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 TLSB 1277HV (2) 91 nls/ko

H.F. 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 -1- LSB 1277HV (2) 91 nls/ko 1/ 3

H.F. 2415 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 -2- LSB 1277HV (2) 91 nls/ko 2/ 3

H.F. 2415 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 -3- LSB 1277HV (2) 91 nls/ko 3/ 3