D.C. Law 23-135. Pregnancy as a Qualifying Event Act of 2020.

D.C. Law 23-135. Pregnancy as a Qualifying Event Act of 2020.

AN ACT

To require health insurers to provide a special enrollment period after an individual learns the individual is pregnant.

BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this act may be cited as the "Pregnancy as a Qualifying Event Act of 2020".

New Chapter 38C of Title 31

New § 31-3841.01

Sec. 2. Definitions.

For the purposes of this act, the term:

(1) "Health insurer" means a person that provides one or more health benefit plans or insurance in the District of Columbia, including an insurer, a hospital and medical services corporation, a fraternal benefit society, a health maintenance organization, a multiple employer welfare arrangement, or any other person providing a plan of health insurance subject to the authority of the Commissioner of the Department of Insurance, Securities, and Banking.

(2) "Open enrollment period" means the yearly period during which a person can enroll in a health insurance plan.

(3) "Special enrollment period" means any time a person has the option to enroll in or change their health insurance outside of the open enrollment period.

New § 31-3841.02

Sec. 3. Pregnancy as a qualifying event.

(a) A health insurer shall allow for a special enrollment period for a pregnant individual for:

(1) Sixty days when offering individual health insurance coverage from the date of confirmation of pregnancy, as certified by a licensed healthcare professional acting within the scope of the professional's practice; and

(2) At least 30 days when offering group health insurance coverage from the date of confirmation of pregnancy, as certified by a licensed healthcare professional acting within the scope of the professional's practice.

(b) Coverage shall be effective as of the first of the month in which the health care professional certifies the individual is pregnant, unless the individual elects to have coverage effective on the first day of the month following the date that the individual makes a plan selection.

Sec. 4. Fiscal impact statement.

The Council adopts the fiscal impact statement in the committee report as the fiscal impact statement required by section 4a of the General Legislative Procedures Act of 1975, approved October 16, 2006 (120 Stat. 2038; D.C. Official Code § 1-301.47a).

Sec. 5. Effective date.

This act shall take effect following approval by the Mayor (or in the event of veto by the Mayor, action by the Council to override the veto), a 30-day period of congressional review as provided in section 602(c)(1) of the District of Columbia Home Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Official Code § 1-206.02(c)(1)), and publication in the District of Columbia Register.