D.C. Mun. Regs. tit. 26, r. 26-A4403

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 26-A4403 - OPEN ENROLLMENT PERIODS

4403.1

A carrier issuing or delivering child-only policies in the District shall accept applications for coverage during the open enrollment periods outlined in this chapter.

4403.2

Each carrier issuing child-only policies shall hold open enrollment periods twice a year from:

(a) January 1 thru January 31 of each year; and

(b) July 1 thru July 31 of each year.

4403.3

During the open enrollment periods, any applicant for a child-only policy shall be offered coverage on a guaranteed issue basis, without any limitations or riders based on medical condition or health status.

4403.4

Notice of the open enrollment period and instructions on how to apply during the open enrollment period shall be displayed prominently on the carrier's website for the duration of the open enrollment period.

4403.5

During open enrollment, a carrier may request from an applicant information to determine whether the proposed insured has substantially similar coverage available and may obtain an attestation from an applicant that the proposed insured does not have substantially similar coverage available.

4403.6

Applications for coverage during the open enrollment period under paragraph 4403.2(a) of this section that are received:

(a) On or before January 15 shall become effective on the first day of February of the same year; and

(b) After January 15 shall become effective no later than February 16 of the same year.

4403.7

Applications for coverage during the open enrollment period under paragraph 4403.2(b) of this section that are received:

(a) On or before July 15 shall become effective on the first day of August of the same year; and

(b) After July 15 shall become effective no later than August 16 of the same year.

4403.8

Notwithstanding the provisions of subsection 4403.1 of this section, a carrier may reject an application during the open enrollment period if the child has other substantially similar coverage available.

D.C. Mun. Regs. tit. 26, r. 26-A4403

Notice of Emergency and Proposed Rulemaking published at 57 DCR 12281 (December 24, 2010)[EXPIRED]; as amended by Notice of Final Rulemaking published at 58 DCR 2492 (March 18, 2011)

Authority: The Acting Commissioner of the Department of Insurance, Securities and Banking, pursuant to the authority set forth in section 23 of the Health Maintenance Organization Act of 1996, effective April 9, 1997 (D.C. Law 11-235; D.C. Official Code §§ 31-3401, et seq.); section 25 of the Hospital and Medical Services Corporation Regulatory Act of 1996, effective April 9, 1996 (D.C. Law 11-245; D.C. Official Code § 31-3508); and section 28 of Chapter V of the Life Insurance Act of 1934, approved June 19, 1934 (48 Stat. 1166; D.C. Official Code § 31-4712 ).