Code of the District of Columbia

§ 31–3834.05. Notice of rights to healthcare coverage.

(a) An insurer that is subject to § 31-3834.01, § 31-3834.02, or § 31-3834.03 shall make readily accessible to enrollees and potential enrollees information regarding:

(1) Full and accurate information relevant to coverage and cost-sharing for contraceptive drugs, devices, products, and services by each health insurance plan, including an explanation of an insured's financial responsibility for payment of premiums, coinsurance, copayments, deductibles, and any other charges;

(2) The coverage of other drugs, devices, products, and services described in §§ 31-3834.01, 31-3834.02, and 31-3834.03; and

(3) The right to receive up to a 12-month supply of self-administered hormonal contraceptives prescribed and dispensed by a licensed pharmacist, pursuant to § 3-1202.08(g-1), without cost-sharing requirements.

(b)(1) The insurer shall provide the information described in subsection (a) of this section in a consumer-friendly format:

(A) That can be viewed on the insurer's public website through a clearly identifiable link or tab without requiring an individual to create or access an account or enter a policy or contract number;

(B) By email or letter within 14 days after a request by an enrollee; and

(C) Within one year after March 28, 2018, or whenever written materials are reprinted, whichever is sooner, in written materials that explain benefits or coverage that are provided to enrollees and potential enrollees, including in an addendum summarizing benefits and coverage.

(2) This subsection shall be construed consistently with section 2715 of the Public Health Services Act, as amended by the Patient Protection and Affordable Care Act, approved March 23, 2010 (124 Stat. 132; 42 U.S.C. § 300gg-15).

(c) The Department of Insurance, Securities and Banking shall provide health insurers operating in the District of Columbia with an annual notice of their obligation to provide coverage for drugs, devices, products, and services described in §§ 31-3834.01, 31-3834.02, and 31-3834.03.


(Apr. 3, 2001, D.C. Law 13-254, § 5e ; as added Mar. 28, 2018, D.C. Law 22-75, § 3(b), 65 DCR 1374; Oct. 30, 2018, D.C. Law 22-164, § 303(d), 65 DCR 9324.)

Emergency Legislation

For temporary (90 days) creation of this section, see § 3(b) of Defending Access to Women's Health Care Services Congressional Review Emergency Amendment Act of 2018 (D.C. Act 22-266, Feb. 21, 2018, 65 DCR 2119).