--- title: HB 1149. Insurance; offer a preenrollment option for anticipated newly born or adopted children; require certain health insurers collection: bills id: 2025-2026/hb1149 cite_as: HB 1149, 2025-2026 Regular Session (Ga.) canonical_url: https://georgiacommons.org/bills/2025-2026/hb1149 md_url: https://georgiacommons.org/bills/2025-2026/hb1149.md text_url: https://georgiacommons.org/bills/2025-2026/hb1149/text source_url: https://www.legis.ga.gov/legislation/72710 date: 2026-02-04 status: introduced corpus_version: bills-2026-09-13 license: Public record of the Georgia General Assembly, via LegiScan; see about.md publisher: Georgia Commons, an independent project of Georgia Civic Data. Not the State of Georgia. Not legal advice. up: https://georgiacommons.org/bills/2025-2026.md previous: https://georgiacommons.org/bills/2025-2026/hb1148.md next: https://georgiacommons.org/bills/2025-2026/hb1150.md index: https://georgiacommons.org/bills/index.md omitted: votes and history omitted_chars: 129 omitted_url: https://georgiacommons.org/bills/2025-2026/hb1149.md?full=1 bill_number: HB 1149 session: 2025-2026 Regular Session session_slug: 2025-2026 chamber: House bill_type: bill status_date: 2026-02-02 last_action: House Second Readers sponsors: - Sharon Cooper - Jan Jones - Lee Hawkins - Eric Gisler - Leesa Hagan - Spencer Frye text_version: Introduced has_text: true legiscan_url: https://legiscan.com/GA/bill/HB1149/2025 upstream_id: 2104409 summaries_model: claude-sonnet-5 topic_tags: - health insurance - newborn coverage - adoption - insurance regulation - maternity care --- # HB 1149. Insurance; offer a preenrollment option for anticipated newly born or adopted children; require certain health insurers ## Text House Bill 1149 By: Representatives Cooper of the 45th, Jones of the 47th, Hawkins of the 27th, Gisler of the 121st, Hagan of the 156th, and others A BILL TO BE ENTITLED AN ACT To amend Chapter 24 of Title 33 of the Official Code of Georgia, relating to insurance generally, so as to require certain health insurers to offer a preenrollment option for anticipated newly born or adopted children; to provide for definitions; to provide for the provision of routine well baby care in certain circumstances; to provide for documentation; to provide for notification; to provide for statutory construction; to provide for applicability; to provide for related matters; to repeal conflicting laws; and for other purposes. BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: SECTION 1. Chapter 24 of Title 33 of the Official Code of Georgia, relating to insurance generally, is amended by revising Code Section 33-24-22, relating to provisions in health insurance policies for coverage of newly born or adopted children, as follows: "33-24-22. (a) As used in this Code section, the term: (1) 'Anticipated family member' means an individual whose birth or adoption is reasonably anticipated to occur within three months. (2) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any maximum limitation on the application of such a deductible, coinsurance, copayment, or similar out-of-pocket expense. (3) 'Health benefit policy' means an individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, or renewed in this state which provides major medical benefits by a healthcare corporation, health maintenance organization, preferred provider organization, fraternal benefit society, hospital service corporation, medical service corporation, or other health insurer or similar entity. Such term shall not include self-funded, employer sponsored health insurance plans subject to the exclusive jurisdiction of the federal Employee Retirement Income Security Act of 1974, as codified and amended at 29 U.S.C. Section 1001, et seq. (4) 'Health insurer' means any person, corporation, or other entity authorized to provide health benefit policies under this title. (a)(b) All individual and group health insurance policies providing coverage on an expense incurred basis and individual and group service or indemnity type contracts issued by a nonprofit corporation health benefit policies which, under the terms of such policies, provide coverage for a family member of the insured or subscriber shall, as to the family members' coverage, also provide that the health insurance benefits applicable for children shall be payable with respect to a newly born child of the insured or subscriber from the moment of birth. A newly born child of the insured or subscriber shall include an adopted child. The coverage for the adopted child shall be effective from the date of the placement for adoption or final decree of adoption, whichever occurs first. (b)(c) The coverage for newly born children or adopted children shall consist of coverage of injury or sickness, including routine well baby care and the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities, but need not include benefits for routine well baby care. (c)(d) If payment of a specific premium or subscription fee is required to provide coverage for a child, the health benefit policy or contract may require that notification of birth of a newly born child or the date of the placement for adoption or final adoption of a child and payment of the required premium or fees must be furnished to the insurer or nonprofit service or indemnity corporation within 31 days after the date of birth, placement for adoption, or final decree of adoption, whichever is applicable, in order to have the coverage continue beyond the 31 day period. (e) Beginning January 1, 2027, any health insurer offering a health benefit policy in this state shall provide insureds and subscribers with the opportunity to participate in an optional preenrollment period in preparation of the arrival of an anticipated family member. The coverage for the anticipated family member shall not become effective until the birth or adoption of the child. (f) In order to participate in the preenrollment of the anticipated family member, insureds or subscribers shall be required to obtain documentation which establishes that the insured is pregnant or will be adopting a child. (1) If the insured is pregnant, the insured shall submit to the health insurer any of the following: (A) A note from a physician or other appropriate healthcare provider; (B) The result of an ultrasound test; or (C) The result of a urine test. (2) If the insured will be adopting a child, the insured shall submit to the health insurer such documentation as the Commissioner shall determine is necessary through the promulgation of rules and regulations. (g) The documentation described in subsection (f) of this Code section shall not be submitted by the insured or subscriber unless the birth or adoption is reasonably anticipated to occur within three months of such submission. (h) Once the health insurer receives the documentation required in subsection (f) of this Code section, within ten business days of such receipt, such insurer shall: (A) Disclose to the insured or subscriber the coverage changes that may occur upon childbirth or adoption, including, but not limited to, any changes to the deductible or premium; and (B) Notify the insured or subscriber of the 31 day period described in subsection (d) of this Code section. (d)(i) This Code section shall not apply to persons adopted as adults pursuant to the provisions of Code Section 19-8-21, relating to the adoption of adult persons. (j) The preenrollment option benefit shall be subject to the same cost-sharing requirements established for other covered benefits within such health benefit policy. Special deductibles, coinsurance, copayment, or other limitations that are not generally applicable to other benefits shall not be imposed regarding coverage for the preenrollment option benefit described in this Code section. (k) Prior to the arrival of the anticipated family member, the health insurer shall assign to the documentation submitted pursuant to subsection (f) of this Code section, such health benefit policy information that will reasonably identify such member in preparation for his or her birth or adoption. (l) Nothing in this Code section shall be construed to prohibit a health insurer from issuing or renewing a health benefit policy which provides benefits greater than the minimum benefits required under this Code section or from issuing or renewing a policy which provides benefits which are generally more favorable to the insured or subscriber than those required under this Code section. (m)(1) The provisions of this Code section shall apply to all policies, contracts, and certificates executed, delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2027. (2) For purposes of this Code section, all contracts are deemed to be renewed no later than the first anniversary of the contract date." SECTION 2. All laws and parts of laws in conflict with this Act are repealed. ## Summaries written by Georgia Commons The following was written by claude-sonnet-5 from the text above and is not part of the bill. Quote the text, not the summary. House Bill 1149 would require Georgia health insurers to let pregnant policyholders or those adopting a child preenroll the expected child in coverage before birth or adoption, starting January 1, 2027. ### Plain-language summary Georgia law already requires health insurance policies that cover family members to automatically cover newly born or adopted children from the moment of birth or placement, including care for congenital defects, but insurers could exclude routine well baby checkups. This bill rewrites that law (O.C.G.A. § 33-24-22) to add routine well baby care to the required coverage and to create a new preenrollment process for an 'anticipated family member,' defined as a child whose birth or adoption is expected within three months. Under the bill, starting January 1, 2027, insurers must let policyholders preenroll an expected child using proof such as a doctor's note, ultrasound, or urine test for pregnancy, or adoption paperwork set by the Insurance Commissioner. Within ten business days of receiving that paperwork, the insurer must disclose any coverage or premium changes coming with the child's arrival and explain the 31-day post-birth notification window. Preenrollment cannot carry special deductibles or copays beyond what applies to other benefits, and the changes apply to policies issued or renewed on or after January 1, 2027. ### What it does - Requires health benefit policies covering family members to include routine well baby care, not just treatment of birth defects and illness, removing the prior exclusion. - Creates a new optional preenrollment period letting insureds register an expected newborn or adopted child before the birth or adoption actually happens. - Requires proof of pregnancy (doctor's note, ultrasound, or urine test) or Commissioner-defined adoption documentation before preenrollment can occur. - Requires insurers to notify policyholders within ten business days of receiving that documentation about coverage or premium changes and the 31-day post-birth deadline. - Bars insurers from applying special deductibles, coinsurance, or copays to the preenrollment benefit beyond what applies to other covered benefits. - Sets the new requirements to take effect for policies issued or renewed on or after January 1, 2027. ### Who it affects Georgia residents who hold individual or group health insurance policies and are expecting a birth or planning an adoption, health insurers and HMOs that sell major medical coverage in the state, and the Georgia Insurance Commissioner's office, which must set rules for adoption documentation. Self-funded employer plans governed by federal ERISA law are excluded. ### Why it matters Expecting parents would be able to line up insurance paperwork and understand cost changes before a child arrives instead of scrambling within the current 31-day window after birth or adoption, and families would gain guaranteed coverage for routine well baby visits that some policies previously did not have to include. ### Key provisions - Section 1 adds definitions for 'anticipated family member,' 'cost-sharing requirement,' 'health benefit policy,' and 'health insurer' to O.C.G.A. § 33-24-22. - Subsection (c) expands required newborn and adopted child coverage to include routine well baby care, removing the old exclusion for it. - Subsection (e) creates the optional preenrollment period for anticipated family members, effective January 1, 2027, with coverage not starting until actual birth or adoption. - Subsection (f) sets documentation requirements: a physician's note, ultrasound result, or urine test for pregnancy, or Commissioner-specified paperwork for adoption. - Subsection (g) limits preenrollment submissions to cases where birth or adoption is expected within three months. - Subsection (h) requires insurers to disclose coverage and premium changes and explain the 31-day notification rule within ten business days of receiving documentation. - Subsection (j) prohibits insurers from imposing special cost-sharing terms on the preenrollment benefit beyond those applied to other covered benefits. - Subsection (m) applies the new rules to policies executed, delivered, or renewed on or after January 1, 2027, with contracts deemed renewed no later than their first anniversary. ## Status - Status: Introduced (2026-02-02) - Last action: House Second Readers (2026-02-04) - Sponsors: Sharon Cooper, Jan Jones, Lee Hawkins, Eric Gisler, Leesa Hagan, Spencer Frye - Official page: https://www.legis.ga.gov/legislation/72710 > The history, votes, and amendments (129 characters) are at https://georgiacommons.org/bills/2025-2026/hb1149.md?full=1