2023 -- H 5338
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LC000806
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S TATE OF RHODE IS LAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2023
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A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
Introduced By: Representatives Baginski, Shanley, Dawson, and J. Brien
Date Introduced: February 03, 2023
Referred To: House Corporations
It is enacted by the General Assembly as follows:
SECTION 1. Section 27-18-59 of the General Laws in Chapter 27-18 entitled "Accident 1
and Sickness Insurance Policies" is hereby amended to read as follows: 2
27-18-59. Eligibility for children’s benefits. 3
(a)(1) Every health benefit plan delivered, issued for delivery, or renewed in this state and 4
every group health insurance contract, plan, or policy delivered, issued for delivery or renewed in 5
this state which provides health benefits coverage for dependents, except for supplemental policies 6
which only provide coverage for specified diseases and other supplemental policies, shall make 7
coverage available for children until attainment of twenty-six (26) thirty (30) years of age, and an 8
unmarried child of any age who is financially dependent upon the parent and medically determined 9
to have a physical or mental impairment which can be expected to result in death or which has 10
lasted or can be expected to last for a continuous period of not less than twelve (12) months. 11
(2) With respect to a child who has not attained twenty-six (26) thirty (30) years of age, a 12
health insurance carrier shall not define “dependent” for purposes of eligibility for dependent 13
coverage of children other than the terms of a relationship between a child and the plan participant, 14
or subscriber. 15
(3) A health insurance carrier shall not deny or restrict coverage for a child who has not 16
attained twenty-six (26) thirty (30) years of age based on the presence or absence of the child’s 17
financial dependency upon the participant, primary subscriber or any other person, residency with 18
the participant and in the individual market the primary subscriber, or with any other person, marital 19
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status, student status, employment or any combination of those factors. A health carrier shall not 1
deny or restrict coverage of a child based on eligibility for other coverage, except as provided in 2
subparagraph (b)(1) of this section. 3
(4) Nothing in this section shall be construed to require a health insurance carrier to make 4
coverage available for the child of a child receiving dependent coverage, unless the grandparent 5
becomes the legal guardian or adoptive parent of that grandchild. 6
(5) The terms of coverage in a health benefit plan offered by a health insurance carrier 7
providing dependent coverage of children cannot vary based on age except for children who are 8
twenty-six (26) thirty (30) years of age or older. 9
(b)(1) For plan years beginning before January 1, 2014, a health insurance carrier providing 10
group health insurance coverage that is a grandfathered health plan and makes available dependent 11
coverage of children may exclude an adult child who has not attained twenty-six (26) thirty (30) 12
years of age from coverage only if the adult child is eligible to enroll in an eligible employer-13
sponsored health benefit plan, as defined in section 5000A(f)(2) of the federal Internal Revenue 14
Code, other than the group health plan of a parent. 15
(2) For plan years, beginning on or after January 1, 2014, a health insurance carrier 16
providing group health insurance coverage that is a grandfathered health plan shall comply with 17
the requirements of subsections (a) through (e) of this section. 18
(c) This section does not apply to insurance coverage providing benefits for: (1) hospital 19
confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare 20
supplement; (6) limited benefit health; (7) specified diseased indemnity; or (8) sickness or bodily 21
injury or death by accident or both; or (9) other limited benefit policies. 22
SECTION 2. Section 27-19-50 of the General Laws in Chapter 27-19 entitled "Nonprofit 23
Hospital Service Corporations" is hereby amended to read as follows: 24
27-19-50. Eligibility for children’s benefits. 25
(a)(1) Every health benefit plan delivered, issued for delivery, or renewed in this state 26
which provides health benefits coverage for dependents, except for supplemental policies which 27
only provide coverage for specified diseases and other supplemental policies, shall make coverage 28
available for children until attainment of twenty-six (26) thirty (30) years of age, and an unmarried 29
child of any age who is financially dependent upon the parent and medically determined to have a 30
physical or mental impairment which can be expected to result in death or which has lasted or can 31
be expected to last for a continuous period of not less than twelve (12) months. 32
(2) With respect to a child who has not attained twenty-six (26) thirty (30) years of age, a 33
health insurance carrier shall not define “dependent” for purposes of eligibility for dependent 34
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coverage of children other than the terms of a relationship between a child and the plan participant 1
or subscriber. 2
(3) A health insurance carrier shall not deny or restrict coverage for a child who has not 3
attained twenty-six (26) thirty (30) years of age based on the presence or absence of the child’s 4
financial dependency upon the participant, primary subscriber or any other person, residency with 5
the participant and in the individual market the primary subscriber, or with any other person, marital 6
status, student status, employment or any combination of those factors. A health carrier shall not 7
deny or restrict coverage of a child based on eligibility for other coverage, except as provided in 8
(b)(1) of this section. 9
(4) Nothing in this section shall be construed to require a health insurance carrier to make 10
coverage available for the child of a child receiving dependent coverage, unless the grandparent 11
becomes the legal guardian or adoptive parent of that grandchild. 12
(5) The terms of coverage in a health benefit plan offered by a health insurance carrier 13
providing dependent coverage of children cannot vary based on age except for children who are 14
twenty-six (26) thirty (30) years of age or older. 15
(b)(1) For plan years beginning before January 1, 2014, a group health plan providing 16
group health insurance coverage that is a grandfathered health plan and makes available dependent 17
coverage of children may exclude an adult child who has not attained twenty-six (26) thirty (30) 18
years of age from coverage only if the adult child is eligible to enroll in an eligible employer-19
sponsored health benefit plan, as defined in section 5000A(f)(2) of the federal Internal Revenue 20
Code, other than the group health plan of a parent. 21
(2) For plan years, beginning on or after January 1, 2014, a group health plan providing 22
group health insurance coverage that is a grandfathered health plan shall comply with the 23
requirements of this section. 24
(c) This section does not apply to insurance coverage providing benefits for: (1) Hospital 25
confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare 26
supplement; (6) Limited benefit health; (7) Specified diseased indemnity; or (8) Other limited 27
benefit policies. 28
SECTION 3. Section 27-20-45 of the General Laws in Chapter 27-20 entitled "Nonprofit 29
Medical Service Corporations" is hereby amended to read as follows: 30
27-20-45. Eligibility for children’s benefits. 31
(a)(1) Every health benefit plan delivered, issued for delivery, or renewed in this state 32
which provides health benefits coverage for dependents, except for supplemental policies which 33
only provide coverage for specified diseases and other supplemental policies, shall make coverage 34
LC000806 - Page 4 of 7
available for children until attainment of twenty-six (26) thirty (30) years of age, and an unmarried 1
child of any age who is financially dependent upon the parent and medically determined to have a 2
physical or mental impairment which can be expected to result in death or which has lasted or can 3
be expected to last for a continuous period of not less than twelve (12) months. 4
(2) With respect to a child who has not attained twenty-six (26) thirty (30) years of age, a 5
nonprofit medical service corporation shall not define “dependent” for purposes of eligibility for 6
dependent coverage of children other than the terms of a relationship between a child and the plan 7
participant or subscriber. 8
(3) A nonprofit medical service corporation shall not deny or restrict coverage for a child 9
who has not attained twenty-six (26) thirty (30) years of age based on the presence or absence of 10
the child’s financial dependency upon the participant, primary subscriber or any other person, 11
residency with the participant and in the individual market the primary subscriber, or with any other 12
person, marital status, student status, employment or any combination of those factors. A nonprofit 13
medical service corporation shall not deny or restrict coverage of a child based on eligibility for 14
other coverage, except as provided in (b)(1) of this section. 15
(4) Nothing in this section shall be construed to require a health insurance carrier to make 16
coverage available for the child of a child receiving dependent coverage, unless the grandparent 17
becomes the legal guardian or adoptive parent of that grandchild. 18
(5) The terms of coverage in a health benefit plan offered by a nonprofit medical service 19
corporation or providing dependent coverage of children cannot vary based on age except for 20
children who are twenty-six (26) thirty (30) years of age or older. 21
(b)(1) For plan years beginning before January 1, 2014, a group health plan providing 22
group health insurance coverage that is a grandfathered health plan and makes available dependent 23
coverage of children may exclude an adult child who has not attained twenty-six (26) thirty (30) 24
years of age from coverage only if the adult child is eligible to enroll in an eligible employer-25
sponsored health benefit plan, as defined in section 5000A(f)(2) of the federal Internal Revenue 26
Code, other than the group health plan of a parent. 27
(2) For plan years, beginning on or after January 1, 2014, a health insurance carrier 28
providing group health insurance coverage that is a grandfathered health plan shall comply with 29
the requirements of this section. 30
(c) This section does not apply to insurance coverage providing benefits for: (1) hospital 31
confinement indemnity; (2) disability income; (3) accident only; (4) long-term care; (5) Medicare 32
supplement; (6) limited benefit health; (7) specified diseased indemnity; or (8) other limited benefit 33
policies. 34
LC000806 - Page 5 of 7
SECTION 4. Section 27-41-61 of the General Laws in Chapter 27-41 entitled "Health 1
Maintenance Organizations" is hereby amended to read as follows: 2
27-41-61. Eligibility for children’s benefits. 3
(a)(1) Every health benefit plan delivered, issued for delivery, or renewed in this state 4
which provides health benefits coverage for dependents, except for supplemental policies which 5
only provide coverage for specified diseases and other supplemental policies, shall make coverage 6
available for children until attainment of twenty-six (26) thirty (30) years of age, and an unmarried 7
child of any age who is financially dependent upon the parent and medically determined to have a 8
physical or mental impairment which can be expected to result in death or which has lasted or can 9
be expected to last for a continuous period of not less than twelve (12) months. 10
(2) With respect to a child who has not attained twenty-six (26) thirty (30) years of age, a 11
health maintenance organization shall not define “dependent” for purposes of eligibility for 12
dependent coverage of children other than the terms of a relationship between a child and the plan 13
participant, or subscriber. 14
(3) A health maintenance organization shall not deny or restrict coverage for a child who 15
has not attained twenty-six (26) thirty (30) years of age based on the presence or absence of the 16
child’s financial dependency upon the participant, primary subscriber or any other person, 17
residency with the participant and in the individual market the primary subscriber, or with any other 18
person, marital status, student status, employment or any combination of those factors. A health 19
carrier shall not deny or restrict coverage of a child based on eligibility for other coverage, except 20
as provided in (b)(1) of this section. 21
(4) Nothing in this section shall be construed to require a health maintenance organization 22
to make coverage available for the child of a child receiving dependent coverage, unless the 23
grandparent becomes the legal guardian or adoptive parent of that grandchild. 24
(5) The terms of coverage in a health benefit plan offered by a health maintenance 25
organization providing dependent coverage of children cannot vary based on age except for 26
children who are twenty-six (26) thirty (30) years of age or older. 27
(b)(1) For plan years beginning before January 1, 2014, a group health plan providing 28
group health insurance coverage that is a grandfathered health plan and makes available dependent 29
coverage of children may exclude an adult child who has not attained twenty-six (26) thirty (30) 30
years of age from coverage only if the adult child is eligible to enroll in an eligible employer-31
sponsored health benefit plan, as defined in section 5000A(f)(2) of the federal Internal Revenue 32
Code, other than the group health plan of a parent. 33
(2) For plan years, beginning on or after January 1, 2014, a group health plan providing 34
LC000806 - Page 6 of 7
group health insurance coverage that is a grandfathered health plan shall comply with the 1
requirements of this section 2
(c) This section does not apply to insurance coverage providing benefits for: (1) hospital 3
confinement indemnity; (2) disability income; (3) accident only; (4) long-term care; (5) Medicare 4
supplement; (6) limited benefit health; (7) specified diseased indemnity; or (8) other limited benefit 5
policies. 6
SECTION 5. This act shall take effect on on January 1, 2024. 7
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LC000806
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
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This act would allow children to stay covered under the parent's health insurance plan until 1
the child reaches thirty (30) years of age. 2
This act would take effect on January 1, 2024. 3
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LC000806
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