 - Renewal, discontinuance, or replacement of group health insurance.
§ 58-51-115 - Coordination of benefits with Medicaid.
§ 58-51-116 - ERISA plans may not require Medicaid to pay first.
§ 58-51-120 - Coverage of children.
§ 58-51-125 - Adopted child coverage.
§ 58-51-130 - Standards for disability income insurance policies.