Read the full stored bill text
House
File
2415
-
Introduced
HOUSE
FILE
2415
BY
COMMITTEE
ON
COMMERCE
(SUCCESSOR
TO
HF
606)
A
BILL
FOR
An
Act
relating
to
certain
health
insurance
policies,
1
contracts,
and
plans
and
a
special
enrollment
period
for
2
pregnant
women.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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2415
Section
1.
NEW
SECTION
.
514C.37
Special
enrollment
period
1
——
pregnant
women.
2
1.
As
used
in
this
section,
unless
the
context
otherwise
3
requires:
4
a.
“Health
care
professional”
means
a
physician
or
other
5
health
care
practitioner
licensed,
accredited,
registered,
or
6
certified
to
perform
specified
health
care
services
consistent
7
with
state
law.
8
b.
“Special
enrollment
period”
means
a
period
other
than
9
the
first
period
in
which
an
eligible
individual
or
the
10
individual’s
dependent
is
eligible
to
enroll
under
the
terms
of
11
a
policy,
contract,
or
plan
providing
for
third-party
payment
12
or
prepayment
of
health
or
medical
expenses,
without
regard
to
13
other
enrollment
periods
defined
under
the
terms
of
the
policy,
14
contract,
or
plan.
15
2.
a.
Notwithstanding
the
uniformity
of
treatment
16
requirements
of
section
514C.6,
and
notwithstanding
any
17
provision
of
law
to
the
contrary,
a
policy,
contract,
or
plan
18
providing
for
third-party
payment
or
prepayment
of
health
or
19
medical
expenses
shall
provide
a
special
enrollment
period
20
for
a
pregnant
woman
that
allows
the
pregnant
woman
to
enroll
21
after
a
health
care
professional
certifies
that
the
woman
is
22
pregnant,
up
to
the
date
that
the
woman’s
pregnancy
reaches
23
sixteen
weeks
gestation.
The
policy,
contract,
or
plan
shall
24
not
impose
a
fee
or
other
penalty
for
special
enrollment
of
the
25
pregnant
woman.
26
b.
Upon
enrollment
of
a
pregnant
woman
in
a
policy,
27
contract,
or
plan
under
paragraph
“a”
,
coverage
shall
be
28
effective
as
of
the
first
day
of
the
month
in
which
the
health
29
care
professional
certifies
that
the
woman
is
pregnant,
unless
30
the
woman
elects
to
have
coverage
effective
on
the
first
31
day
of
the
month
following
the
date
that
the
woman
received
32
certification
of
the
pregnancy.
33
3.
a.
This
section
applies
to
the
following
classes
of
34
third-party
payment
provider
policies,
contracts,
or
plans
35
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delivered,
issued
for
delivery,
continued,
or
renewed
in
this
1
state
on
or
after
January
1,
2027:
2
(1)
Individual
or
group
accident
and
sickness
insurance
3
providing
coverage
on
an
expense-incurred
basis.
4
(2)
An
individual
or
group
hospital
or
medical
service
5
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
6
(3)
An
individual
or
group
health
maintenance
organization
7
contract
regulated
under
chapter
514B.
8
(4)
A
plan
established
for
public
employees
pursuant
to
9
chapter
509A.
10
b.
This
section
shall
not
apply
to
accident-only,
specified
11
disease,
short-term
hospital
or
medical,
hospital
confinement
12
indemnity,
credit,
dental,
vision,
Medicare
supplement,
13
long-term
care,
basic
hospital
and
medical-surgical
expense
14
coverage
as
defined
by
the
commissioner
of
insurance,
15
disability
income
insurance
coverage,
coverage
issued
as
a
16
supplement
to
liability
insurance,
workers’
compensation
or
17
similar
insurance,
or
automobile
medical
payment
insurance.
18
4.
The
commissioner
of
insurance
may
adopt
rules
pursuant
to
19
chapter
17A
to
administer
this
section.
20
EXPLANATION
21
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
22
the
explanation’s
substance
by
the
members
of
the
general
assembly.
23
This
bill
relates
to
a
special
enrollment
period
for
24
pregnant
women.
25
The
bill
requires
a
policy,
contract,
or
plan
(policy)
26
providing
for
third-party
payment
or
prepayment
of
health
or
27
medical
expenses
to
provide
a
special
enrollment
period
for
a
28
pregnant
woman
that
allows
the
pregnant
woman
to
enroll
after
29
a
health
care
professional
(professional)
certifies
that
the
30
woman
is
pregnant,
up
to
the
date
that
the
woman’s
pregnancy
31
reaches
16
weeks
gestation.
The
policy
shall
not
impose
a
fee
32
or
other
penalty
for
special
enrollment
of
the
pregnant
woman.
33
Upon
enrollment
of
a
pregnant
woman
in
a
policy,
coverage
34
shall
be
effective
as
of
the
first
day
of
the
month
in
which
35
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the
professional
certifies
that
the
woman
is
pregnant,
unless
1
the
individual
elects
to
have
coverage
effective
on
the
first
2
day
of
the
month
following
the
date
that
the
woman
received
3
certification
of
the
pregnancy.
4
The
bill
applies
to
third-party
payment
providers
enumerated
5
in
the
bill.
The
bill
specifies
the
types
of
specialized
6
health-related
insurance
which
are
not
subject
to
the
coverage
7
requirements
of
the
bill.
8
The
commissioner
of
insurance
may
adopt
rules
to
administer
9
the
bill.
10
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