AI-assisted research summary: Employers must help enroll a child in family health coverage, may not drop that coverage except in stated cases, and must withhold and pay the employee’s premium share within a federal limit.
(a)As used in this section and in G.S. 108A-70: (1)“Health benefit plan” means an accident and health insurance policy or certificate; a nonprofit hospital or medical service corporation contract; a health maintenance organization subscriber contract; a plan provided by a multiple employer welfare arrangement; the State Health Plan for Teachers and State Employees under Chapter 135 of the General Statutes; or a plan provided by another benefit arrangement. “Health benefit plan” does not mean a Medicare supplement policy as defined in G.S. 58-54-1(5). (2)“Health insurer” means any health insurance company subject to Articles 1 through 63 of Chapter 58 of the General Statutes, including a multiple employee welfare arrangement, and any corporation subject to Articles 65 and 67 of Chapter 58 of the General Statutes; a group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974; and the State Health Plan for Teachers and State Employees under Chapter 135 of the General Statutes. (b)If a parent is required by a court or administrative order to provide health benefit plan coverage for a child, and the parent is eligible for family health benefit plan coverage through an employer, the employer: (1)Must allow the parent to enroll, under family coverage, the child if the child would be otherwise eligible for coverage without regard to any enrollment season restrictions. (2)Must enroll the child under family coverage upon application of the child’s other parent or upon receipt of notice from the Department of Health and Human Services in connection with its administration of the Medical Assistance or Child Support Enforcement Program if the parent is enrolled but fails to make application to obtain coverage for the child. (3)May not disenroll or eliminate coverage of the child unless: a.The employer is provided satisfactory written evidence that: 1.The court or administrative order is no longer in effect; or 2.The child is or will be enrolled in comparable health benefit plan coverage that will take effect not later than the effective date of disenrollment; or b.The employer has eliminated family health benefit plan coverage for all of its employees. (4)Must withhold from the employee’s compensation the employee’s share, if any, of premiums for health benefit plan coverage, not to exceed the maximum amount permitted to be withheld under section 303(b) of the federal Consumer Credit Protection Act, as amended; and must pay this amount to the health insurer; subject to regulations, if any, adopted by the Secretary of the U.S. Department of Health and Human Services. History: History.1993 (Reg. Sess., 1994), c. 644, s. 3; 1995, c. 193, s. 44; 1997-433, s. 3.2; 1997-443, s. 11A.118(a); 1998-17, s. 1; 1999-293, s. 8; 2007-323, s. 28.22A(o); 2007-345, s. 12.