Ch. 95 1997 Session Laws of Kansas 329
An Act concerning health benefit coverage; policies and
contracts therefor; coverage for
certain children; insurance coverage for immunizations; amending
K.S.A. 1996 Supp.
40-2,102 and repealing the existing section.
Be it enacted by the Legislature of the State of
Kansas:
Section 1. K.S.A. 1996 Supp. 40-2,102 is hereby amended to read
as
follows: 40-2,102. (a) (1) All individual and group health
insurance policies
providing coverage on an expense incurred basis, individual and
group
service or indemnity type contracts issued by a profit or nonprofit
cor-
poration and all contracts issued by health maintenance
organizations
organized or authorized to transact business in this state which
provides
coverage for a family member of the enrollee, insured or subscriber
shall,
as to such family members' coverage, also provide that the health
insur-
ance benefits applicable for children shall be payable with respect
to a:
(A) Newly born child of the enrollee, insured or subscriber from
the
moment of birth; (B) newly born child adopted by the enrollee,
insured
or subscriber from the moment of birth if a petition for adoption
as pro-
vided in K.S.A. 59-2128 and amendments thereto was filed within 31
days
of the birth of the child; or (C) child adopted by the enrollee,
insured or
subscriber from the date the petition for adoption as provided in
K.S.A.
59-2128 and amendments thereto was filed or (D) child placed in
enrollee,
insured or subscriber's home by a child placement agency as defined
by
K.S.A. 65-503 and amendments thereto, for the purpose of adoption
from
the date of placement as certified by the enrollee, insured or
subscriber.
In no case shall the time from the date of placement to the date
the petition
for adoption as provided in K.S.A. 59-2128 and amendments thereto
was
filed exceed 280 days.
(2) The coverage for newly born children shall consist of: (A)
Cov-
erage of injury or sickness including the necessary care and
treatment of
medically diagnosed congenital defects and birth abnormalities; and
(B)
routine and necessary immunizations for all newly born children of
the
insured or subscriber. For purposes of this paragraph ``routine and
nec-
essary immunizations'' shall consist of at least
three five doses of vaccine
against diptheria, pertussis, tetanus,; at
least four doses of vaccine against
polio, and Haemophilus B (Hib)
and ; and three doses of vaccine
against
330 1997 Session Laws of Kansas Ch. 95
Hepatitis B; one dose two doses of
vaccine against measles, mumps and
rubella; one dose of vaccine against varicella and such
other vaccines and
dosages as may be prescribed by the secretary of health and
environment.
The required benefits shall apply to immunizations administered to
each
newly born child from birth to 36 72 months
of age and shall not be
subject to any deductible, copayment or coinsurance
requirements.
(3) If payment of a specific premium or subscription fee is
required
to provide coverage for a child, the policy or contract may require
that
notification of birth of a newly born child or the filing of the
petition for
adoption or certification that a child has been placed in the
home for
adoption as defined by subsection (a)(1)(D) and payment of the
required
premium or fees must be furnished to the health maintenance
organi-
zation, insurer or nonprofit service or indemnity corporation
within 31
days after the date of birth or the filing of the petition for
adoption or
certification that a child has been placed in the home for adoption
as
defined by subsection (a)(1)(D) in order to have the coverage
continue
beyond such 31-day period.
(4) The contract issued by a health maintenance organization
may
provide that the benefits required pursuant to this subsection
shall be
covered benefits only if the services are rendered by a provider
who is
designated by and affiliated with the health maintenance
organization.
(b) (1) All individual and group health insurance policies
providing
coverage on an expense incurred basis, individual and group service
or
indemnity type contracts issued by a profit or nonprofit
corporation and
all contracts issued by health maintenance organizations organized
or au-
thorized to transact business in this state which provides coverage
for a
family member of the enrollee, insured or subscriber, as to such
family
members' coverage, shall also offer an option whereby the health
insur-
ance benefits shall include delivery and obstetrical
expenses at birth of
the birth mother of a child adopted within 90 days of birth of such
child
by the enrollee, insured or subscriber subject to the same
limitations
contained in such policy or contract applicable to the enrollee,
insured
or subscriber. Such offer of an option regarding such delivery
and ob-
stetrical expense shall be made to the enrollee of a health
maintenance
organization and to the insured and, to the individual subscribers
in the
case of a group health insurance policy.
(2) Contracts issued by a health maintenance organization may
pro-
vide that the benefits required pursuant to paragraph (1) of this
subsec-
tion, shall be covered benefits only if the services are rendered
by a pro-
vider who is designated by and affiliated with the health
maintenance
organization.
Sec. 2. K.S.A. 1996 Supp. 40-2,102 is hereby repealed.
Ch. 95 1997 Session Laws of Kansas 331
Sec. 3. This act shall take effect and be in force from and
after its
publication in the statute book.
Approved April 10, 1997.