<?xml version='1.0' encoding='utf-8'?>
<section article="gin" article_name="Insurance" number="15-403" title_number="15" title_name="Health Insurance" subtitle_number="4" subtitle_name="Eligibility for Coverage; Continuation and Conversion of Policies">
  <level label="a">
    <text>This section applies to:</text>
    <level label="1">
      <text>each individual health insurance policy that:</text>
      <level label="i">
        <text>provides coverage on an expense–incurred basis; and</text>
      </level>
      <level label="ii">
        <text>provides coverage for a family member of the insured;</text>
      </level>
    </level>
    <level label="2">
      <text>each group health insurance policy that:</text>
      <level label="i">
        <text>provides coverage on an expense–incurred basis for employees of an employer or employers or members of a union or unions; and</text>
      </level>
      <level label="ii">
        <text>provides coverage for a family member of a covered employee or member;</text>
      </level>
    </level>
    <level label="3">
      <text>each individual service or indemnity contract that:</text>
      <level label="i">
        <text>is issued by a nonprofit health service plan; and</text>
      </level>
      <level label="ii">
        <text>provides coverage for a family member of the subscriber;</text>
      </level>
    </level>
    <level label="4">
      <text>each individual contract that:</text>
      <level label="i">
        <text>is issued by a health maintenance organization; and</text>
      </level>
      <level label="ii">
        <text>provides coverage for a family member of the subscriber; and</text>
      </level>
    </level>
    <level label="5">
      <text>each group contract that:</text>
      <level label="i">
        <text>is issued by a health maintenance organization;</text>
      </level>
      <level label="ii">
        <text>provides coverage for employees of an employer or employers or members of a union or unions; and</text>
      </level>
      <level label="iii">
        <text>provides coverage for a family member of the covered employee or member.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <text>Each policy or contract subject to this section shall provide that the same health insurance benefits and eligibility guidelines that apply to any covered dependent are available, on request of the insured, subscriber, employee, or member, to a grandchild who:</text>
    <level label="1">
      <text>is unmarried;</text>
    </level>
    <level label="2">
      <text>is in the court–ordered custody of the insured, subscriber, employee, or member;</text>
    </level>
    <level label="3">
      <text>resides with the insured, subscriber, employee, or member;</text>
    </level>
    <level label="4">
      <text>is the dependent of the insured, subscriber, employee, or member; and</text>
    </level>
    <level label="5">
      <text>has not attained the limiting age under the terms of the policy or contract.</text>
    </level>
  </level>
  <level label="c">
    <text>On request, an insurer that issues an individual or group health insurance policy that provides coverage on an expense–incurred basis, a nonprofit health service plan, or a health maintenance organization shall offer family members’ coverage to an insured or subscriber regardless of the marital status of the insured or subscriber.</text>
  </level>
  <level label="d">
    <level label="1">
      <text>An insurer, nonprofit health service plan, or health maintenance organization may require proof that the insured or subscriber is the grandparent of the grandchild.</text>
    </level>
    <level label="2">
      <text>If the insurer, nonprofit health service plan, or health maintenance organization requires proof under this subsection, the insurer, nonprofit health service plan, or health maintenance organization shall pay the cost of the proof.</text>
    </level>
  </level>
</section>
