P.R. Laws tit. 26, § 10026
(a) For a newborn child, the health insurance organization or issuer shall be required to provide covered persons or enrollees with reasonable notice of the following:
(1) If payment of a specific premium or subscription fee is required to provide coverage for a newborn child, as provided in this chapter, the health plan may require the covered person or enrollee to notify the health insurance organization or issuer of the birth of the child and furnish payment of the required premium or fees within thirty (30) days after the date of birth.
(2) If notice and the payment described above are not provided, the health insurance organization or issuer may refuse to continue coverage for the child under the health plan beyond the thirty (30)-day period. However, if within four (4) months after the birth of the child the covered person or enrollee makes all past-due payments, coverage shall be restored.
(3) If payment of a specific premium or subscription fee is not required to provide coverage for a newborn child, the health insurance organization or issuer may request notification of the birth of the child, but shall not deny or refuse to continue coverage if the covered person or enrollee does not furnish the notice.
(b) For a newly adopted child or child placed for adoption, the health insurance organization or issuer shall be required to provide covered persons or enrollees with reasonable notice of the following:
(1) If payment of a specific premium or subscription fee is required to provide coverage for a newly adopted child or child placed for adoption, the health plan may require the covered person or enrollee to notify the health insurance organization or issuer of the adoption or placement for adoption and furnish payment of the required premium or fees within thirty (30) days after coverage is required to begin under § 10025(a)(2) of this title.
(2) If the covered person fails to provide the notice or make the payment described in the preceding paragraph within the thirty (30)-day period, the health insurance organization or issuer shall treat the adopted child or child placed for adoption no less favorably than it treats other dependents, other than newborn children, who seek coverage at a time other than when the dependent was first eligible to apply for coverage.
History —Aug. 29, 2011, No. 194, § 54.060, eff. 180 days after Aug. 29, 2011.