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H.B. 85
This document includes House Committee Amendments incorporated into the bill on
Wed, Feb 11, 2004 at 11:54 AM by kholt. -->
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HEALTH INSURANCE MANDATE AMENDMENTS
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2004 GENERAL SESSION
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STATE OF UTAH
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Sponsor: Rebecca D. Lockhart
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LONG TITLE
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General Description:
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This bill amends the health insurance adoption indemnity law.
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Highlighted Provisions:
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This bill:
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. amends the adoption indemnity benefit to:
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. remove the requirement for the commissioner to review the adoption indemnity
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benefit every two years;
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. increase the adoption indemnity benefit to H [
$3,155
]
4,000
h ; and
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. clarify that a single adoption benefit is payable to an insured adopting multiple
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children from one birth.
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Monies Appropriated in this Bill:
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None
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Other Special Clauses:
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None
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Utah Code Sections Affected:
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AMENDS:
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31A-22-610.1, as last amended by Chapter 198, Laws of Utah 2000
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Be it enacted by the Legislature of the state of Utah:
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Section 1.
Section
31A-22-610.1
is amended to read:
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31A-22-610.1. Adoption indemnity benefit.
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(1) (a) (i) If an insured has coverage for maternity benefits on the date of an adoptive
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placement, the insured's policy shall provide an adoption indemnity benefit payable to the
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insured, if a child is placed for adoption with the insured within 90 days of the child's birth. If
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more than one child from the same birth is placed for adoption with the insured, only one
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adoption indemnity benefit is required.
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(ii) This section does not prevent an accident and health insurer from adjusting the
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benefit payable under this section for cost sharing measures imposed under the policy or
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contract for maternity benefit coverage.
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(b) An insurer that has paid the adoption indemnity benefit under Subsection (1)(a)
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may seek reimbursement of the benefit if:
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(i) the postplacement evaluation disapproves the adoption placement; and
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(ii) a court rules the adoption may not be finalized because of an act or omission of an
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adoptive parent or parents that affects the child's health or safety.
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(c) The [commissioner shall:(i) establish, by rule, the] amount of the adoption
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indemnity benefit provided under Subsection (1) [at a minimum of $2,500; and] is
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H [
$3,155
]
4,000
h
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subject to the adjustments permitted by Subsection (1)(a)(ii).
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[(ii) review the amount of the adoption indemnity benefit every two years to make any
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necessary and reasonable adjustments, taking into account the average insurance cost of an
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uncomplicated birth.]
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(d) Each insurer shall pay its pro rata share of the adoption indemnity benefit if each
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adoptive parent:
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(i) has coverage for maternity benefits with a different insurer; and
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(ii) makes a claim for the adoption indemnity benefit provided in Subsection (1)(a).
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(2) If a policy offers optional maternity benefits, it shall also offer coverage for
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adoption indemnity benefits if:
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(a) a child is placed for adoption with the insured within 90 days of the child's birth;
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and
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(b) the adoption is finalized within one year of the child's birth.
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(3) If an insured qualifies for the adoption indemnity benefit under this section and
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receives services from a health care provider under contract with his insurer, the contracting
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health care provider may only collect from the insured the amount that the contracting health
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care provider is entitled to receive for such services under the contract, including any
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applicable copayment.
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(4) For purposes of this section, "contracting health care provider" means:
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(a) a "participating provider" as defined in Section
31A-8-101
; or
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(b) a "preferred health care provider" as described in Section
31A-22-617
.
Legislative Review Note
as of 12-12-03 12:09 PM
A limited legal review of this legislation raises no obvious constitutional or statutory concerns.