BULLETIN 1997-5

TO: All Companies Authorized to Transact Accident and Health Insurance Business in the State of Kansas

FROM: Kathleen Sebelius, Commissioner of Insurance

SUBJECT: 1997 House Bill No. 2137

DATE: May 9, 1997

The purpose of this bulletin is to advise all companies authorized to transact Accident and Health Insurance in Kansas of the requirements of the captioned legislation. This bill was enacted by the 1997 Kansas Legislature and will become effective July 1, 1997.

1997 Kansas House Bill No. 2137

Pursuant to the requirements of K.S.A. 40-2,102, this statute applies to all insurance policies, subscriber contracts or certificates of insurance delivered, renewed, or issued for delivery within this state by or for an individual who resides or is employed in this state. Therefore, the amendments to K.S.A. 40-2,102 set forth in this bill apply to all contracts and certificates issued to residents of this state on or after July 1, 1997. Contracts and certificates which were in existence prior to July 1, 1997 must be brought into compliance no later than the first renewal date or the first policy annual anniversary date on or after July 1, 1997.

The amendments to K.S.A. 40-2,102 apply to all individual and group contracts providing coverage on an expense incurred basis issued by a profit or nonprofit corporation or an health maintenance organization (HMO) organized or authorized to transact business in this state which provides coverage for a family member of the enrollee, insured or subscriber shall as to such family members' coverage, also provide that the health benefits applicable for children shall be payable with respect to the following:

1. A child placed in an insured's home by a child placement agency (as defined by K.S.A. 65-503 and amendments thereto) for the purpose of adoption from the date of placement as certified by the insured. In no case shall the time from the date of placement to the date the petition for adoption was filed (as provided in K.S.A. 59-2129 and amendments thereto) exceed 280 days."

2. The age for required benefits for routine and necessary immunizations has been increased. The required benefits shall apply to immunizations administered to each newly born child from birth to 72 months of age. The dosage amounts have been revised as follows:

The above required benefits shall not be subject to any deductible, copayment, or coinsurance requirements.

3. If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy may require that notification of birth of a newly born child or the filing of the petition for adoption or certification that a child has been placed in the home for adoption as defined by subsection (a)(1)(D) of the bill. The payment of required premium must be furnished to the insurer within 31 days after the date of birth or filing of the petition for adoption or certification that a child has been placed in the home for adoption.

4. House Bill No. 2137 further provides that the optional coverage for delivery expenses include obstetrical expenses at birth of the birth mother of a child adopted within 90 days of birth of such child by the insured.

Compliance Required

The purpose of this bulletin is to make each affected insurance company aware that when the aforementioned bill becomes effective, failure to comply with the requirements could result in monetary fines and/or penalty provisions in accordance with Kansas law. Companies are hereby advised to notify all company representatives in marketing and appropriate amendments must be filed with, and approved by this department prior to issuance. We will make every effort to expedite our action on those filings.

If you have any questions or comments regarding the information contained herein, please direct them to the Accident and Health Division of the Kansas Insurance Department, 420 SW 9th Street, Topeka, KS 66612, (913) 296-7850.