§ 58-3-290. Nondependent child coverage defined; open enrollment.

280 words·~1 min read·/nc/chapter-58/58-3-290

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(a)As used in this section, the following definitions apply:

(1)"Health benefit plan" has the same meaning as G.S. 58-3-167(a)(1).

(2)"Individual market" has the same meaning as G.S. 58-68-25(a)(9).

(3)"Insurer" has the same meaning as G.S. 58-3-167(a)(2).

(4)"Nondependent child coverage" or "nondependent child policy" means an individual health benefit plan which provides coverage to an individual under age 19. This shall not include health benefit plans that cover children under age 19 as dependents.

(5)"Open enrollment" means, with respect to "nondependent child coverage," the period of time during which any individual under age 19 has the opportunity to apply for coverage under a health benefit plan offered by an insurer and shall not be denied eligibility for coverage under the plan due to factors relating to the individual's health status.

(b)An insurer who offers nondependent child coverage shall offer open enrollment either continuously throughout the year or for the months of January and July of each year. Coverage issued under this section shall be issued without any riders based on the health status of the child. Nothing in this section shall require an insurer to offer nondependent child coverage or maternity coverage within an offer of nondependent child coverage.

(c)The Commissioner shall adopt rules as necessary or proper to implement the provisions of this section.

(d)Nothing in this section shall prohibit an insurer from adjusting the initial premium charged an individual afforded coverage under this section based upon medical underwriting to the extent that such an adjustment is in compliance with the applicable product's current rate filing approved by the Commissioner. (2011-196, s. 5.)