HF2415: Pregnant Women Coverage

Requires health insurance policies, contracts, or plans providing third-party payment or prepayment of health or medical expenses in Iowa to offer a special enrollment period for pregnant women. This period allows a pregnant woman to enroll after pregnancy is certified by a health care professional, up to 16 weeks gestation, without any enrollment fee or penalty. Coverage becomes effective on the first day of the month in which pregnancy is certified, or the following month if the woman chooses. The bill specifies which types of insurance are included and excluded from this requirement and authorizes the insurance commissioner to adopt administrative rules.

Key Points & Impacts:

• Mandates a special enrollment period for pregnant women in specified health insurance policies, contracts, and plans.

• Enrollment is allowed after certification of pregnancy by a licensed health care professional, up to 16 weeks gestation.

• Prohibits fees or penalties for special enrollment of pregnant women.

• Coverage becomes effective on the first day of the month of certification or optionally the following month.

• Applies to individual and group accident and sickness insurance, hospital or medical service contracts, HMO contracts, and public employee plans.

• Excludes certain policies (e.g., accident-only, specified disease, dental/vision, Medicare supplement, long-term care, workers’ compensation, automobile medical payment insurance).

• Effective for policies delivered, issued, continued, or renewed in Iowa on or after January 1, 2027.

• Authorizes the commissioner of insurance to adopt rules to administer the new requirements.