38.2-3407.2 - Coverage for medical child support.
§ 38.2-3407.2. Coverage for medical child support.
A. No insurer, health services plan, or health maintenance organization shallrefuse to enroll a child under a parent's coverage because (i) the child wasborn out of wedlock; (ii) the child is not claimed as a dependent on theparent's federal income tax return; or (iii) the child does not reside withthe parent or in the insurer's, health services plan's, or health maintenanceorganization's service area.
B. Upon receipt of proof that a parent eligible for family coverage under anaccident and sickness policy, health services plan, or health maintenanceorganization contract has been required by a court or administrative order toprovide health coverage for a child, the insurer, health services plan, orhealth maintenance organization shall:
1. Permit such parent to enroll under such family coverage any such child whois otherwise eligible for such coverage, without regard to any enrollmentseason restrictions;
2. If such parent is enrolled but fails to make application to obtaincoverage for such child, enroll such child upon application by the child'sother parent or by the Department of Social Services; and
3. Not disenroll or otherwise eliminate coverage of such child unless theinsurer, health services plan, or health maintenance organization is providedsatisfactory written evidence that:
a. Such court or administrative order is no longer in effect;
b. Such child is or will be enrolled in comparable health coverage throughanother insurer, health services plan, or health maintenance organizationwhich will take effect not later than the effective date of termination ofthe child's coverage under the policy or contract issued by the insurer,health services plan, or health maintenance organization; or
c. Family health coverage has been eliminated under the insurance policy,health services plan, or health maintenance organization contract.
C. Any insurer, health services plan, or health maintenance organizationproviding coverage to the child of a noncustodial parent shall (i) provide tothe custodial parent, upon request, any information that is necessary toobtain benefits for such child under such coverage; (ii) permit the custodialparent, or the provider of health services if approved by the custodialparent, to submit claims for services without the approval of thenoncustodial parent; and (iii) make payment on claims submitted pursuant toclause (ii) directly to such custodial parent, provider, or the Department ofMedical Assistance Services.
(1994, c. 213.)