2016 Kentucky Revised Statutes CHAPTER 304 - INSURANCE CODE Subtitle 17A - Health Benefit Plans 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.
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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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