(1)
Coverage shall provide that health insurance benefits are
applicable to children of the person in whose name the policy is
issued including adopted and newly born natural children.
Coverage shall also include necessary care and treatment of
medically diagnosed congenital defects and birth abnormalities.
If payment of a specific premium is required to provide coverage
for the child, the policy may require that notification of the
birth or adoption of a child and payment of the required premium
must be furnished to the pool within thirty-one days after the
date of birth or adoption in order to have the coverage continued
beyond the thirty-one day period. For purposes of this
subsection, a child is deemed to be adopted, and benefits are
payable, when the child is physically placed for purposes of
adoption under the laws of this state with the person in whose
name the policy is issued; and, when the person in whose name the
policy is issued assumes financial responsibility for the medical
expenses of the child. For purposes of this subsection, "newly
born" means, and benefits are payable, from the moment of birth.
(2) A pool policy shall provide that coverage of a dependent, person shall terminate when the person becomes twenty-six years
of age: PROVIDED, That coverage of such person shall not
terminate at age twenty-six while he or she is and continues to
be both (a) incapable of self-sustaining employment by reason of
developmental disability or physical handicap and (b) chiefly
dependent upon the person in whose name the policy is issued for
support and maintenance, provided proof of such incapacity and
dependency is furnished to the pool by the policyholder within
thirty-one days of the dependent's attainment of age twenty-six
and subsequently as may be required by the pool but not more
frequently than annually after the two-year period following the
dependent's attainment of age twenty-six.
[2011 c 314 § 16; 2000 c 79 § 16; 1987 c 431 § 14.]
NOTES:
Effective date -- Severability -- 2000 c 79: See notes following RCW 48.04.010.