Pennsylvania Act 1994-152 — HEALTH INSURANCE - COVERAGE FOR ADOPTED CHILDREN

Act text

HEALTH INSURANCE - COVERAGE FOR ADOPTED CHILDREN
                 Act of Dec. 16, 1994, P.L. 1333, No. 152             Cl. 40
                                  AN ACT

     Requiring health insurers to cover adopted children.

        The General Assembly of the Commonwealth of Pennsylvania
     hereby enacts as follows:

     Section 1.  Family coverage to include adopted children.
        (a)  General rule.--This act shall apply to all group or
     individual health or sickness or accident policies, all group
     policies, all group or individual contracts or certificates
     issued by an entity subject to the act of December 29, 1972
     (P.L.1701, No.364), known as the Health Maintenance Organization
     Act, the act of December 14, 1992 (P.L.835, No.134), known as
     the Fraternal Benefit Societies Code, 40 Pa.C.S. Ch. 61
     (relating to hospital plan corporations) or 63 (relating to
     professional health services plan corporations) or an employee
     welfare benefit plan as defined in section 3 of the Employee
     Retirement Income Security Act of 1974 (Public Law 93-406, 88
     Stat. 829) which provide hospital or medical/surgical coverage.
     Such plans which provide coverage for a family member of the
     insured or subscriber shall, as to family members' coverage,
     also provide coverage for adopted children of the insured,
     subscriber or enrollee on the same terms and conditions as other
     covered dependent children. Notwithstanding any other provision
     within the policy, certificate or subscriber contracts, no
     policy shall contain preexisting conditions limitations or
     insurability, eligibility or health underwriting approval which
     treats adopted children differently than natural-born children.
     The coverage required by this section is effective from the date
     of placement for the purpose of adoption and continues unless
     the placement is disrupted prior to legal adoption and the child
     is removed from placement.
        (b)  Definition.--As used in this section, the term
     "placement" means the assumption and retention by a person of a
     legal obligation for total or partial support of a child in
     anticipation of adoption of the child. The child's placement
     with a person terminates upon the termination of such legal
     obligation. Coverage is not contingent on whether a final
     adoption order is ever issued. The term "child" here means an
     individual under 19 years of age as of the date of adoption or
     placement for adoption. This includes infants subject to the act
     of August 1, 1975 (P.L.157, No.81), entitled "An act providing
     for the health and welfare of newborn children and their parents
     by regulating certain health insurance coverage for newborn
     children," which applies to newborns placed for adoption or
     adopted. Adopting parents must notify the insurer within 31 days
     that a child has been added to the family. The adoptive child
     shall be treated the same as any other dependent under the
     insured or subscriber contract.
     Section 2.  Applicability.
        This act shall apply to all insurance policies, subscriber
     contracts and group insurance certificates issued under any
     group master policy delivered or issued for delivery on or after
     the effective date of this act. This act shall also apply to all
     renewals of contracts on any renewal date which is on or after
     the effective date of this act.
     Section 3.  Effective date.
        This act shall take effect immediately.