Session of 1998
                   
SENATE BILL No. 461
         
By Committee on Financial Institutions and Insurance
         
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            9             AN ACT concerning accident and health insurance; mandatory offer of
10             maternity benefits; amending K.S.A. 1997 Supp. 40-2,102 and repeal-
11             ing the existing section.
12            
13       Be it enacted by the Legislature of the State of Kansas:
14           Section 1. K.S.A. 1997 Supp. 40-2,102 is hereby amended to read as
15       follows: 40-2,102. (a) (1) All individual and group health insurance policies
16       providing coverage on an expense incurred basis, individual and group
17       service or indemnity type contracts issued by a profit or nonprofit cor-
18       poration and all contracts issued by health maintenance organizations
19       organized or authorized to transact business in this state which provides
20       coverage for a family member of the enrollee, insured or subscriber shall,
21       as to such family members' coverage, also provide that the health insur-
22       ance benefits applicable for children shall be payable with respect to a:
23       (A) Newly born child of the enrollee, insured or subscriber from the
24       moment of birth; (B) newly born child adopted by the enrollee, insured
25       or subscriber from the moment of birth if a petition for adoption as pro-
26       vided in K.S.A. 59-2128 and amendments thereto was filed within 31 days
27       of the birth of the child; or (C) child adopted by the enrollee, insured or
28       subscriber from the date the petition for adoption as provided in K.S.A.
29       59-2128 and amendments thereto was filed or (D) child placed in en-
30       rollee, insured or subscriber's home by a child placement agency as de-
31       fined by K.S.A. 65-503 and amendments thereto, for the purpose of adop-
32       tion from the date of placement as certified by the enrollee, insured or
33       subscriber. In no case shall the time from the date of placement to the
34       date the petition for adoption as provided in K.S.A. 59-2128 and amend-
35       ments thereto was filed exceed 280 days.
36           (2) The coverage for newly born children shall consist of: (A) Cov-
37       erage of injury or sickness including the necessary care and treatment of
38       medically diagnosed congenital defects and birth abnormalities; and (B)
39       routine and necessary immunizations for all newly born children of the
40       insured or subscriber. For purposes of this paragraph ``routine and nec-
41       essary immunizations'' shall consist of at least five doses of vaccine against
42       diphtheria, pertussis, tetanus; at least four doses of vaccine against polio
43       and Haemophilus B (Hib) ; and three doses of vaccine against Hepatitis

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  1       B; two doses of vaccine against measles, mumps and rubella; one dose of
  2       vaccine against varicella and such other vaccines and dosages as may be
  3       prescribed by the secretary of health and environment. The required
  4       benefits shall apply to immunizations administered to each newly born
  5       child from birth to 72 months of age and shall not be subject to any
  6       deductible, copayment or coinsurance requirements.
  7           (3) If payment of a specific premium or subscription fee is required
  8       to provide coverage for a child, the policy or contract may require that
  9       notification of birth of a newly born child or the filing of the petition for
10       adoption or certification that a child has been placed in the home for
11       adoption as defined by subsection (a)(1)(D) and payment of the required
12       premium or fees must be furnished to the health maintenance organi-
13       zation, insurer or nonprofit service or indemnity corporation within 31
14       days after the date of birth or the filing of the petition for adoption or
15       certification that a child has been placed in the home for adoption as
16       defined by subsection (a)(1)(D) in order to have the coverage continue
17       beyond such 31-day period.
18           (4) The contract issued by a health maintenance organization may
19       provide that the benefits required pursuant to this subsection shall be
20       covered benefits only if the services are rendered by a provider who is
21       designated by and affiliated with the health maintenance organization.
22           (b) (1) All individual and group health insurance policies providing
23       coverage on an expense incurred basis, individual and group service or
24       indemnity type contracts issued by a profit or nonprofit corporation and
25       all contracts issued by health maintenance organizations organized or au-
26       thorized to transact business in this state which provides coverage for a
27       family member of the enrollee, insured or subscriber, as to such family
28       members' coverage, shall also offer an option whereby the health insur-
29       ance benefits shall include if not already provided, an option whereby the
30       health insurance benefits shall include maternity coverage for an insured
31       or enrollee and delivery and obstetrical expenses at birth of the birth
32       mother of a child adopted within 90 days of birth of such child by the
33       enrollee, insured or subscriber subject to the same limitations contained
34       in such policy or contract applicable to the enrollee, insured or subscriber.
35       Such offer of an option regarding such maternity and such delivery and
36       obstetrical expense shall be made to the enrollee of a health maintenance
37       organization and to the insured and, to the individual subscribers in the
38       case of a group health insurance policy.
39           (2) Contracts issued by a health maintenance organization may pro-
40       vide that the benefits required pursuant to paragraph (1) of this subsec-
41       tion, shall be covered benefits only if the services are rendered by a pro-
42       vider who is designated by and affiliated with the health maintenance
43       organization.

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  1           Sec. 2. K.S.A. 1997 Supp. 40-2,102 is hereby repealed.
  2           Sec. 3. This act shall take effect and be in force from and after its
  3       publication in the statute book.
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