§ 38.2-3411. Coverage of newborn children required.
A. Each individual and group accident and sickness insurance policy orindividual and group subscription contract providing coverage on an expenseincurred basis that provides coverage for a family member of the insured orthe subscriber shall, as to the family members' coverage, also provide thatthe accident and sickness insurance benefits applicable for children shall bepayable with respect to a newly born child of the insured or subscriber fromthe moment of birth.
B. Coverage for newly born children shall be identical to coverage providedto the insured or subscriber, except that, regardless of whether suchcoverage would otherwise be provided under the terms and conditions of theinsurance policy or subscription contract, coverage shall be provided for:
1. Necessary care and treatment of medically diagnosed congenital defects andbirth abnormalities, with coverage limits no more restrictive than for anyinjury or sickness covered under the insurance policy or subscriptioncontract; and
2. Inpatient and outpatient dental, oral surgical, and orthodontic serviceswhich are medically necessary for the treatment of medically diagnosed cleftlip, cleft palate or ectodermal dysplasia. Such coverage shall be subject toany deductible, cost-sharing, and policy or contract maximum provisions,provided they are no more restrictive for such services than for any injuryor sickness covered under the insurance policy or subscription contract.
C. If payment of a specific premium or subscription fee is required toprovide coverage for a child, the policy or subscription contract may requirethat notification of birth of a newly born child and payment of the requiredpremium or fees shall be furnished to the insurer issuing the policy orcorporation issuing the subscription contract within thirty-one days afterthe date of birth in order to have the coverage continue beyond thethirty-one-day period.
(1975, c. 281, § 38.1-348.6; 1976, c. 342; 1986, c. 562; 1993, c. 263.)
§ 38.2-3411. Coverage of newborn children required.
A. Each individual and group accident and sickness insurance policy orindividual and group subscription contract providing coverage on an expenseincurred basis that provides coverage for a family member of the insured orthe subscriber shall, as to the family members' coverage, also provide thatthe accident and sickness insurance benefits applicable for children shall bepayable with respect to a newly born child of the insured or subscriber fromthe moment of birth.
B. Coverage for newly born children shall be identical to coverage providedto the insured or subscriber, except that, regardless of whether suchcoverage would otherwise be provided under the terms and conditions of theinsurance policy or subscription contract, coverage shall be provided for:
1. Necessary care and treatment of medically diagnosed congenital defects andbirth abnormalities, with coverage limits no more restrictive than for anyinjury or sickness covered under the insurance policy or subscriptioncontract; and
2. Inpatient and outpatient dental, oral surgical, and orthodontic serviceswhich are medically necessary for the treatment of medically diagnosed cleftlip, cleft palate or ectodermal dysplasia. Such coverage shall be subject toany deductible, cost-sharing, and policy or contract maximum provisions,provided they are no more restrictive for such services than for any injuryor sickness covered under the insurance policy or subscription contract.
C. If payment of a specific premium or subscription fee is required toprovide coverage for a child, the policy or subscription contract may requirethat notification of birth of a newly born child and payment of the requiredpremium or fees shall be furnished to the insurer issuing the policy orcorporation issuing the subscription contract within thirty-one days afterthe date of birth in order to have the coverage continue beyond thethirty-one-day period.
(1975, c. 281, § 38.1-348.6; 1976, c. 342; 1986, c. 562; 1993, c. 263.)
§ 38.2-3411. Coverage of newborn children required.
A. Each individual and group accident and sickness insurance policy orindividual and group subscription contract providing coverage on an expenseincurred basis that provides coverage for a family member of the insured orthe subscriber shall, as to the family members' coverage, also provide thatthe accident and sickness insurance benefits applicable for children shall bepayable with respect to a newly born child of the insured or subscriber fromthe moment of birth.
B. Coverage for newly born children shall be identical to coverage providedto the insured or subscriber, except that, regardless of whether suchcoverage would otherwise be provided under the terms and conditions of theinsurance policy or subscription contract, coverage shall be provided for:
1. Necessary care and treatment of medically diagnosed congenital defects andbirth abnormalities, with coverage limits no more restrictive than for anyinjury or sickness covered under the insurance policy or subscriptioncontract; and
2. Inpatient and outpatient dental, oral surgical, and orthodontic serviceswhich are medically necessary for the treatment of medically diagnosed cleftlip, cleft palate or ectodermal dysplasia. Such coverage shall be subject toany deductible, cost-sharing, and policy or contract maximum provisions,provided they are no more restrictive for such services than for any injuryor sickness covered under the insurance policy or subscription contract.
C. If payment of a specific premium or subscription fee is required toprovide coverage for a child, the policy or subscription contract may requirethat notification of birth of a newly born child and payment of the requiredpremium or fees shall be furnished to the insurer issuing the policy orcorporation issuing the subscription contract within thirty-one days afterthe date of birth in order to have the coverage continue beyond thethirty-one-day period.
(1975, c. 281, § 38.1-348.6; 1976, c. 342; 1986, c. 562; 1993, c. 263.)
