§ 31-3303.13e — Negotiated health benefit plans.

District of Columbia § 31-3303.13e

• Jurisdiction: District of Columbia
• Title 31: Insurance and Securities.
• Ch. 33: Health Insurance Portability and Accountability.
• Subch. III: Group Insurance.

Text

(a) When a negotiated health benefit plan differs in coverage of health services from the standard health benefit plan or formulary offered by the health insurer, the employer shall provide notice to all employees, regardless of whether they are enrolled in the negotiated health benefit plan, of any treatments, including particular services or medications, covered under the standard health benefit plan or formulary but are not covered under the negotiated health benefit plan or formulary offered to employees.

(b) Notice under subsection (a) of this section shall be provided to employees:

(1) At least 30 days prior to the conclusion of any open enrollment period; and

(2) Within 30 days after the employer and health insurer finalize the terms of coverage under a negotiated health benefit plan.

(c) For the purposes of this section, the term "negotiated health benefit plan" means a health benefit plan that an employer negotiates with a health insurer to provide to its employees which may otherwise differ from the standard health benefit plan offered by the health insurer.

Legislative History

Apr. 13, 1999, D.C. Law 12-209, § 313e