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H.B. 85 Enrolled
This bill amends the health insurance adoption indemnity law.
. amends the adoption indemnity benefit to:
. remove the requirement for the commissioner to review the adoption indemnity
benefit every two years;
. increase the adoption indemnity benefit to $4,000; and
. clarify that a single adoption benefit is payable to an insured adopting multiple
children from one birth.
Monies Appropriated in this Bill:
Other Special Clauses:
Utah Code Sections Affected:
31A-22-610.1, as last amended by Chapter 198, Laws of Utah 2000
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 31A-22-610.1 is amended to read:
31A-22-610.1. Adoption indemnity benefit.
(1) (a) (i) If an insured has coverage for maternity benefits on the date of an adoptive
placement, the insured's policy shall provide an adoption indemnity benefit payable to the
insured, if a child is placed for adoption with the insured within 90 days of the child's birth. If
more than one child from the same birth is placed for adoption with the insured, only one
adoption indemnity benefit is required.
(ii) This section does not prevent an accident and health insurer from adjusting the benefit
payable under this section for cost sharing measures imposed under the policy or contract for
maternity benefit coverage.
(b) An insurer that has paid the adoption indemnity benefit under Subsection (1)(a) may
seek reimbursement of the benefit if:
(i) the postplacement evaluation disapproves the adoption placement; and
(ii) a court rules the adoption may not be finalized because of an act or omission of an
adoptive parent or parents that affects the child's health or safety.
(c) The [
benefit provided under Subsection (1) [
adjustments permitted by Subsection (1)(a)(ii).
(d) Each insurer shall pay its pro rata share of the adoption indemnity benefit if each
(i) has coverage for maternity benefits with a different insurer; and
(ii) makes a claim for the adoption indemnity benefit provided in Subsection (1)(a).
(2) If a policy offers optional maternity benefits, it shall also offer coverage for adoption
indemnity benefits if:
(a) a child is placed for adoption with the insured within 90 days of the child's birth; and
(b) the adoption is finalized within one year of the child's birth.
(3) If an insured qualifies for the adoption indemnity benefit under this section and
receives services from a health care provider under contract with his insurer, the contracting
health care provider may only collect from the insured the amount that the contracting health care
provider is entitled to receive for such services under the contract, including any applicable
(4) For purposes of this section, "contracting health care provider" means:
(a) a "participating provider" as defined in Section 31A-8-101 ; or
(b) a "preferred health care provider" as described in Section 31A-22-617 .
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