Health Insurance - Special Enrollment Period for Pregnancy - Coverage Effective Date, the official text

WES MOORE, Governor                                 Ch. 787

Chapter 787

                   (Senate Bill 794)

AN ACT concerning

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

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

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

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

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

                   Article – Insurance

15–1316.

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

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

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

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

(c) A carrier participating in the Individual Exchange shall provide:
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Ch. 787                              2026 LAWS OF MARYLAND

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

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

(d) A carrier shall provide:

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

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

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

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

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

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

                (2) (I) If an individual enrolls for coverage or enrolls a dependent for
coverage during a special enrollment period described in subsection (c)(2) or (d)(2) of this
section, the INDIVIDUAL MAY CHOOSE WHETHER THE coverage [shall become]
BECOMES effective on:

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

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

                         (II) IF THE INDIVIDUAL FAILS TO SELECT THE DAY ON WHICH
COVERAGE BECOMES EFFECTIVE, THE CARRIER SHALL SELECT THE DAY FROM
THOSE LISTED UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH.

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WES MOORE, Governor  Ch. 787

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

         SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
January 1, 2027.

Approved by the Governor, May 26, 2026.

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