House File 606 - Introduced HOUSE FILE 606 BY A. MEYER 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 1277YH (4) 91 nls/ko

H.F. 606 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 for 20 a pregnant woman that allows the pregnant woman to enroll at 21 any time after a health care professional certifies that the 22 woman is pregnant. The policy, contract, or plan shall not 23 impose a fee or other penalty for special enrollment of the 24 pregnant woman. 25 b. Upon enrollment of a pregnant woman in a policy, 26 contract, or plan under paragraph “a” , coverage shall be 27 effective as of the first day of the month in which the health 28 care professional certifies that the woman is pregnant, unless 29 the woman elects to have coverage effective on the first 30 day of the month following the date that the woman received 31 certification of the pregnancy. 32 3. a. This section applies to the following classes of 33 third-party payment provider policies, contracts, or plans 34 delivered, issued for delivery, continued, or renewed in this 35 -1- LSB 1277YH (4) 91 nls/ko 1/ 3

H.F. 606 state on or after January 1, 2026: 1 (1) Individual or group accident and sickness insurance 2 providing coverage on an expense-incurred basis. 3 (2) An individual or group hospital or medical service 4 contract issued pursuant to chapter 509, 514, or 514A. 5 (3) An individual or group health maintenance organization 6 contract regulated under chapter 514B. 7 (4) A plan established for public employees pursuant to 8 chapter 509A. 9 b. This section shall not apply to accident-only, specified 10 disease, short-term hospital or medical, hospital confinement 11 indemnity, credit, dental, vision, Medicare supplement, 12 long-term care, basic hospital and medical-surgical expense 13 coverage as defined by the commissioner of insurance, 14 disability income insurance coverage, coverage issued as a 15 supplement to liability insurance, workers’ compensation or 16 similar insurance, or automobile medical payment insurance. 17 4. The commissioner of insurance shall adopt rules pursuant 18 to chapter 17A to administer this section. 19 EXPLANATION 20 The inclusion of this explanation does not constitute agreement with 21 the explanation’s substance by the members of the general assembly. 22 This bill relates to a special enrollment period for 23 pregnant women. 24 The bill requires a policy, contract, or plan (policy) 25 providing for third-party payment or prepayment of health or 26 medical expenses to provide a special enrollment period for a 27 pregnant woman that allows the pregnant woman to enroll at any 28 time after a health care professional (professional) certifies 29 that the woman is pregnant. The policy shall not impose a fee 30 or other penalty for special enrollment of the pregnant woman. 31 Upon enrollment of a pregnant woman in a policy, coverage 32 shall be effective as of the first day of the month in which 33 the professional certifies that the woman is pregnant, unless 34 the individual elects to have coverage effective on the first 35 -2- LSB 1277YH (4) 91 nls/ko 2/ 3

H.F. 606 day of the month following the date that the woman received 1 certification of the pregnancy. 2 The bill applies to third-party payment providers enumerated 3 in the bill. The bill specifies the types of specialized 4 health-related insurance which are not subject to the coverage 5 requirements of the bill. 6 The commissioner of insurance shall adopt rules to 7 administer the bill. 8 -3- LSB 1277YH (4) 91 nls/ko 3/ 3