17.1.3 Other Provisions
Insuring Clause
Defines and describes the scope of the coverage provided and limits of indemnification.
Consideration Clause
States the amount and frequency of premium payments and may include the effective date of the contract, the initial term of the policy and the insured's right to renew.
Conversion Privilege for Dependents
Dependents (including eligible children, adopted children, stepchildren, and foster children) listed on a single health policy must meet certain age requirements. Generally, children of the insured are eligible for coverage under a family policy until they attain a specified age. Effective October 1, 2010, the Affordable Health Care Act mandated that all policies and plans must provide dependent coverage up to age 26. Florida currently requires insurers to provide the offer of dependent coverage up to age 30. As long as a policy is in force, coverage for a child generally continues until the child marries or reaches the limiting age. In Florida, both individual and group policies must continue to provide coverage for a handicapped child when the child becomes an adult. Newborns may be covered from birth, or after a minimum age depending upon the policy. Some policies may require advance notice of a pending birth along with an additional premium.
If a covered individual no longer qualifies as a "family member," that person has a right to take out a conversion policy without evidence of insurability, including divorced spouses and covered children.
Free Look Provision
Florida law mandates a 10-day free look period for health insurance policies and a 30-day free look period for Medicare supplement and long term care policies.
