Oklahoma § 36-6058 - Newly-born children - Health insurance benefits

§ 36-6058. Newly-born children - Health insurance benefits

A. All individual and group health insurance policies providing

coverage on an expense incurred, fixed, or capitated basis, and all

individual and group insurance policies, certificates, service or

indemnity type contracts issued by insurance companies, health

maintenance organizations, nonprofit corporations, or charitable and

benevolent corporations established for the purpose of operating a

nonprofit hospital service, indemnity, fixed or capitated plan, or a

nonprofit medical or indemnity plan, and all self-insurers which

provide coverage for a family member of the insured or subscriber

shall, as to such family member's coverage, also provide that the

health insurance benefits applicable for children shall be payable

with respect to a newly born child of the insured or subscriber from

the moment of birth.

B. The coverage for newly born children shall consist of

coverage of injury or sickness including the necessary care and

treatment of medically diagnosed congenital defects and birth

abnormalities. Such coverage shall also include transportation

necessary for the provision of medical care for such newly born

children when (1) the newly born is transported to the nearest

hospital capable of providing the medically necessary treatment on a

timely basis, and (2) the mode of transportation is the most

economical consistent with the well-being of the newly born.

Transportation coverage shall not exceed the reasonable costs of

providing such service and an itemized statement of costs shall

accompany each claim.

The provisions of this subsection shall not apply to policies

involving Medicare and supplements to Medicare.

C. If payment of a specific premium or subscription fee is

required to provide coverage for a child, the policy or contract may

require that notification of birth and payment of the required

premium or fees must be furnished to the insurer or nonprofit

service or indemnity corporation within thirty-one (31) days after

Oklahoma Statutes - Title 36. Insurance

the date of birth in order to have the coverage continue beyond such

thirty-one-day period.

Added by Laws 1975, c. 87, § 1, operative Sept. 1, 1975. Amended by

Laws 1984, c. 129, § 1, eff. July 1, 1985; Laws 2006, c. 264, § 63,

eff. July 1, 2006.