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2020 SESSION
SB 861 Group health benefit plans; bona fide associations, benefits consortium.
Introduced by: T. Montgomery "Monty" Mason | all patrons ... notes | add to my profiles
SUMMARY AS PASSED: (all summaries)
Group health benefit plans; bona fide associations; benefits consortium. Provides that certain trusts constitute a benefits consortium and are authorized to sell health benefits plans to members of a sponsoring association that (i) has been formed and maintained in good faith for purposes other than obtaining or providing health benefits; (ii) does not condition membership in the sponsoring association on any factor relating to the health status of an individual, including an employee of a member of the sponsoring association or a dependent of such an employee; (iii) makes any health benefit plan available to all members regardless of any factor relating to the health status of such members or individuals eligible for coverage through a member; (iv) does not make any health benefit plan available to any person who is not a member of the association; (v) makes available health plans or health benefit plans that meet requirements provided for in the bill; (vi) operates as a nonprofit entity under § 501(c)(5) or 501(c)(6) of the Internal Revenue Code; and (vii) has been in active existence for at least five years. The bill replaces references to "bona fide association," as used in provisions applicable to health care plans in the small employer market, with the term "sponsoring association."
The bill requires any health benefit plan issued by a self-funded multiple employer welfare arrangement (MEWA) that covers one or more employees of one or more small employers to (a) provide essential health benefits and cost-sharing requirements; (b) offer a minimum level of coverage designed to provide benefits that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided under the plan; (c) not limit or exclude coverage for an individual by imposing a preexisting condition exclusion on that individual; (d) be prohibited from establishing discriminatory rules based on health status related to eligibility or premium or contribution requirements as imposed on health carriers; (e) meet the renewability standards set forth for health insurance issuers; (f) establish base rates formed on an actuarially sound, modified community rating methodology that considers the pooling of all participant claims; and (g) utilize each employer member's specific risk profile to determine premiums by actuarially adjusting above or below established base rates, and utilize either pooling or reinsurance of individual large claimants to reduce the adverse impact on any specific employer member's premiums.
The bill prohibits a self-funded MEWA from issuing health benefit plans in the Commonwealth until it has obtained a license pursuant to regulations promulgated by the Commission. The bill authorizes the Commission to adopt regulations applicable to self-funded MEWAs, including regulations addressing financial condition, solvency requirements, and the exclusion of self-funded MEWAs from the Virginia Life, Accident and Sickness Insurance Guaranty Association.
FULL TEXT
- 01/08/20 Senate: Prefiled and ordered printed; offered 01/08/20 20103816D pdf | impact statement
- 01/23/20 Senate: Printed as engrossed 20103816D-E pdf | impact statement
- 02/25/20 House: Committee substitute printed 20108216D-H1 pdf | impact statement
- 03/06/20 Senate: Bill text as passed Senate and House (SB861ER) pdf | impact statement
AMENDMENTS
- House subcommittee amendments and substitutes offered
- House subcommittee amendments and substitutes adopted
- House committee, floor amendments and substitutes offered
- Senate amendments
- Governor's recommendation
- Governor's veto explanation
HISTORY
- 01/08/20 Senate: Prefiled and ordered printed; offered 01/08/20 20103816D
- 01/08/20 Senate: Referred to Committee on Commerce and Labor
- 01/15/20 Senate: Assigned C&L sub: Health Insurance
- 01/20/20 Senate: Reported from Commerce and Labor with amendments (14-Y 0-N 1-A)
- 01/22/20 Senate: Constitutional reading dispensed (40-Y 0-N)
- 01/23/20 Senate: Read second time
- 01/23/20 Senate: Reading of amendments waived
- 01/23/20 Senate: Committee amendments agreed to
- 01/23/20 Senate: Engrossed by Senate as amended SB861E
- 01/23/20 Senate: Printed as engrossed 20103816D-E
- 01/24/20 Senate: Read third time and passed Senate (35-Y 2-N)
- 02/13/20 House: Placed on Calendar
- 02/13/20 House: Read first time
- 02/13/20 House: Referred to Committee on Labor and Commerce
- 02/18/20 House: Subcommittee recommends reporting with substitute (8-Y 0-N)
- 02/25/20 House: Reported from Labor and Commerce with substitute (8-Y 7-N)
- 02/25/20 House: Committee substitute printed 20108216D-H1
- 02/27/20 House: Read second time
- 02/28/20 House: Passed by for the day
- 03/02/20 House: Read third time
- 03/02/20 House: Committee substitute agreed to 20108216D-H1
- 03/02/20 House: Engrossed by House - committee substitute SB861H1
- 03/02/20 House: Passed House with substitute (57-Y 41-N)
- 03/02/20 House: VOTE: Passage (57-Y 41-N)
- 03/03/20 Senate: House substitute agreed to by Senate (40-Y 0-N)
- 03/03/20 Senate: Title replaced 20108216D-H1
- 03/06/20 Senate: Enrolled
- 03/06/20 Senate: Bill text as passed Senate and House (SB861ER)
- 03/07/20 Senate: Signed by President
- 03/07/20 House: Signed by Speaker
- 03/12/20 Senate: Enrolled Bill Communicated to Governor on March 12, 2020
- 03/12/20 Governor: Governor's Action Deadline 11:59 p.m., April 11, 2020
- 04/11/20 Senate: Governor's recommendation received by Senate
- 04/22/20 Senate: Senate rejected Governor's recommendation (7-Y 33-N)
- 04/22/20 Senate: Communicated to Governor
- 04/22/20 Governor: Governor's Action Deadline 11:59 p.m., May 22, 2020
- 05/21/20 Governor: Vetoed by Governor