Chapter 38C. Health Insurer Requirement to Provide a Special Enrollment Period for a Pregnant Individual.
§ 31–3841.01. Definitions.
For the purposes of this chapter, 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.
§ 31–3841.02. 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.
