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2009 SESSION

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HB 2024 Health insurance, basic; increasing availability thereof in State.

Introduced by: Daniel W. Marshall, III | all patrons    ...    notes | add to my profiles | history

SUMMARY AS ENACTED WITH GOVERNOR'S RECOMMENDATION:

Availability of basic health insurance.  Allows health insurers to offer and sell group health insurance policies or contracts that do not include state mandated health insurance benefits to employers with 50 or fewer employees to provide coverage for employees. Such a group policy or contract may include any, or none, of the state-mandated health benefits as the health insurer and the qualified small employer agree.  Applications and enrollment forms for such policies shall disclose prominently the mandated benefits that are provided by the policy. The measure also provides that a plan of correction prepared by a holder of a certificate of public need for a medical care facility may allow the holder to satisfy the conditions of the certificate regarding the provision of charity care by (i) making direct payments to a private nonprofit foundation that funds basic insurance coverage for indigents authorized under a memorandum of understanding with the Department of Health to receive contributions satisfying conditions of a certificate, or (ii) other documented efforts to provide primary or specialized care to underserved populations.  The measure states that a health insurance policy or subscription contract may include caps or limits on the total annual or lifetime benefits provided thereunder at specified dollar amounts, which statement is declarative of existing law. Health insurers offering plans under this act are required to report annually to the Bureau of Insurance on the number of small employers and individuals using plans that do not offer mandated benefits, the coverage provided, and the cost of premiums and out-of-pocket expenses, which information shall be compiled, evaluated, and submitted to the Governor and General Assembly. Finally, the measure provides that employees of small employers whose group health insurance coverage does not provide for continuation of coverage under federal COBRA, and who are involuntarily terminated during the period beginning September 1, 2008, and ending December 31, 2009, or during any period for which premium assistance is specified by the American Recovery and Reinvestment Act, as later amended, shall be offered the option to continue their existing group health insurance coverage; this provision will take effect upon passage.  HB 2209 is incorporated.

SUMMARY AS PASSED:

Availability of basic health insurance.  Allows health insurers to offer and sell group health insurance policies or contracts that do not include state mandated health insurance benefits to employers with 50 or fewer employees to provide coverage for employees who have been uninsured during the preceding six months. Such a group policy or contract may include any, or none, of the state-mandated health benefits as the health insurer and the qualified small employer agree. Contracts shall be filed with the Bureau of Insurance and shall disclose the mandated benefits that are excluded from coverage. The measure also provides that a plan of correction prepared by a holder of a certificate of public need for a medical care facility may allow the holder to satisfy the conditions of the certificate regarding the provision of charity care by (i) making direct payments to a private nonprofit foundation that funds basic insurance coverage for indigents authorized under a memorandum of understanding with the Department of Health to receive contributions satisfying conditions of a certificate, or (ii) other documented efforts to provide primary or specialized care to underserved populations. Finally, the measure states that a health insurance policy or subscription contract may include caps or limits on the total annual or lifetime benefits provided thereunder at specified dollar amounts, which statement is declarative of existing law. Health insurers offering plans under this act are required to report annually to the Bureau of Insurance on the number of small employers and individuals using plans that do not offer mandated benefits, the coverage provided, and the cost of premiums and out-of-pocket expenses, which information shall be compiled, evaluated, and submitted to the Governor and General Assembly. HB 2209 is incorporated and SB 1411 is identical.

SUMMARY AS PASSED HOUSE:

Availability of basic health insurance.  Allows health insurers to offer and sell group health insurance policies or contracts that do not include state mandated health insurance benefits to employers with 50 or fewer employees in order to provide coverage for employees who have been uninsured during the preceding six months. Such a group policy or contract may include any, or none, of the state-mandated health benefits as the health insurer and the small employer agree. The measure also provides that a plan of correction prepared by a holder of a certificate of public need for a medical care facility may allow the holder to satisfy the conditions of the certificate regarding the provision of charity care by (i) making direct payments to an organization authorized under a memorandum of understanding with the Department of Health to receive contributions satisfying conditions of a certificate, or (ii) making direct payments to a private nonprofit foundation that funds basic insurance coverage for indigents authorized under a memorandum of understanding with the Department to receive contributions satisfying conditions of a certificate. Finally, the measure states that a health insurance policy or subscription contract may include caps or limits on the total annual or lifetime benefits provided thereunder at specified dollar amounts, which statement is declarative of existing law. Health insurers offering plans under this act are required to report annually to the Bureau of Insurance on the number of small employers and individuals using plans that do not offer mandated benefits, which information shall be compiled, evaluated, and submitted to the Governor and General Assembly. If a plan includes health care services covered by the plan that may be provided by a health care provider who is not a physician, the plan allows for the reimbursement of such covered services by such provider. HB 2209 is incorporated.

SUMMARY AS INTRODUCED:

Availability of basic health insurance.  Allows health insurers to offer and sell group health insurance policies or contracts that do not include state mandated health insurance benefits to employers with 50 or fewer employees if the employer has not offered health insurance coverage to its employees during the preceding six months. Such a group policy or contract may include any, or none, of the state-mandated health benefits as the health insurer and the qualified small employer agree. The measure also provides that a person that obtained a certificate of public need for a medical care facility subject to an agreement to provide charity care may satisfy such conditions by making direct payments to an entity that is authorized to receive payments satisfying charity care conditions or to a private nonprofit foundation that funds basic health insurance coverage to indigents pursuant to a memorandum of understanding with the Department of Health. Finally, the measure states that a health insurance policy or subscription contract may include caps or limits on the total annual or lifetime benefits provided thereunder at specified dollar amounts.