Health Insurance - Special Enrollment Period for Newly Hired Employees of Small Businesses

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1068*

HOUSE BILL 1068
J5 6lr2114

By: Delegate Solomon Delegates Solomon, Alston, Bagnall, Cullison, Guzzone,
Hill, Hutchinson, S. Johnson, Kaufman, Kipke, Lopez, Martinez, Rosenberg,
Ross, Taveras, White Holland, and Woorman
Introduced and read first time: February 10, 2026
Assigned to: Health
Committee Report: Favorable with amendments
House action: Adopted
Read second time: February 26, 2026

CHAPTER ______

AN ACT concerning 1

Health Insurance – Special Enrollment Period for Newly Hired Employees of 2
Small Businesses 3

FOR the purpose of requiring certain health insurance carriers to provide certain special 4
enrollment periods for individuals who become employed by small employers that do 5
not offer employer –sponsored health plans and the individual’s dependents ; and 6
generally relating to special enrollment periods for health insurance. 7

BY repealing and reenacting, with amendments, 8
Article – Insurance 9
Section 15–1316(c) 15–1316(a) and (c) through (f) 10
Annotated Code of Maryland 11
(2017 Replacement Volume and 2025 Supplement) 12

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 13
That the Laws of Maryland read as follows: 14

Article – Insurance 15

15–1316. 16

(a) (1) In this section the following words have the meanings indicated. 17

2 HOUSE BILL 1068

(2) “Dependent” means an individual who is or who may become eligible 1
for coverage under the terms of a health benefit plan because of a relationship with another 2
individual. 3

(3) “EMPLOYER–SPONSORED HEALTH BEN EFIT PLAN ” HAS THE 4
MEANING STATED IN § 15–1104(A) OF THIS TITLE. 5

[(3)] (4) “Health care practitioner” has the meaning stated in § 1 –301 of 6
the Health Occupations Article. 7

[(4)] (5) “Qualifying coverage in an eligible employer –sponsored plan” 8
has the meaning stated in 45 C.F.R. § 155.300. 9

(6) “SMALL EMPLOYER” HAS THE MEANING STATED IN § 31–101(AA) 10
OF THIS ARTICLE. 11

(c) A carrier participating in the Individual Exchange shall provide: 12

(1) the special enrollment periods specified in 45 C.F.R. § 155.420 for 13
individuals who purchase coverage through the Individual Exchange; [and] 14

(2) a special enrollment period for an individual who purchases coverage 15
through the Individual Exchange if the individual or a dependent of the individual becomes 16
pregnant, as confirmed by a health care practitioner; AND 17

(3) A SPECIAL ENROLLMENT PERIOD FOR: 18

(I) AN INDIVIDUAL WHO: 19

1. PURCHASES COVERAGE T HROUGH THE INDIVIDUAL 20
EXCHANGE BECAUSE THE INDIVIDUAL HAS BECOM E EMPLOYED TO WORK A 21
MINIMUM OF 30 HOURS PER WEEK BY A SMALL EMPLOYER THAT DOES NOT OFFER 22
AN EMPLOYER–SPONSORED HEALTH BENEFIT PLAN; AND 23

2. PROVIDES THE INDIVIDUAL EXCHANGE WITH A FORM 24
DEVELOPED BY THE COMMISSIONER AND COMP LETED BY THE EMPLOYE R THAT 25
INDICATES: 26

A. THE FIRST DAY OF EMPLOYMENT OF THE INDIVIDUAL; 27
AND 28

B. THAT THE INDIVIDUAL WAS HIRED TO WORK A 29
MINIMUM OF 30 HOURS PER WEEK; AND 30

HOUSE BILL 1068 3

(II) EACH DEPENDENT OF THE INDIVIDUAL DESCRIBED IN ITEM 1
(I) OF THIS ITEM. 2

(d) A carrier shall provide: 3

(1) the special enrollment periods specified in 45 C.F.R. § 147.104(b)(2) for 4
individuals who purchase coverage outside the Individual Exchange; [and] 5

(2) a special enrollment period for an individual who purchases coverage 6
outside the Individual Exchange if the individual or a dependent of the individual becomes 7
pregnant, as confirmed by a health care practitioner; AND 8

(3) A SPECIAL ENROLLMENT PERIOD FOR: 9

(I) AN INDIVIDUAL WHO: 10

1. PURCHASES COVERAGE O UTSIDE THE INDIVIDUAL 11
EXCHANGE BECAUSE THE INDIVIDUAL HAS BECOM E EMPLOYED TO WORK A 12
MINIMUM OF 30 HOURS PER WEEK BY A SMALL EMPLOYER THAT DOES NOT OFFER 13
AN EMPLOYER–SPONSORED HEALTH BENEFIT PLAN; AND 14

2. PROVIDES THE CARRIER WITH A FORM DEVELOPE D 15
BY THE COMMISSIONER AND COMPLETED BY THE EMPLOYER THAT INDICATES: 16

A. THE FIRST DAY OF EMPLOYMENT OF THE INDIVIDUAL; 17
AND 18

B. THAT THE INDIVIDUAL WAS HIRED TO WORK A 19
MINIMUM OF 30 HOURS PER WEEK; AND 20

(II) EACH DEPENDENT OF THE INDIVIDUAL DESCRIBED IN ITEM 21
(I) OF THIS ITEM. 22

(e) (1) A special enrollment period described in subsection (c)(2) or (d)(2) of this 23
section shall: 24

[(1)] (I) be open for a period of 90 days; and 25

[(2)] (II) begin on the date the health care practitioner confirms the 26
pregnancy. 27

(2) A SPECIAL ENROLLMENT P ERIOD DESCRIBED IN S UBSECTION 28
(C)(3) OR (D)(3) OF THIS SECTION SHALL: 29

(I) BE OPEN FOR A PERIOD OF 60 DAYS; AND 30
4 HOUSE BILL 1068

(II) BEGIN ON THE FIRST D AY OF EMPLOYMENT OF THE 1
INDIVIDUAL BY A SMAL L EMPLOYER THAT DOES NOT OFFER AN 2
EMPLOYER–SPONSORED HEALTH BEN EFIT PLAN AS INDICATED ON THE FORM 3
DEVELOPED BY THE COMMISSIONER, COMPLETED BY THE EMP LOYER, AND 4
PROVIDED TO THE INDIVIDUAL EXCHANGE IN ACCORDANC E WITH SUBSECTION 5
(C)(3)(I)2 OF THIS SECTION OR T HE CARRIER IN ACCORD ANCE WITH SUBSECTION 6
(D)(3)(I)2 OF THIS SECTION, AS APPLICABLE. 7

(f) (1) If an individual enrolls for coverage during one of the open enrollment 8
periods described in subsection (b) of this section or during one of the special open 9
enrollment periods described in subsections (c)(1) and (d)(1) of this section, coverage shall 10
be effective in accordance with the requirements in 45 C.F.R. § 155.420. 11

(2) If an individual enrolls for coverage or enrolls a dependent for coverage 12
during a special enrollment period described in subsection (c)(2) or (d)(2) of this section, the 13
coverage shall become effective on the first day of the month in which the individual 14
receives confirmation of pregnancy. 15

(3) IF AN INDIVIDUAL ENROLLS FOR COVERAGE OR ENROLLS A 16
DEPENDENT FOR COVERAGE DURING A SPECIAL ENROLLMENT PERIOD DESCRIBED 17
IN SUBSECTION (C)(3) OR (D)(3) OF THIS SECTION, THE COVERAGE SHALL BECOME 18
EFFECTIVE ON THE FIR ST DAY OF THE MONTH FOLLOWING THE DATE O F PLAN 19
SELECTION. 20

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 21
January 1, 2027. 22

Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.