2014 Kentucky Revised Statutes CHAPTER 304 - INSURANCE CODE Subtitle 17A - Health Benefit Plans 17A.17A-139 Family or dependents coverage to apply to newly born child from moment of birth and to include inherited metabolic diseases -- Requirement for notification and payment of premium -- Coverage for milk fortifiers to prevent enterocolitis.
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304.17A-139 Family or dependents coverage to apply to newly born child
from moment of birth and to include inherited metabolic diseases -Requirement for notification and payment of premium -- Coverage for
milk fortifiers to prevent enterocolitis.
(1)
(2)
(3)
(4)
(5)
A health benefit plan that provides coverage for a family or dependent shall
provide coverage of a newly born child of the insured from the moment of birth.
Coverage for a newly born child shall consist of coverage of injury or sickness,
including the necessary care and treatment of medically diagnosed congenital
defects and birth abnormalities.
If payment of a specific premium or fee is required to provide coverage for a
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 within thirty-one (31) days after the date of birth in order to have the
coverage continue beyond that thirty-one (31) day period.
(a) For the purposes of this subsection:
1.
"Milk fortifier" means a commercially prepared human milk fortifier
made from concentrated one hundred percent (100%) human milk;
and
2.
"One hundred percent (100%) human diet" means the
supplementation of a mother's expressed breast milk or donor milk
with a milk fortifier.
(b) A health benefit plan that provides prescription drug coverage shall
provide that coverage for a one hundred percent (100%) human diet, if
the one hundred percent (100%) human diet and supplemented milk
fortifier products are prescribed for the prevention of necrotizing
enterocolitis and associated comorbidities, and are administered under
the direction of a physician. Coverage under this subsection may be
subject to a cap of fifteen thousand dollars ($15,000) per infant, for each
plan year, subject to annual inflation adjustments.
The requirements of this section shall apply to all health benefit plans delivered
or issued for delivery on or after June 25, 2013.
Effective:June 25, 2013
History: Amended 2013 Ky. Acts ch. 118, sec. 11, effective June 25, 2013. -Amended 2008 Ky. Acts ch. 119, sec. 3, effective July 15, 2008. -- Amended
2002 Ky. Acts ch. 195, sec. 1, effective July 15, 2002. -- Created 2000 Ky. Acts
ch. 457, sec. 4, effective July 14, 2000.
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