354.536. Continuation of dependent child coverage, when--dependent child defined. - Missouri Statutes

Continuation of dependent child coverage, when--dependent childdefined.

354.536. 1. If a health maintenance organization plan provides thatcoverage of a dependent child terminates upon attainment of the limitingage for dependent children, such coverage shall continue while the child isand continues to be both incapable of self-sustaining employment by reasonof mental or physical handicap and chiefly dependent upon the enrollee forsupport and maintenance. Proof of such incapacity and dependency must befurnished to the health maintenance organization by the enrollee at leastthirty-one days after the child's attainment of the limiting age. Thehealth maintenance organization may require at reasonable intervals duringthe two years following the child's attainment of the limiting agesubsequent proof of the child's disability and dependency. After suchtwo-year period, the health maintenance organization may require subsequentproof not more than once each year.

2. If a health maintenance organization plan provides that coverageof a dependent child terminates upon attainment of the limiting age fordependent children, such plan, so long as it remains in force, until thedependent child attains the limiting age, shall remain in force at theoption of the enrollee. The enrollee's election for continued coverageunder this section shall be furnished to the health maintenanceorganization within thirty-one days after the child's attainment of thelimiting age. As used in this subsection, a dependent child is a personwho is:

(1) Unmarried and no more than twenty-five years of age; and

(2) A resident of this state; and

(3) Not provided coverage as a named subscriber, insured, enrollee,or covered person under any group or individual health benefit plan, orentitled to benefits under Title XVIII of the Social Security Act, P.L.89-97, 42 U.S.C. Section 1395, et seq.

(L. 2007 H.B. 818)

Effective 1-01-08