(a) As used in this section: (1) "Carrier" means any entity that provides health insurance in this State that is subject to the provisions of this chapter. "Carrier" includes an insurance company, health service corporation, managed care organization, health maintenance organization, and any other entity providing a plan of health insurance or health benefits subject to state insurance regulation. "Carrier" also includes any third- party administrator or other entity that adjusts, administers, or settles claims in connection with health benefit plans. (2) "Health benefit plan" means as defined in § 3342A of this title. (b) A carrier subject to this section shall cover services related to the termination of pregnancy for enrollees. (1) a. Except as provided in paragraphs (b)(1)b. and (b)(1)c. of this section, coverage provided under this section may not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement. b. The limitations on cost-sharing in paragraph (b)(1)a. of this section do not apply to a high deductible health plan if the limitations would cause the plan to lose its status as a high deductible health plan. under § 223(c)(2) of the Internal Revenue Code [26 U.S.C. § 223(c)(2)]. c. Coverage under this section may be limited to $750 per covered individual per year. (2) A carrier must provide coverage for the full scope of services permissible under the law. (3) Coverage provided under this section may not require a referral or prior authorization as a condition of coverage. (4) If a policy or contract limits an insured's access to a network of participating providers for other health-care services, then it may limit access for services related to termination of pregnancy, but the policy or contract must include in all its provider networks a sufficient number of providers of termination of pregnancy services to accommodate the direct access needs of their enrollees. (c) (1) A religious employer may request, and the plan must grant, an exclusion from the coverage requirement if the coverage requirement conflicts with the religious organization's bona fide religious beliefs and practices. If such employer obtains an exclusion, it must provide its employees reasonable and timely notice of the exclusion. (2) An exclusion under this subsection does not authorize the exclusion of coverage for services related to the termination of pregnancy that are necessary to preserve the life or health of a covered individual. (d) This section applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2025.
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