H.B. 85

This document includes House Committee Amendments incorporated into the bill on Wed, Feb 11, 2004 at 11:54 AM by kholt. --> 1

HEALTH INSURANCE MANDATE AMENDMENTS
2 2004 GENERAL SESSION
3 STATE OF UTAH
4 Sponsor: Rebecca D. Lockhart
5
6 LONG TITLE
7 General Description:
8 This bill amends the health insurance adoption indemnity law.
9 Highlighted Provisions:
10 This bill:
11 . amends the adoption indemnity benefit to:
12 . remove the requirement for the commissioner to review the adoption indemnity
13 benefit every two years;
14 . increase the adoption indemnity benefit to H [ $3,155 ] 4,000 h ; and
15 . clarify that a single adoption benefit is payable to an insured adopting multiple
16 children from one birth.
17 Monies Appropriated in this Bill:
18 None
19 Other Special Clauses:
20 None
21 Utah Code Sections Affected:
22 AMENDS:
23 31A-22-610.1, as last amended by Chapter 198, Laws of Utah 2000
24
25 Be it enacted by the Legislature of the state of Utah:
26 Section 1. Section 31A-22-610.1 is amended to read:
27 31A-22-610.1. Adoption indemnity benefit.

28 (1) (a) (i) If an insured has coverage for maternity benefits on the date of an adoptive
29 placement, the insured's policy shall provide an adoption indemnity benefit payable to the
30 insured, if a child is placed for adoption with the insured within 90 days of the child's birth. If
31 more than one child from the same birth is placed for adoption with the insured, only one
32 adoption indemnity benefit is required.
33 (ii) This section does not prevent an accident and health insurer from adjusting the
34 benefit payable under this section for cost sharing measures imposed under the policy or
35 contract for maternity benefit coverage.
36 (b) An insurer that has paid the adoption indemnity benefit under Subsection (1)(a)
37 may seek reimbursement of the benefit if:
38 (i) the postplacement evaluation disapproves the adoption placement; and
39 (ii) a court rules the adoption may not be finalized because of an act or omission of an
40 adoptive parent or parents that affects the child's health or safety.
41 (c) The [commissioner shall:(i) establish, by rule, the] amount of the adoption
42 indemnity benefit provided under Subsection (1) [at a minimum of $2,500; and] is
42a H [ $3,155 ] 4,000 h
43 subject to the adjustments permitted by Subsection (1)(a)(ii).
44 [(ii) review the amount of the adoption indemnity benefit every two years to make any
45 necessary and reasonable adjustments, taking into account the average insurance cost of an
46 uncomplicated birth.]
47 (d) Each insurer shall pay its pro rata share of the adoption indemnity benefit if each
48 adoptive parent:
49 (i) has coverage for maternity benefits with a different insurer; and
50 (ii) makes a claim for the adoption indemnity benefit provided in Subsection (1)(a).
51 (2) If a policy offers optional maternity benefits, it shall also offer coverage for
52 adoption indemnity benefits if:
53 (a) a child is placed for adoption with the insured within 90 days of the child's birth;
54 and
55 (b) the adoption is finalized within one year of the child's birth.
56 (3) If an insured qualifies for the adoption indemnity benefit under this section and
57 receives services from a health care provider under contract with his insurer, the contracting
58 health care provider may only collect from the insured the amount that the contracting health

59 care provider is entitled to receive for such services under the contract, including any
60 applicable copayment.
61 (4) For purposes of this section, "contracting health care provider" means:
62 (a) a "participating provider" as defined in Section 31A-8-101 ; or
63 (b) a "preferred health care provider" as described in Section 31A-22-617 .




Legislative Review Note
as of 12-12-03 12:09 PM

A limited legal review of this legislation raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel