Florida Regulations 69O-191.045: Newborn and Adopted Children Coverage
Current as of: 2024 | Check for updates
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(1) Each HMO shall comply with the requirements of Florida Statutes § 641.31(9) If the HMO does not require pre-enrollment for newborns, newborn coverage will commence from the moment of birth in accordance with the subscriber contract.
(2) If the HMO does have a pre-enrollment requirement, the subscriber must be allowed to pre-enroll the newborn up to the moment of birth. The HMO must notify the subscriber of any pre-enrollment requirement, both in the subscriber contract and handbook. Additionally, the HMO should emphasize the pre-enrollment requirements after the subscriber or covered family member is known by the HMO to be pregnant.
(3) Failure to comply with pre-enrollment procedures shall require the newborn to be enrolled during the subscriber’s next open enrollment period.
(4) Coverage for adopted children shall be provided pursuant to the requirements enumerated in Florida Statutes § 641.31(17)
Rulemaking Authority 641.36 FS. Law Implemented 641.31(9), (17) FS. History-New 2-22-88, Amended 10-25-89, Formerly 4-31.045, Amended 5-28-92, Formerly 4-191.045.
Terms Used In Florida Regulations 69O-191.045
- Contract: A legal written agreement that becomes binding when signed.
(3) Failure to comply with pre-enrollment procedures shall require the newborn to be enrolled during the subscriber’s next open enrollment period.
(4) Coverage for adopted children shall be provided pursuant to the requirements enumerated in Florida Statutes § 641.31(17)
Rulemaking Authority 641.36 FS. Law Implemented 641.31(9), (17) FS. History-New 2-22-88, Amended 10-25-89, Formerly 4-31.045, Amended 5-28-92, Formerly 4-191.045.