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2009 SESSION

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SB 1411 Health insurance, basic; increasing availability thereof in State.

Introduced by: John C. Watkins | all patrons    ...    notes | add to my profiles

SUMMARY AS ENACTED WITH GOVERNOR'S RECOMMENDATION: (all summaries)

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, except that coverage shall be provided for mammograms, pap smears, PSA testing, and colorectal cancer screenings.  Applications and enrollment forms shall disclose prominently any and all state-mandated health benefits that are not provided and shall clearly describe all eligibility requirements. 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.


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