For the purposes of this section, unless the context otherwise indicates, the following
terms have the following meanings.
A. "Dependent children" means children who are under 19 years of age and are children,
stepchildren or adopted children of, or children placed for adoption with the policyholder,
member or spouse of the policyholder or member. [1993, c. 666, Pt. A, §3 (NEW).]
B. "Placed for adoption" means the assumption and retention of a legal obligation by
a person for the total or partial support of a child in anticipation of adoption of
the child. If the legal obligation ceases to exist, the child is no longer considered
placed for adoption. [1993, c. 666, Pt. A, §3 (NEW).]
1993, c. 666, Pt. A, §3 (RPR)
All insurance policies or plans issued in accordance with the requirements of section
2741 must provide unmarried women policyholders with the coverage or option of coverage
for dependent children, under the same terms and conditions and at appropriate rates
as are extended to married policyholders with dependents.
1991, c. 200, Pt. B, §3 (NEW)
Financial dependency of dependent children on the policyholder or the spouse of
the policyholder may not be required as a condition for eligibility coverage.
1991, c. 200, Pt. B, §3 (NEW)
All individual policies issued in accordance with the requirements of this section
must provide the same benefits to dependent children placed for adoption with the
policyholder or spouse of the policyholder under the same terms and conditions as
apply to natural dependent children or stepchildren of the policyholder or spouse
of the policyholder, irrespective of whether the adoption has become final.
1993, c. 666, Pt. A, §4 (NEW)
An insurer issuing policies under this chapter must comply with 42 United States
Code, Section 1396g-1. If a parent is required by a court or administrative order
to provide health coverage for a child and the parent is eligible for family health
coverage through an insurer, the insurer shall permit either of the child's parents
or the Department of Health and Human Services to enroll the child under the family
coverage without regard to any enrollment season restrictions if the child is otherwise
eligible for the coverage. An insurer must provide policy information to the custodial
parent of any dependent child so that the custodial parent can obtain benefits for
the child directly from the insurer. An insurer must permit the custodial parent
of any dependent child to submit claims for covered services without the approval
of the noncustodial parent. If the custodial parent approves, an insurer must permit
the provider to submit claims for covered services without the approval of the noncustodial
parent. An insurer shall make payment on claims submitted under this section directly
to the custodial parent or, if the custodial parent approves, to the provider.
1997, c. 795, §8 (AMD);
2003, c. 689, Pt. B, §6 (REV)
An insurer may not impose requirements on a state agency that has been assigned
the rights of an individual eligible for medical assistance and who is covered for
health benefits from the insurer that are different from requirements applicable to
an agent or assignee of any other individual so covered. If a child is otherwise
eligible for health coverage, an insurer may not refuse to provide the coverage for
the child because the child is eligible for medical assistance under Title 22.
1997, c. 795, §9 (NEW)
1975, c. 276, §2 (NEW).
1991, c. 200, §B3 (RPR).
1993, c. 666, §§A3,4 (AMD).
1995, c. 418, §C2 (AMD).
1997, c. 795, §§8,9 (AMD).
2003, c. 689, §B6 (REV).
Data for this page extracted on 12/03/2013 11:59:41.
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.