31A-22-610.1 - Adoption indemnity benefit.
31A-22-610.1. Adoption indemnity benefit.
(1) (a) (i) If an insured has coverage for maternity benefits on the date of an adoptiveplacement, the insured's policy shall provide an adoption indemnity benefit payable to theinsured, if a child is placed for adoption with the insured within 90 days of the child's birth. Ifmore than one child from the same birth is placed for adoption with the insured, only oneadoption indemnity benefit is required.
(ii) This section does not prevent an accident and health insurer from:
(A) adjusting the benefit payable under this section for cost sharing measures imposedunder the policy or contract for maternity benefit coverage; or
(B) providing additional adoption indemnity benefits including:
(I) extending the period of time after birth in which a child must be placed with aninsured; or
(II) providing a benefit in excess of the amount specified in Subsection (1)(c).
(b) An insurer that has paid the adoption indemnity benefit under Subsection (1)(a) mayseek 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 anadoptive parent or parents that affects the child's health or safety.
(c) The amount of the adoption indemnity benefit provided under Subsection (1) is$4,000 subject to the adjustments permitted by Subsection (1)(a)(ii).
(d) Each insurer shall pay its pro rata share of the adoption indemnity benefit if eachadoptive parent:
(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 adoptionindemnity 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 andreceives services from a health care provider under contract with his insurer, the contractinghealth care provider may only collect from the insured the amount that the contracting health careprovider is entitled to receive for such services under the contract, including any applicablecopayment.
(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.
Amended by Chapter 94, 2006 General Session