Newborns’ and Mothers’ Health Protection Act. The plan will reflect the hours requirement for newborns and mothers.
Newborns’ and Mothers’ Health Protection Act. Notwithstanding anything in the Plan to the contrary, the Plan will comply with the Newborns’ and Mothers’ Health Protection Act.
Newborns’ and Mothers’ Health Protection Act. “NMHPA”). Notwithstanding any provision of this Plan to the contrary, this Plan shall be operated and maintained in a manner consistent with NMHPA. Federal law requires the following statement be included in the Plan document, verbatim: Under federal law, group health plans and health insurance issuers offering group health insurance generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, the plan or issuer may pay for a shorter stay if the attending physician (e.g., your physician, nurse, or midwife, or a physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. In addition, a plan or issuer may not, under federal law, require that a physician or other health care provider obtain authorization for prescribing a length of stay of up 48 hours (or 96 hours). However, to use certain providers or facilities, or to reduce out-of-pocket costs, a Participant may be required to obtain precertification. For information on pre-certification, contact the Plan Administrator.
Newborns’ and Mothers’ Health Protection Act. The Newborns' and Mothers' Health Protection Act of 1996 (NMHPA) affects the amount of time you and your newborn child are covered for a hospital stay following childbirth. In general, health insurance issuers and Health Maintenance Organizations (HMOs) may not restrict benefits for a hospital stay in connection with childbirth to less than 48 hours following delivery (96 hours following a delivery by cesarean section). If you deliver in the hospital, the 48-hour (or 96-hour) period starts at the time of delivery. If you deliver outside the hospital and you are later admitted to the hospital in connection with childbirth, the period begins at the time of the admission. Also, a health insurance issuer or HMO cannot require you or your attending provider to obtain prior authorization for your delivery or show that the 48-hour (or 96-hour) stay is medically necessary. However, a health insurance issuer or HMO may require you to get prior authorization for any portion of a stay after the 48 hours (or 96 hours). CIVIL RIGHTS Coventry Health and Life Insurance Company does not discriminate in the employment of staff or in the provision of health care services on the basis of race, disability, religion, gender, color, age or national origin. If you feel you have been treated unfairly or discriminated against for any reason, call the Coventry Health and Life Insurance Company Civil Rights Coordinator at 000-000-0000 or 0-000-000-0000 extension 3538. TABLE OF CONTENTS SECTION 1 USING YOUR BENEFITS 7 SECTION 2 ENROLLMENT, ELIGIBILITY AND EFFECTIVE DATES 14 SECTION 3 TERMINATION OF COVERAGE 16 SECTION 4 CLAIMS FOR REIMBURSEMENT OF SERVICES RENDERED BY NON-PARTICIPATING PROVIDERS 18 SECTION 5 COVERED SERVICES 18 SECTION 6 EXCLUSIONS AND LIMITATIONS 19 SECTION 7 COMPLAINTS AND APPEALS 19 SECTION 8 CONFIDENTIALITY OF YOUR HEALTH INFORMATION 23 SECTION 9 COORDINATION OF BENEFITS 28 SECTION 10 GENERAL PROVISIONS 32 SECTION 11 DEFINITIONS 33 SECTION 1 USING YOUR BENEFITS CoventryOne® is a Preferred Provider Organization (PPO) Product. Under this Product, We offer In- Network health care services to You through a network of Participating Providers, who have signed a Contract with Us, where they agree to provide health care services to Members. Our Participating Provider Network (hereafter referred to as the “Network”) may change from time to time. Please visit Our website at xxx.xxxxxxxxx.xxx, or You may call Our Customer Service Department at 000-000-0000, in order to find...
Newborns’ and Mothers’ Health Protection Act. Notwithstanding anything in the Plan to the contrary, the Plan will comply with the Newborns' and Mothers' Health Protection Act. CERTIFICATE OF ADOPTING RESOLUTION The undersigned City Manager of the City of Xxxxx Heights (the Employer) hereby certifies that the following resolutions were duly adopted by the city council on , and that such resolutions have not been modified or rescinded as of the date hereof: RESOLVED, that the Health Reimbursement Arrangement effective , presented to this meeting is hereby approved and adopted and that the proper council members of the Employer are hereby authorized and directed to execute and deliver to the Administrator of the Plan one or more counterparts of the Plan. RESOLVED, that the Administrator shall be instructed to take such actions that are deemed necessary and proper in order to implement the Plan, and to set up adequate accounting and administrative procedures to provide benefits under the Plan. The undersigned further certifies that attached hereto is a true copy of the Health Reimbursement Arrangement and the Summary Plan Description approved and adopted in the foregoing resolutions. City Manager
