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2009 SESSION

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SB 976 Basic health benefit plans; requires health insurer, etc., to offer to eligible individuals.

Introduced by: Richard H. Stuart | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Basic health benefit plans.  Requires every health insurer, health maintenance organization, and corporation providing accident and sickness subscription contracts, as a condition of transacting business in Virginia, to offer to eligible individuals a basic health benefit plan. Eligible individuals are residents of the Commonwealth that have a family income that does not exceed 150 percent of the federal poverty level, have not been insured within the preceding six months, and are not eligible for coverage under certain government-sponsored health plans. Coverage under a basic health insurance policy provides benefits of at least 75 percent of necessary, reasonable, and customary charges for medical care, including hospitalization, surgery, physician services, emergency services, diagnostic tests, with a minimum annual deductible of $5,000 for the eligible individual and $10,000 for the eligible individual and dependent coverage, with maximum annual amount out-of-pocket limits for co-payments, co-insurance, deductibles, and other cost-sharing arrangement of $10,000 for the eligible individual and $20,000 for the eligible individual and dependents, and with maximum lifetime benefits of at least $1 million. Such a policy will not provide benefits for routine physician visits, prescription drugs, or dental treatment, or for any mandated benefit.


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