| Chapter 220 |
| 2023 -- H 5539 Enacted 06/21/2023 |
| A N A C T |
| RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES |
Introduced By: Representatives Casimiro, Noret, Spears, Roberts, Cotter, Diaz, Chippendale, and Morales |
| Date Introduced: February 15, 2023 |
| It is enacted by the General Assembly as follows: |
| SECTION 1. Section 27-18-59 of the General Laws in Chapter 27-18 entitled "Accident |
| and Sickness Insurance Policies" is hereby amended to read as follows: |
| 27-18-59. Eligibility for children’s benefits. |
| (a)(1) Every health benefit plan delivered, issued for delivery, or renewed in this state and |
| every group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in |
| this state which that provides health benefits coverage for dependents, except for supplemental |
| policies which that only provide coverage for specified diseases and other supplemental policies, |
| shall make coverage available for children, including children under guardianship, until attainment |
| of twenty-six (26) years of age, and an unmarried child of any age who is financially dependent |
| upon the parent and medically determined to have a physical or mental impairment which that can |
| be expected to result in death or which that has lasted or can be expected to last for a continuous |
| period of not less than twelve (12) months. |
| (2) With respect to a child who has not attained twenty-six (26) years of age, a health |
| insurance carrier shall not define “dependent” for purposes of eligibility for dependent coverage of |
| children other than the terms of a relationship between a child and the plan participant, or |
| subscriber; provided, however, that a child in the care of a court appointed guardian who is a plan |
| participant or subscriber, shall have rights of eligibility identical to a natural born child of the plan |
| participant or subscriber. |
| (3) A health insurance carrier shall not deny or restrict coverage for a child who has not |
| attained twenty-six (26) years of age based on the presence or absence of the child’s financial |
| dependency upon the participant, primary subscriber or any other person, residency with the |
| participant and in the individual market the primary subscriber, or with any other person, marital |
| status, student status, employment, or any combination of those factors. A health carrier shall not |
| deny or restrict coverage of a child based on eligibility for other coverage, except as provided in |
| subparagraph (b)(1) of this section. |
| (4) Nothing in this section shall be construed to require a health insurance carrier to make |
| coverage available for the child of a child receiving dependent coverage, unless the grandparent |
| becomes the legal guardian or adoptive parent of that grandchild. |
| (5) The terms of coverage in a health benefit plan offered by a health insurance carrier |
| providing dependent coverage of children cannot vary based on age except for children who are |
| twenty-six (26) years of age or older. |
| (b)(1) For plan years beginning before January 1, 2014, a health insurance carrier providing |
| group health insurance coverage that is a grandfathered health plan and makes available dependent |
| coverage of children may exclude an adult child who has not attained twenty-six (26) years of age |
| from coverage only if the adult child is eligible to enroll in an eligible employer-sponsored health |
| benefit plan, as defined in section 5000A(f)(2) of the federal Internal Revenue Code, other than the |
| group health plan of a parent. |
| (2) For plan years, beginning on or after January 1, 2014, a health insurance carrier |
| providing group health insurance coverage that is a grandfathered health plan shall comply with |
| the requirements of subsections (a) through (e) of this section. |
| (c) This section does not apply to insurance coverage providing benefits for: (1) hospital |
| Hospital confinement indemnity; (2) disability Disability income; (3) accident Accident only; (4) |
| long Long-term care; (5) Medicare supplement; (6) limited Limited benefit health; (7) specified |
| Specified diseased disease indemnity; or (8) sickness Sickness or bodily injury or death by |
| accident or both; or (9) other Other limited benefit policies. |
| SECTION 2. This act shall take effect on January 1, 2024. |
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| LC001319 |
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