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S1394.......................................by COMMERCE AND HUMAN RESOURCES
INSURANCE - Amends existing law relating to insurance and dependents to
increase the age for certain dependents to be permitted to remain on
certain contracts or plans.
02/08 Senate intro - 1st rdg - to printing
02/11 Rpt prt - to Com/HuRes
02/13 Rpt out - rec d/p - to 2nd rdg
02/14 2nd rdg - to 3rd rdg
02/20 3rd rdg - PASSED - 34-0-1
AYES -- Andreason, Bair, Bastian, Bilyeu, Broadsword, Burkett,
Cameron, Coiner, Darrington, Davis, Fulcher, Gannon, Geddes, Goedde,
Hammond, Heinrich, Hill, Jorgenson, Kelly, Keough, Langhorst, Little,
Lodge, Malepeai(Sagness), McGee, McKague, McKenzie, Pearce,
Richardson, Schroeder, Siddoway, Stegner, Stennett, Werk
NAYS -- None
Absent and excused -- Corder
Floor Sponsor - Cameron
Title apvd - to House
02/21 House intro - 1st rdg - to Bus
03/14 Rpt out - rec d/p - to 2nd rdg
03/17 2nd rdg - to 3rd rdg
03/19 3rd rdg - PASSED - 68-0-2
AYES -- Anderson, Andrus, Barrett, Bayer, Bedke, Bell, Bilbao, Black,
Block, Bock, Boe, Bolz, Bowers, Brackett, Bradford, Chadderdon,
Chavez, Chew, Clark, Collins, Crane, Durst, Eskridge, Hagedorn, Hart,
Harwood, Henbest, Jaquet, Killen, King, Kren, Labrador, Lake,
LeFavour, Loertscher, Luker, Marriott, Mathews, McGeachin, Mortimer,
Moyle, Nielsen, Nonini, Pasley-Stuart, Patrick, Pence, Raybould,
Ringo, Roberts, Ruchti, Rusche, Sayler, Schaefer, Shepherd(02),
Shepherd(08), Shirley, Shively, Smith(30), Smith(24), Snodgrass,
Stevenson, Thayn, Thomas, Vander Woude, Wills, Wood(27), Wood(35),
Mr. Speaker
NAYS -- None
Absent and excused -- Henderson, Trail
Floor Sponsor - Collins
Title apvd - to Senate
03/20 To enrol - Rpt enrol - Pres signed
03/21 Sp signed
03/24 To Governor
03/28 Governor signed
Session Law Chapter 296
Effective: 07/01/08
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-ninth Legislature Second Regular Session - 2008IN THE SENATE SENATE BILL NO. 1394 BY COMMERCE AND HUMAN RESOURCES COMMITTEE 1 AN ACT 2 RELATING TO INSURANCE; AMENDING SECTIONS 41-2210 AND 41-3216, IDAHO CODE, TO 3 PROVIDE THAT CERTAIN PERSONS SHALL BE PERMITTED TO REMAIN ON CERTAIN CON- 4 TRACTS; AMENDING SECTION 41-3436, IDAHO CODE, TO PROVIDE THAT CERTAIN PER- 5 SONS SHALL BE PERMITTED TO REMAIN ON CERTAIN CONTRACTS AND TO MAKE TECHNI- 6 CAL CORRECTIONS; AND AMENDING SECTIONS 41-4023 AND 41-4124, IDAHO CODE, TO 7 PROVIDE THAT CERTAIN PERSONS SHALL BE PERMITTED TO REMAIN ON CERTAIN 8 PLANS. 9 Be It Enacted by the Legislature of the State of Idaho: 10 SECTION 1. That Section 41-2210, Idaho Code, be, and the same is hereby 11 amended to read as follows: 12 41-2210. REQUIRED PROVISION IN GROUP AND BLANKET POLICIES. (1) Any group 13 disability insurance contract or blanket disability insurance contract, deliv- 14 ered or issued for delivery in this state which provides coverage for injury 15 or sickness for newborn dependent children of subscribers or other members of 16 the covered group, shall provide coverage for such newborn children, including 17 adopted newborn children that are placed with the adoptive subscriber or other 18 member of the covered group within sixty (60) days of the adopted child's date 19 of birth, from and after the moment of birth. Coverage under the contract for 20 an adopted newborn child placed with the adoptive subscriber or other member 21 of the covered group more than sixty (60) days after the birth of the adopted 22 child shall be from and after the date the child is so placed. Coverage pro- 23 vided in accord with this section shall include, but not be limited to, cover- 24 age for congenital anomalies. For the purposes of this section, "child" means 25 an individual who has not attained age eighteen (18) years as of the date of 26 the adoption or placement for adoption. For the purposes of this section, 27 "placed" shall mean physical placement in the care of the adoptive subscriber 28 or other member of the covered group, or in those circumstances in which such 29 physical placement is prevented due to the medical needs of the child requir- 30 ing placement in a medical facility, it shall mean when the adoptive sub- 31 scriber or other member of the covered group signs an agreement for adoption 32 of such child and signs an agreement assuming financial responsibility for 33 such child. Prior to legal finalization of adoption, the coverage required 34 under the provisions of this subsection (1) as to a child placed for adoption 35 with a subscriber or other member of the covered group continues in the same 36 manner as it would with respect to a naturally born child of the subscriber or 37 other member of the covered group until the first to occur of the following 38 events: 39 (a) Date the child is removed permanently from that placement and the 40 legal obligation terminates; or 41 (b) The date the subscriber or other member of the covered group 42 rescinds, in writing, the agreement of adoption or agreement assuming 43 financial responsibility. 2 1 (2) An insurer shall not restrict coverage under a group disability 2 insurance contract or a blanket disability insurance contract of any dependent 3 child adopted by a participant or beneficiary, or placed with a participant or 4 beneficiary for adoption, solely on the basis of a preexisting condition of a 5 child at the time the child would otherwise become eligible for coverage under 6 the plan, if the adoption or placement for adoption occurs while the partici- 7 pant or beneficiary is eligible for coverage under the plan. 8 (3) Any group disability insurance contract or blanket disability insur- 9 ance contract delivered or issued for delivery in this state shall provide 10 that an unmarried child under the age of twenty-one (21) years or an unmarried 11 child who is a full-time student under the age of twenty-five (25) years and 12 who is financially dependent upon the parent shall be permitted to remain on 13 the parent's or parents' contract. Further, any unmarried child of any age who 14 is medically certified as disabled and financially dependent upon the parent 15 is permitted to remain on the parent's or parents' contract. 16 (4) No policy of disability insurance which provides maternity benefits 17 for a person covered continuously from conception shall be issued, amended, 18 delivered, or renewed in this state on or after January 1, 1977, if it con- 19 tains any exclusion, reduction, or other limitations as to coverage, 20 deductibles, or coinsurance provisions, as to involuntary complications of 21 pregnancy, unless such provisions apply generally to all benefits paid under 22 the policy. If a fixed amount is specified in such policy for surgery, the 23 fixed amounts for surgical procedures involving involuntary complications of 24 pregnancy shall be commensurate with other fixed amounts payable for proce- 25 dures of comparable difficulty and severity. In a case where a fixed amount is 26 payable for maternity benefits, involuntary complications of pregnancy shall 27 be deemed an illness and entitled to benefits otherwise provided by the pol- 28 icy. Where the policy contains a maternity deductible, the maternity deduct- 29 ible shall apply only to expenses resulting from normal delivery and cesarean 30 section delivery; however, expenses for cesarean section delivery in excess of 31 the deductible shall be treated as expenses for any other illness under the 32 policy. This section shall apply to all disability policies except any group 33 disability policy made subject to an applicable collective-bargaining agree- 34 ment in effect before January 1, 1977. 35 For purposes of this section, involuntary complications of pregnancy shall 36 include, but not be limited to, puerperal infection, eclampsia, cesarean sec- 37 tion delivery, ectopic pregnancy, and toxemia. 38 All policies subject to this section and issued, amended, delivered, or 39 renewed in this state on or after January 1, 1977, shall be construed to be in 40 compliance with this section, and any provision in any such policy which is in 41 conflict with this section shall be of no force or effect. 42 (45) From and after January 1, 1998, no policy of disability insurance 43 which provides medical expense maternity benefits, shall restrict benefits for 44 any hospital length of stay in connection with childbirth for the mother or 45 newborn child in a manner that would be in conflict with the newborns' and 46 mothers' health protection act of 1996. 47 SECTION 2. That Section 41-3216, Idaho Code, be, and the same is hereby 48 amended to read as follows: 49 41-3216. BENEFITS. (1) A society may provide the following contractual 50 benefits in any form: 51 (a) Death benefits; 52 (b) Endowment benefits; 3 1 (c) Annuity benefits; 2 (d) Temporary or permanent disability benefits; 3 (e) Hospital, medical or nursing benefits; and 4 (f) Monument or tombstone benefits to the memory of deceased members; and 5 (g) Such other benefits as authorized for life insurers and which are not 6 inconsistent with this chapter. 7 (2) A society shall specify in its rules those persons who may be issued, 8 or covered by, the contractual benefits in subsection (1) of this section, 9 consistent with providing benefits to members and their dependents. A society 10 may provide benefits on the lives of children under the minimum age for adult 11 membership upon application of an adult person. 12 (3) Any society contract relating to hospital, medical or nursing bene- 13 fits delivered or issued for delivery in this state shall provide that an 14 unmarried child under the age of twenty-one (21) years or an unmarried child 15 who is a full-time student under the age of twenty-five (25) years and who is 16 financially dependent upon the parent shall be permitted to remain on the 17 parent's or parents' contract. Further, any unmarried child of any age who is 18 medically certified as disabled and financially dependent upon the parent is 19 permitted to remain on the parent's or parents' contract. 20 SECTION 3. That Section 41-3436, Idaho Code, be, and the same is hereby 21 amended to read as follows: 22 41-3436. DEPENDENT'S COVERAGE -- DEPENDENT'S TERMINATION OF COVERAGE, 23 DISABILITY AND DEPENDENCY PROOF AND APPLICATION. (1) Any subscriber contract 24 delivered or issued for delivery in this state shall provide that an unmarried 25 child under the age of twenty-one (21) years or an unmarried child who is a 26 full-time student under the age of twenty-five (25) years and who is finan- 27 cially dependent upon the parent shall be permitted to remain on the parent's 28 or parents' contract. Further, any unmarried child of any age who is medi- 29 cally certified as disabled and financially dependent upon the parent is per- 30 mitted to remain on the parent's or parents' contract. 31 (2) There shall be a provision that a subscriber's contract delivered or 32 issued for delivery in this state more than one hundred twenty (120) days 33 after the effective date of this act under which coverage of a dependent of a 34 subscriber terminates at a specified age shall, with respect to an unmarried 35 child who is incapable of self-sustaining employment by reason of mental 36 retardation or physical handicap and who became so incapable prior to attain- 37 ment of the limiting age and who is chiefly dependent upon such member for 38 support and maintenance, notsoto terminate while the contract remains in 39 force and the dependent remains in such condition, if the member has within 40 thirty-one (31) days of such dependent's attainment of the limiting age sub- 41 mitted proof of such dependent's incapacity as described herein. The service 42 corporation may require at reasonable intervals during the two (2) years fol- 43 lowing the child's attainment of the limiting age subsequent proof of the 44 child's disability and dependency. After the two (2) year period, such subse- 45 quent proof may not be required more thanoneonce each year. 46 SECTION 4. That Section 41-4023, Idaho Code, be, and the same is hereby 47 amended to read as follows: 48 41-4023. COVERAGE FROM MOMENT OF BIRTH -- COMPLICATIONS OF PREGNANCY. (1) 49 Every self-funded plan issued in this state or providing coverage to any cov- 50 ered family residing within this state, shall contain a provision granting 4 1 immediate accident and sickness coverage, from and after the moment of birth, 2 to each newborn child or infant of any covered family covered, including a 3 newborn child placed with the adoptive covered family within sixty (60) days 4 of the adopted child's date of birth. Coverage under the self-funded plan for 5 an adopted newborn child placed with the adoptive covered family more than 6 sixty (60) days after the birth of the adopted child shall be from and after 7 the date the child is so placed. Coverage provided in accordance with this 8 section shall include, but not be limited to, coverage for congenital anoma- 9 lies. For the purposes of this section, "child" means an individual who has 10 not reached eighteen (18) years of age as of the date of the adoption or 11 placement for adoption. For the purposes of this section, "placed" shall mean 12 physical placement in the care of the adoptive covered family, or in those 13 circumstances in which such physical placement is prevented due to the medical 14 needs of the child requiring placement in a medical facility, it shall mean 15 when the adoptive covered family signs an agreement for adoption of such child 16 and signs an agreement assuming financial responsibility for such child. Prior 17 to legal finalization of adoption, the coverage required under the provisions 18 of this subsection (1) as to a child placed for adoption with a covered family 19 continues in the same manner as it would with respect to a naturally born 20 child of the covered family until the first to occur of the following events: 21 (a) Date the child is removed permanently from that placement and the 22 legal obligation terminates; or 23 (b) The date the covered family rescinds, in writing, the agreement of 24 adoption or agreement assuming financial responsibility. No such plan may 25 be issued or amended if it contains any disclaimer, waiver, or other limi- 26 tation of coverage relative to the coverage or insurability of newborn or 27 adopted children or infants of a covered family covered from and after the 28 moment of birth that is inconsistent with the provisions of this section. 29 (2) Neither the plan trustee or employer nor an insurer shall restrict 30 coverage under a self-funded plan of any dependent child adopted by a partici- 31 pant or beneficiary, or placed with a participant or beneficiary for adoption, 32 solely on the basis of a preexisting condition of the child at the time the 33 child would otherwise become eligible for coverage under the plan, if the 34 adoption or placement for adoption occurs while the participant or beneficiary 35 is eligible for coverage under the plan. 36 (3) No self-funded plan which provides maternity benefits for a person 37 covered continuously from conception shall be issued, amended, delivered, or 38 renewed in this state on or after January 1, 1977, if it contains any exclu- 39 sion, reduction, or other limitations as to coverage, deductibles, or coinsur- 40 ance provisions as to involuntary complications of pregnancy, unless such pro- 41 visions apply generally to all benefits paid under the plan. If a fixed amount 42 is specified in such plan for surgery, the fixed amounts for surgical proce- 43 dures involving involuntary complications of pregnancy shall be commensurate 44 with other fixed amounts payable for procedures of comparable difficulty and 45 severity. In a case where a fixed amount is payable for maternity benefits, 46 involuntary complications of pregnancy shall be deemed an illness and entitled 47 to benefits otherwise provided by the plan. Where the plan contains a mater- 48 nity deductible, the maternity deductible shall apply only to expenses result- 49 ing from normal delivery and cesarean section delivery; however, expenses for 50 cesarean section delivery in excess of the deductible shall be treated as 51 expenses for any other illness under the plan. This subsection shall apply to 52 all self-funded plans except any such plan made subject to an applicable 53 collective-bargaining agreement in effect before January 1, 1977. 54 For purposes of this subsection, involuntary complications of pregnancy 5 1 shall include, but not be limited to, puerperal infection, eclampsia, cesarean 2 section delivery, ectopic pregnancy, and toxemia. 3 All plans subject to this subsection and issued, amended, delivered, or 4 renewed in this state on or after January 1, 1977, shall be construed to be 5 in compliance with this section, and any provision in any such plan which is 6 in conflict with this section shall be of no force or effect. 7 (4) From and after January 1, 1998, no self-funded plan that provides 8 maternity benefits shall restrict benefits for any hospital length of stay in 9 connection with childbirth for the mother or newborn child in a manner that 10 would be in conflict with the newborns' and mothers' health protection act of 11 1996. 12 (5) Any self-funded group disability plan or blanket disability plan 13 delivered or issued for delivery in this state shall provide that an unmarried 14 child under the age of twenty-one (21) years or an unmarried child who is a 15 full-time student under the age of twenty-five (25) years and who is finan- 16 cially dependent upon the parent shall be permitted to remain on the parent's 17 or parents' plan. Further, any unmarried child of any age who is medically 18 certified as disabled and financially dependent upon the parent is permitted 19 to remain on the parent's or parents' plan. 20 SECTION 5. That Section 41-4124, Idaho Code, be, and the same is hereby 21 amended to read as follows: 22 41-4124. SERVICES PROVIDED BY GOVERNMENTAL ENTITIES. (1) From and after 23 July 1, 2006, no joint public agency self-funded plan shall be issued in Idaho 24 which excludes from coverage services rendered the subscriber while a resident 25 in an Idaho state institution, provided the services to the subscriber would 26 be covered by the contract if rendered to him outside an Idaho state institu- 27 tion. 28 (2) From and after July 1, 2006, no joint public agency self-funded plan 29 may contain any provision denying or reducing benefits otherwise provided 30 under the policy for the reason that the person insured is receiving health or 31 mental health care or developmental services provided by the department of 32 health and welfare, whether or not the department of health and welfare bases 33 its charges for such services on the recipient's ability to pay. Provided, 34 nothing in this section shall prevent the issuance of a contract which 35 excludes or reduces benefits where the charge level or amount of the charge 36 levied by a governmental entity for such services would vary or be affected in 37 any way by the existence of coverage under a joint public agency self-funded 38 plan. 39 (3) Any joint public agency self-funded plan delivered or issued for 40 delivery in this state shall provide that an unmarried child under the age of 41 twenty-one (21) years or an unmarried child who is a full-time student under 42 the age of twenty-five (25) years and who is financially dependent upon the 43 parent shall be permitted to remain on the parent's or parents' plan. Further, 44 any unmarried child of any age who is medically certified as disabled and 45 financially dependent upon the parent is permitted to remain on the parent's 46 or parents' plan.
STATEMENT OF PURPOSE
RS 17793
In 2007, the Legislature passed Senate Bill 1105 to raise
the dependent age that children could remain on their parents'
health insurance policy. That age was raised to 21 if the
dependent was not a full-time student or to age 25 if the
dependent was a full-time student.
The intent of SB 1105 was to affect all types of health
insurance. Inadvertently, large group, government entities,
fraternal societies, public service corporations and self-funded
plans were excluded. This legislation rectifies that oversight.
The indirect benefits of this legislation would be to: a)
reduce the number of uninsured, b) reduce the educational cost of
going to college, and c) improve the actuarial demographics of
individual and group policies, as they retain coverage on an age
group which is typically healthy and inexpensive.
FISCAL IMPACT
None.
Contact
Name: Senator Dean Cameron
Phone: 334-4735
Name: Senator Joe Stegner Rep. Gary Collins
Senator John Goedde Rep. Sharon Block
Senator Patti Anne Lodge Rep. Jim Marriott
Senator Tim Corder Rep. Carlos Bilboa
Senator John McGee Rep. Fred Wood
STATEMENT OF PURPOSE/FISCAL NOTE S 1394