Title 33, Chapter 29, Section 3.4
(a) As used in this Code section, the term:
(1) "Child wellness services" means the periodic review of a
child's physical and emotional status conducted by a physician or
conducted pursuant to a physician's supervision, but shall not
include periodic dental examinations or other dental services.
The review shall include a medical history, complete physical
examination, developmental assessment, appropriate immunizations,
anticipatory guidance for the parent or parents, and laboratory
testing in keeping with prevailing medical standards.
(2) "Policy" means any health care plan, subscriber contract, or
accident and sickness plan, contract, or policy by whatever name
called other than a disability income policy, a long-term care
insurance policy, a medicare supplement policy, a health insurance
policy written as a part of workers' compensation equivalent
coverage, a specified disease policy, a credit insurance policy, a
hospital indemnity policy, a limited accident policy, or other
type of limited accident and sickness policy.
(b) Every insurer authorized to issue an individual accident and
sickness policy in this state shall include, either as a part of or
as a required endorsement to each basic medical or hospital expense,
major medical, or comprehensive medical expense policy issued,
delivered, issued for delivery, or renewed in this state on or after
July 1, 1995, basic coverage for child wellness services for an
insured child from birth through the age of five years. Any such
policy may provide that the child wellness services which are
rendered during a periodic review shall only be covered to the
extent that such services are provided by or under the supervision
of a single physician during the course of one visit. The
Commissioner shall define by regulation the basic coverage for child
wellness services and may consider the current recommendations for
preventive pediatric health care by the American Academy for
Pediatrics and any other relevant data or information in the
promulgation of such regulation.
(c) The coverage required under subsection (b) of this Code section
may be subject to exclusions, reductions, or other limitations as to
coverages or coinsurance provisions as may be approved by the
Commissioner, but shall not be subject to deductibles.
(d) Nothing in this Code section shall be construed to prohibit the
issuance of individual accident and sickness policies which provide
benefits greater than those required by subsection (b) of this Code
section or more favorable to the insured than those required by
subsection (b) of this Code section.
(e) The provisions of this Code section shall apply to individual
basic medical or hospital expense, major medical, or comprehensive
medical expense insurance policies issued by a fraternal benefit
society, a nonprofit hospital service corporation, a nonprofit
medical service corporation, a health care corporation, a health
maintenance organization, or any similar entity.
(f) Nothing contained in this Code section shall be deemed to
prohibit the payment of different levels of benefits or having
differences in coinsurance percentages applicable to benefit levels
for services provided by preferred and nonpreferred providers as
otherwise authorized under the provisions of Article 2 of Chapter 30
of this title, relating to preferred provider arrangements.
(g) Beginning July 1, 2000, the Commissioner shall conduct a review
of the cost associated with the coverage required by this Code
section and shall provide the members of the General Assembly with
such information not later than December 31, 2000.