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2013 SESSION

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Senate Committee on Commerce and Labor
Subcommittee Health Insurance

McWaters (Chairman), Stuart, Herring

Clerk: Maribeth Turner, Cheryl Law
Staff: Frank Munyan
Date of Meeting: January 16, 2013
Time and Place:

S.B. 922 Health insurance; plan management and rate review.

Patron: Watkins

Health insurance; plan management and rate review. Authorizes the State Corporation Commission (SCC), with assistance from the Virginia Department of Health, to perform plan management functions required to certify health benefit plans for participation in a federally facilitated health benefit exchange in Virginia. This obligation is contingent upon the availability of full funding, technology infrastructure being made available to the SCC, and there being no other impediments that effectively prevent the SCC from performing any required plan management functions. In addition, the SCC's obligation to perform plan management functions is contingent upon receiving federal funding sufficient to pay the operating expenses necessary to carry out the functions. The SCC may contract with and enter into memoranda of understanding to carry out its plan management functions with any state or federal agency. The measure also authorizes the SCC to review and approve accident and sickness insurance premium rates applicable to health benefit plans in the individual and small group markets and health benefit plans providing health insurance coverage in the individual market through certain non-employer group plans. The power to review and approve rates is a condition to the SCC being found to be an effective regulator of such rates. Finally, the measure authorizes the Virginia Department of Health to assist the SCC in carrying out the plan management functions. The measure will take effect upon its passage.

A BILL amend and reenact §§ 32.1-16 and 32.1-137.2 of the Code of Virginia and §§ 38.2-4214, 38.2-4319, and 38.2-4509 of the Code of Virginia as they are currently effective and as they shall become effective, and to amend the Code of Virginia by adding in Chapter 3 of Title 38.2 sections numbered 38.2-316.1 and 38.2-326, relating to the powers of the State Corporation Commission to perform plan management functions for participation in a federally facilitated health benefit exchange; review and approval of health insurance premium rates.

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EMERGENCY

S.B. 924 Virginia Health Benefit Exchange; created, report.

Patron: Watkins

Virginia Health Benefit Exchange. Creates the Virginia Health Benefit Exchange, which will be established and operated by a new division within the State Corporation Commission (SCC). The Exchange shall facilitate the purchase and sale of qualified health plans and qualified dental plans to qualified individuals and qualified employers. The Exchange shall make qualified plans available to qualified individuals and qualified employers beginning with effective dates on January 1, 2014, which date may be postponed by the SCC as it deems necessary to permit the completion of the establishment of the Exchange. The Exchange will be funded by assessments on health insurers offering plans in the Exchange. A health plan will not be required to cover any state mandated health benefit if federal law does not require it to be covered as part of the essential benefits package. The essential health benefits are items and services included in the benchmark health insurance plan, which is the largest plan in the largest product in the Commonwealth's small group market as supplemented in order to provide coverage for the items and services within the statutory essential health benefits categories. The Exchange shall ensure that no qualified health insurance plan that is sold or offered for sale through the Exchange provides coverage for abortions, except for an abortion performed (i) when the life of the mother is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, or (ii) when the pregnancy is the result of an alleged act of rape or incest. The measure also authorizes the SCC to review and approve accident and sickness insurance premium rates applicable to health benefit plans in the individual and small group markets and health benefit plans providing health insurance coverage in the individual market through certain non-employer group plans. The power to review and approve rates is a condition to the SCC being found to be an effective regulator of such rates, which finding is a requirement for its operation of a state-run health benefit exchange.

A BILL to amend and reenact §§ 38.2-4214, 38.2-4319, and 38.2-4509, as they are currently effective and as they shall become effective, of the Code of Virginia and to amend the Code of Virginia by adding a section numbered 38.2-316.1 and by adding in Title 38.2 a chapter numbered 64, consisting of sections numbered 38.2-6400 through 38.2-6416, relating to the establishment and operation of a health benefit exchange for the Commonwealth; assessments.

13101038D

S.B. 1084 Health insurance; authorizes SCC to establish state plan management partnership exchange.

Patron: Herring


State partnership health benefit exchange. Directs the State Corporation Commission (SCC) to contract with and enter into memoranda of understanding with the U.S. Department of Health and Human Services or any other state or federal agency as may be required in order to establish a state plan management partnership exchange for the Commonwealth. The SCC, with assistance from the Virginia Department of Health, is required to perform any plan management functions consistent with guidelines developed by the Secretary of the U.S. Department of Health and Human Services to support such an exchange in Virginia. The SCC's obligation to perform plan management functions is contingent upon the availability of full funding, technology infrastructure being made available, and there being no other impediments that effectively prevent the SCC from performing any required plan management functions. In addition, the SCC's obligation to perform plan management functions is contingent upon receiving a general fund appropriation sufficient to pay the operating expenses necessary to carry out the functions. The SCC is required to seek full reimbursement from the U.S. Department of Health and Human Services for the expenses and to reimburse the general fund for the amount received. The SCC may contract with and enter into memoranda of understanding to carry out its plan management functions with any state or federal agency. The Department of Health, Department of Medical Assistance Services, and Department of Social Services are authorized to assist the SCC in the establishment, operation, and plan management functions of a state plan management partnership exchange. The SCC may not use special fund revenues dedicated to its other functions and duties to fund plan management functions. The measure also authorizes the SCC to review and approve accident and sickness insurance premium rates applicable to health benefit plans in the individual and small group markets and health benefit plans providing health insurance coverage in the individual market through certain non-employer group plans. The power to review and approve rates is a condition to the SCC being found to be an effective regulator of such rates, which finding is a requirement for its participation in the health benefit exchange partnership model. The measure will take effect upon its passage.

A BILL to amend and reenact §§ 32.1-16, 32.1-137.2, and 32.1-321.1 of the Code of Virginia, §§ 38.2-4214, 38.2-4319, and 38.2-4509 of the Code of Virginia as they are currently effective and as they shall become effective, and § 63.2-206 of the Code of Virginia and to amend the Code of Virginia by adding in Chapter 3 of Title 38.2 sections numbered 38.2-316.1 and 38.2-326, relating to the participation of the Commonwealth in a state plan management partnership exchange; review and approval of health insurance premium rates.

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EMERGENCY