§431L-3  Coverage of children. (a)  No insurer shall deny enrollment of a child under the health plan of thechild's parent for the following grounds:

(1)  The child was born out of wedlock;

(2)  The child is not claimed as a dependent on theparent's federal tax return; or

(3)  The child does not reside with the parent or inthe insurer's service area.

(b)  Where a child has health coverage throughan insurer of a noncustodial parent the insurer shall:

(1)  Provide such information to the custodial parentas may be necessary for the child to obtain benefits through that coverage;

(2)  Permit the custodial parent (or the provider,with the custodial parent's approval) to submit claims for covered serviceswithout the approval of the noncustodial parent; and

(3)  Make payments on claims submitted in accordancewith paragraph (2) directly to the custodial parent, the provider, or the statemedicaid agency.

(c)  Where a parent is required by a court oradministrative order to provide health coverage for a child, and the parent iseligible for family coverage, as defined in section 431:10A-103, and reciprocalbeneficiary family coverage, as defined in section 431:10A-601, the insurershall be required:

(1)  To permit the parent to enroll, under the familycoverage or reciprocal beneficiary family coverage, a child who is otherwiseeligible for the coverage without regard to any enrollment season restrictions;

(2)  If the parent is enrolled but fails to makeapplication to obtain coverage for the child, to enroll the child under familycoverage or reciprocal beneficiary family coverage upon application of thechild's other parent, the state agency administering the medicaid program, orthe state agency administering the child support enforcement program; and

(3)  Not to disenroll (or eliminate coverage of) thechild unless the insurer is provided satisfactory written evidence that:

(A)  The court or administrative order is nolonger in effect; or

(B)  The child is or will be enrolled incomparable health coverage through another insurer that will take effect notlater than the effective date of disenrollment.

(d)  An insurer may not impose requirements ona state agency, which has been assigned the rights of an individual eligiblefor medical assistance under medicaid and covered for health benefits from theinsurer, that are different from requirements applicable to an agent orassignee of any other individual so covered. [L 1995, c 83, pt of §2; am L1997, c 383, §8; am L 2004, c 122, §81]