Updated Notification Regarding Coverage Requirement and Issuer Accommodation Notification

BULLETIN

26-IB-001-1/6

TO:

HEALTH INSURERS OPERATING IN THE DISTRICT OF COLUMBIA

FROM:

KARIMA WOODS, COMMISSIONER

SUBJECT:

UPDATED NOTICE REGARDING COVERAGE REQUIREMENT AND

ISSUER ACCOMMODATION NOTIFICATION

DATE:

FEBRUARY 11, 2026

The purpose of this Bulletin is to implement provisions of the Defending Access to Women’s

Health Care Services Amendment Act of 2018, effective March 28, 2018 (D.C. Law 22-75, 65

DCR 1374). First, the Bulletin is intended to remind health insurers of their responsibility to

provide insureds with an annual notice of their obligation to provide coverage for services, drugs,

devices, products, and procedures as required by section 5e(c) of the Women’s Health and

Cancer Rights Federal Law Conformity Act of 2000, effective April 3, 2001 (D.C. Law 13-254,

as added March 28, 2018 by D.C. Law 22-75; D.C. Official Code § 31-3834.05(c)) (the “2018

Act”). Second, the Bulletin outlines the procedures and provides forms to comply with the

employer self-certification of religious exemptions and issuer accommodation notification

required by D.C. Official Code § 31-3834.04(b)(2) and (c). This Bulletin constitutes interpretive

guidance.

In 2023, the Expanding Access to Fertility Treatment Amendment Act (D.C. Law 25-49)

amended § 31-3834.04 to expand the scope of coverage obligations for which an employer may

request religious accommodation. Under the amended statute, group health insurance issuers

must now provide accommodation not only for contraceptive services, but for any services

required under §§ 31-3834.01, 31-3834.02, 31-3834.03, 31-3834.03a, 31-3834.06, and 31-

3834.07. Accordingly, the Department is updating this Bulletin and its accompanying forms to

reflect the broadened statutory requirements and to ensure that issuers and employers comply

with the full scope of accommodation obligations under § 31-3834.04(c).

Notice of Rights to Healthcare Coverage

To comply with D.C

d under §§ 31-3834.01, 31-3834.02, 31-3834.03, 31-3834.03a, 31-3834.06, and 31-

3834.07. Accordingly, the Department is updating this Bulletin and its accompanying forms to

reflect the broadened statutory requirements and to ensure that issuers and employers comply

with the full scope of accommodation obligations under § 31-3834.04(c).

Notice of Rights to Healthcare Coverage

To comply with D.C. Official Code § 31-3834.05, the Department hereby gives notice to all health

insurers of their obligation to make readily accessible to enrollees and potential enrollees

information concerning the coverage of all services, drugs, devices, products, and procedures

required under §§ 31-3834.01, 31-3834.02, 31-3834.03, 31-3834.03a, 3834.06, and 31-3834.07.

As applicable, an insurer subject to these provisions shall make readily accessible full and accurate

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information relevant to coverage and cost-sharing for required services, including but not limited

to contraceptive services, voluntary sterilization procedures, fertility-enhancing drugs and

infertility diagnosis and treatment, abortion and abortion-care services, and additional services

described in §§ 31-3834.01, 31-3834.02, 31-3834.03, 31-3834.03a, 3834.06, and 31-3834.07. This

information shall include an explanation of an insured’s financial responsibility for premiums,

coinsurance, copayments, deductibles, and any other charges.

Health insurers shall provide the information described in § 31-3834.01 in the following

consumer-friendly formats:

1. A version 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;

2. By email or letter within 14 days after a request by an enrollee; or

3. In written materials that explain benefits or coverage that are provided to enrollees and

potential enrollees, including in an addendum summarizing benefits and coverage

at 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;

2. By email or letter within 14 days after a request by an enrollee; or

3. In written materials that explain benefits or coverage that are provided to enrollees and

potential enrollees, including in an addendum summarizing benefits and coverage.

Employer Notice of Request for Accommodation and Self-Certification and Issuer

Accommodation Notification

To comply with D.C. Official Code §§ 31-3834.04(b) and (c), the Department is making

available the following forms:

(1) Employer Notice of Request for Accommodation and Self-Certification Form; and

(2) Issuer Accommodation Notification Form.

Employer Notice of Request for Accommodation and Self-Certification Form

An employer claiming an exemption under D.C. Official Code § 31-3834.04(a) shall provide a

notice of request for accommodation to a group health insurance issuer pursuant to § 31-3834.04(b)

indicating that it meets the criterion in §§ 31-3834.04(c)(1) or (2) and has a religious objection to

providing coverage of one or more services required under §§ 31-3834.01, 31-3834.02, 31-

3834.03, 31-3834.03a, 31-3834.06, or 31-3834.07. A group health insurance issuer that has

certified that the employer meets the requirements of §§ 31-3834.04(c)(1) or (2) shall provide the

employer an accommodation pursuant to § 31-3834.04(c).

Group health insurance issuers shall make available to employers the Employer Notice of Request

for Accommodation and Self-Certification Form.

Issuer Accommodation Notification Form

Group health insurance issuers shall notify the Department on a quarterly basis which employers

have been granted accommodations pursuant to D.C. Official Code § 31-3834.04(c).

If a group health insurance issuer has not granted any accommodation during a given quarterly

period, no notification is required for that period.

n and Self-Certification Form.

Issuer Accommodation Notification Form

Group health insurance issuers shall notify the Department on a quarterly basis which employers

have been granted accommodations pursuant to D.C. Official Code § 31-3834.04(c).

If a group health insurance issuer has not granted any accommodation during a given quarterly

period, no notification is required for that period.

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Quarterly notifications, when required, shall be submitted via email to Insurance.Bureau@dc.gov.

The quarterly notification schedule shall follow the standard calendar quarters:

•

January 1 – March 31 (Notification due April 30)

•

April 1 – June 30 (Notification due July 31)

•

July 1 – September 30 (Notification due October 31)

•

October 1 – December 31 (Notification due January 31)

Employer Notice of Request for Accommodation and Self-Certification Form

The form shall be completed annually for any employer seeking accommodation. Once

completed, the form should be submitted via email to: (Insurer’s email address) or by U.S. mail

to: (Insurer’s mailing address).

Date:

_____________________

Plan Year:

_____________________

Group:

_____________________

The following eligible employer has a religious objection to providing coverage of:

[ ] All benefits and services required under §§ 31-3834.01, 31-3834.02, 31-3834.03, 31-

3834.03a, 3834.06, and 31-3834.07; OR

[ ] A subset of benefits and services required under §§ 31-3834.01, 31-3834.02, 31-3834.03, 31-

3834.03a, 3834.06, and 31-3834.07, specifically:

_____________________________________________________________

(1)

Name of eligible employer:

Contact information:

Eligible employer is a:

[ ] Closely held for-profit entity; OR [ ] Non-profit entity (religious organization)

(2)

If the eligible employer objects to providing coverage to a subset of benefits and services,

include a list of the benefits and services the eligible organization objects to covering:

______________________________________________

(1)

Name of eligible employer:

Contact information:

Eligible employer is a:

[ ] Closely held for-profit entity; OR [ ] Non-profit entity (religious organization)

(2)

If the eligible employer objects to providing coverage to a subset of benefits and services,

include a list of the benefits and services the eligible organization objects to covering:

(3)

Information being submitted is (check one):

[ ] Original information; OR

[ ] Updated information.

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If updated information is being provided, specify the date upon which the updated information

was, or will be, effective and what has changed:

_______________

Signature of authorized representative of eligible employer

Date

Typed name of authorized representative of eligible employer

Issuer Accommodation Notification Form

Notification Period

Section 31-3834(b)(2) of the D.C. Official Code mandates that all group health insurance issuers

notify the Department on a quarterly basis which employers have been granted an accommodation

pursuant to D.C. Official Code § 31-3834.04(c). To comply with this notification requirement,

issuers shall complete the following matrix for each notification period.

Employer

Name

Plan

Year

Group

Eligibility

Category

Objection to All or a

Subset of Benefits and

Services under §§ 31-

3834.01, 31-3834.02,

31-3834.03, 31-

3834.03a, 3834.06, and

31-3834.07

(If a subset, list specific

exempted services)

Comments

Completed notifications shall be submitted to the Department of Insurance, Securities and Banking

by email at Insurance.Bureau@dc.gov.

Any questions or concerns regarding this Bulletin may be directed to the Insurance Bureau of the

Department of Insurance, Securities and Banking by email at insurance.bureau@dc.gov or by

phone at (202) 727-8000.