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2013 SESSION

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HB 1769 Health insurance; SCC, et al., to perform plan management functions, review of premium rates.

Introduced by: Terry G. Kilgore | all patrons    ...    notes | add to my profiles

SUMMARY AS PASSED: (all summaries)

Health insurance; plan management and rate review. Authorizes the State Corporation Commission (SCC) to perform plan management functions for participation in the federal health benefit exchange established by the Secretary of the U.S. Department of Health and Human Services pursuant to § 1321 of the Patient Protection and Affordable Care Act. This obligation is contingent upon the availability of full funding, technology infrastructure being made available to the SCC, there being no other impediments that effectively prevent the SCC from performing any required plan management functions, and that the performance of such plan management functions is not deemed to establish a health benefit exchange pursuant to § 1311 of the Patient Protection and Affordable Care Act. 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. The measure provides that no agent, employee, officer, or agency of the Commonwealth is authorized to take any action to establish, or that could be deemed to establish, a health benefit exchange pursuant to § 1311 of the Patient Protection and Affordable Care Act. Finally, the measure authorizes the Virginia Department of Health to assist in the plan management functions. This bill is identical to SB 922.


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