HB 1149: Insurance; offer a preenrollment option for anticipated newly born or adopted children; require certain health insurers

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.

• 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.

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.

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.

• 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.

1. 2026-02-04House Second Readers (Cámara de Representantes)
2. 2026-02-03House First Readers (Cámara de Representantes)
3. 2026-02-02House Hopper (Cámara de Representantes)

• Sharon Cooper (R, HD-045)Patrocinador principal
• Jan Jones (R, HD-047)
• Lee Hawkins (R, HD-027)
• Eric Gisler (D, HD-121)
• Leesa Hagan (R, HD-156)
• Spencer Frye (D, HD-122)

• health insurance
• newborn coverage
• adoption
• insurance regulation
• maternity care