Health Insurance - Special Enrollment Period for Pregnancy - Coverage Effective Date

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.
*sb0794*

SENATE BILL 794
J5 6lr2246

By: Senator Lam Senators Lam and Gile
Introduced and read first time: February 6, 2026
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 1, 2026

CHAPTER ______

AN ACT concerning 1

Health Insurance – Special Enrollment Period for Pregnancy – Coverage 2
Effective Date 3

FOR the purpose of authorizing an individual who enrolls for coverage or enrolls a 4
dependent for coverage during a certain special enrollment period for pregnancy to 5
choose a certain date option on which the coverage will become effective; requiring 6
the carrier, if the individual fails to select the effective date, to select a certain date 7
option; and generally relating to special enrollment periods for health insurance. 8

BY repealing and reenacting, without amendments, 9
Article – Insurance 10
Section 15–1316(a) and (c) through (e) 11
Annotated Code of Maryland 12
(2017 Replacement Volume and 2025 Supplement) 13

BY repealing and reenacting, with amendments, 14
Article – Insurance 15
Section 15–1316(f) 16
Annotated Code of Maryland 17
(2017 Replacement Volume and 2025 Supplement) 18

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 19
That the Laws of Maryland read as follows: 20

Article – Insurance 21
2 SENATE BILL 794

15–1316. 1

(a) (1) In this section the following words have the meanings indicated. 2

(2) “Dependent” means an individual who is or who may becom e eligible 3
for coverage under the terms of a health benefit plan because of a relationship with another 4
individual. 5

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

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

(c) A carrier participating in the Individual Exchange shall provide: 10

(1) the special enrollment periods specified in 45 C.F.R. § 155.420 for 11
individuals who purchase coverage through the Individual Exchange; and 12

(2) a special enrollment period for an individual who purchases coverage 13
through the Individual Exchange if the individual or a dependent of the individual becomes 14
pregnant, as confirmed by a health care practitioner. 15

(d) A carrier shall provide: 16

(1) the special enrollment periods specified in 45 C.F.R. § 147.104(b)(2) for 17
individuals who purchase coverage outside the Individual Exchange; and 18

(2) a special enrollment period for an individual who purchases coverage 19
outside the Individual Exchange if the individual or a dependent of the individual becomes 20
pregnant, as confirmed by a health care practitioner. 21

(e) A special enrollment period described in subsection (c)(2) or (d)(2) of this 22
section shall: 23

(1) be open for a period of 90 days; and 24

(2) begin on the date the health care practitioner confirms the pregnancy. 25

(f) (1) If an individual enrolls for coverage during one of the open enrollment 26
periods described in subsection (b) of this section or d uring one of the special open 27
enrollment periods described in subsections (c)(1) and (d)(1) of this section, coverage shall 28
be effective in accordance with the requirements in 45 C.F.R. § 155.420. 29

(2) (I) If an individual enrolls for coverage or enrolls a dependent for 30
coverage during a special enrollment period described in subsection (c)(2) or (d)(2) of this 31
SENATE BILL 794 3

section, the INDIVIDUAL MAY CHOOS E WHETHER THE coverage [shall become ] 1
BECOMES effective on: 2

1. the first day of the month in which the individual receives 3
confirmation of pregnancy; OR 4

2. THE FIRST DAY OF THE MONTH FOLLOWING THE DATE 5
OF PLAN SELECTION. 6

(II) IF THE INDIVIDUAL FAI LS TO SELECT THE DAY ON WHICH 7
COVERAGE BECOMES EFF ECTIVE, THE CARRIER SHALL SE LECT THE DAY FROM 8
THOSE LISTED UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH. 9

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 10
health benefit plans issued, delivered, or renewed in the State on or after January 1, 2027. 11

SECTION 3. AND BE IT FURTHER ENACTED, That th is Act shall take effect 12
January 1, 2027. 13

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