(a) No policy of group health insurance shall be delivered or issued in the District of Columbia or be issued or amended to cover any resident of the District of Columbia if it contains a provision which would restrict access to psychologists or optometrists. When a policy relating to group health insurance requires payment or reimbursement for services which may be performed by a duly licensed psychologist or optometrist, any person covered by the policy shall be free to select and have direct access to such psychologist or optometrist without supervision or referral by a practitioner of the healing art and shall be entitled under the policy to have payment or reimbursement made for services performed.
(b) No policy of group health insurance shall be delivered or issued in the District or be issued or amended to cover any resident of the District if it does not contain a provision which:
(1) For a policy issued or renewed after April 15, 1995, covers a minor grandchild, niece, or nephew of an employee of the District of Columbia if the minor grandchild, niece, or nephew is under the primary care of the insured, and if the legal guardian of the minor grandchild, niece, or nephew, if other than the insured, is not covered by an accident or sickness policy. For the purposes of this paragraph, the term “primary care” means that the insured provides food, clothing, and shelter, on a regular and continuous basis, for the minor grandchild, niece, or nephew during the time that the District of Columbia public schools are in regular session; and
(2) For a policy issued or renewed after April 15, 1996, covers a minor grandchild, niece, or nephew under the primary care of the insured, and if the legal guardian of the minor grandchild, niece, or nephew, if other than the insured, is not covered by an accident or sickness policy. For the purposes of this paragraph, the term “primary care” means that the insured provides food, clothing, and shelter, on a regular and continuous basis, for the minor grandchild, niece or nephew during the time that the District of Columbia public schools are in regular session.
(June 19, 1934, 48 Stat. 1156, ch. 672, ch. V, § 24; as added Feb. 11, 1982, D.C. Law 4-66,§ 2(b), 28 DCR 5040; Aug. 25, 1994, D.C. Law 10-158, § 3, 41 DCR 4881.)
1981 Ed., § 35-530.
This section is referenced in § 31-3503 and § 31-4712.
Hospital and medical services corporations, applicability of this section, see § 31-3503.
Structure District of Columbia Code
Title 31 - Insurance and Securities
Chapter 47 - Provisions Relating to All Life Insurance Companies
§ 31–4701. Valuation of reserves by Commissioner
§ 31–4702. Companies issuing both participating and nonparticipating policies
§ 31–4703. Life policies — Required provisions
§ 31–4704. Life policies — Prohibited provisions
§ 31–4705.01. Nonforfeiture benefits and cash surrender values
§ 31–4705.02. Standard nonforfeiture law — In general
§ 31–4705.03. Standard nonforfeiture law — Individual deferred annuities
§ 31–4705.04. Loan provisions in policies
§ 31–4706. Extension of time for payment of premiums
§ 31–4707. Ascertainment of loan indebtedness
§ 31–4708. Filing and approval of life policy forms
§ 31–4709. Policy provisions required by foreign government entities
§ 31–4710. Group policies — General requirements. [Repealed]
§ 31–4711. Group policies — Required provisions
§ 31–4711.01. Group policies — Right to, and notice of, issuance of individual policy
§ 31–4712. Accident and sickness policies
§ 31–4713. Prohibited activities — Securities operations. [Repealed]
§ 31–4714. Prohibited activities—Misrepresentations. [Repealed]
§ 31–4715. Prohibited activities—Discriminations. [Repealed]
§ 31–4716. Rights of parties under life policies
§ 31–4716.01. Exemption from legal process — Disability benefits
§ 31–4717. Exemption from legal process — Group life policy or proceeds
§ 31–4718. Fraudulent statements or representations against companies. [Repealed]
§ 31–4719. Authority to hold proceeds under trust or agreement
§ 31–4720. Calculations of premiums and reserves
§ 31–4721. Acceptance and recordation of premiums on industrial life or sick-benefit policies
§ 31–4722. Industrial life policies — Required provisions
§ 31–4723. Industrial life policies — Prohibited provisions
§ 31–4724. Access to psychologists or optometrists under group health insurance policy
§ 31–4725. Policy language simplification standards
§ 31–4726. Commissioner’s review of test
§ 31–4727. Applicability of §§ 31-4725 through 31-4730
§ 31–4729. Construction of §§ 31-4725 through 31-4730