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2009 SESSION

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HB 1829 Health insurance, individual; requires SCC establish, by regulation, etc., for underwriting thereof.

Introduced by: William H. Fralin, Jr. | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Individual health insurance; classes of coverage.  Requires the State Corporation Commission to establish, by regulation, classes, and tiers with each class, for the underwriting of health insurance coverage in the individual market. Classes and tiers shall recognize the risk associated with an individual's health condition or diagnosis, while differentiating among individuals diagnosed with or treated for a specific illness, disease, or condition based upon factors including the individual's current health condition and diagnosis; the current severity of the illness, disease, or condition; the prognosis for increased severity during the term of the coverage; projections of medical treatments and services expected to be required during the term of the coverage; and the extent to which the symptoms or pathologies associated with the illness, disease, or condition are adequately controlled through such measures as medication, diet, and exercise. Health insurers are required to underwrite such individual health insurance coverage, and to rate insured individuals, in a manner that ensures that the individual is placed in the appropriate class or tier. Insurers are required to provide an internal review procedure, and individuals aggrieved by the insurer's decision may appeal to the Commission, which may modify, affirm, or reverse the decision.


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