State RegulationsCO specificDifficulty 2/5
A Denver couple adds their newborn daughter to their group health policy. Under C.R.S. § 10-16-104(1), when does coverage for the newborn begin?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
C.R.S. § 10-16-104(1) requires a Colorado sickness and accident policy that covers dependents to cover a newborn from the moment of birth, including injury or sickness (including congenital defects and birth abnormalities) during the first 31 days of life. The insurer may require notice of birth and premium payment within 31 days to continue the newborn's coverage, but coverage itself attaches at birth, not at any later administrative date.
Why the other options are wrong
- A) Coverage does not wait for a month boundary; the statute attaches coverage from the moment of birth.
- B) Premium mechanics cannot delay the statutory start of newborn coverage; premium relates only to continuing coverage beyond the first 31 days of life.
- C) There is no 31-day underwriting review; the 31-day period in C.R.S. § 10-16-104(1) concerns notice of birth and premium to continue the newborn's coverage.
Memory hook
Birth = benefits: a Colorado newborn is covered from the moment of birth, with 31 days for notice and premium.