State RegulationsMI specificDifficulty 2/5
A Grand Rapids employee's daughter is born with a medically diagnosed congenital defect, and the mother is enrolled in her employer's group health plan. Under Michigan law, how must the plan treat the newborn?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
M.C.L. 500.3403(1)(d) and 500.3403(2) of the Michigan Insurance Code require newborn coverage from the moment of birth, including medically diagnosed congenital defects and birth abnormalities. The statute also forbids denying enrollment because the child was born out of wedlock, is not claimed as a tax dependent, or does not reside with the insured, so the defect must be covered without a preexisting-condition hurdle.
Why the other options are wrong
- B) A 12-month exclusion for the diagnosed defect directly contradicts the from-birth coverage mandate in M.C.L. 500.3403(1)(d).
- C) Coverage attaches at the moment of birth under Michigan law, not when the employer files the enrollment paperwork.
- D) M.C.L. 500.3403(2) expressly bars denying enrollment for birth out of wedlock or lack of tax-dependent status.
Memory hook
Born covered — Michigan babies start the day they arrive.