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HB 372 (BR 1303) - T. Thompson, B. Smith, J. Adams, Dw. Butler, M. Cherry, D. Horlander, F. Nesler, R. Palumbo, R. Thomas, R. Wilkey, B. Yonts
AN ACT relating to insurance.
Amend KRS 304.17A-200 to permit small employers with two to ten employees to refuse coverage to all individuals; allow an insurer to refuse to accept all small employers in the small group market who apply for coverage if the insurer's small group offering is made through a bona fide association program or employer-organized association program; create a new section of Subtitle 17A of KRS Chapter 304 to direct an insurer to offer to employer-organized associations a health benefit plan that excludes mandated health benefits; create new sections of Subtitles 17A, 18, and 38 of KRS Chapter 304 to require group insurers to provide to an employer-organized association health benefit plan requested claim and expense information for the previous three years; create a new section of Subtitle 18 of KRS Chapter 304 to provide that beginning no later than August 1, 2004, every insurer shall use the uniform employee application form developed by the commissioner; amend KRS 304.12-090 to prohibit an insurer from negotiating any pricing with any person for a good or service under a health insurance contract that includes a rebate or return of funds in any form to the insurer, unless that insurer returns such funds directly to the policyholder in the form of direct funds or premium reductions, and accounts directly to the policyholder for the application of any such funds returned to the insurers.
HB 372 - AMENDMENTS
HCS - Retain original provisions except: substitute employer-organized association for small group market; provide that state-mandated benefits that are excluded from coverage shall not include payment, indemnity or reimbursement of specified health care providers for specific health care service; provide that drug rebates are included in restrictions on price negotiations; and, amend KRS 304.17B-15 to authorize selection to participate in Kentucky access rather than the employer-organized association health benefit plan.
HFA (1, T. Thompson) - Provide that upon request an insurer must offer an employer-organized association a health benefit plan that excludes coverage for any state-mandated health insurance benefits; change limited health benefit plan to modified health benefit plan; clarify that an employer-organized association may request information from an insurer pertaining to the association's plan; provide that the uniform employee application form be used in the association and employer-organized association insurance markets; clarify that a person is eligible for Kentucky Access coverage if the person is enrolled in a small group of two (2) to ten (10) employees which is eligible for participation in an employer-organized association health benefit plan and the person has voluntarily waived the association group coverage pursuant to this Act; provide that this Act may be cited as the Small Business Health Insurance Relief Act of 2004.
HFA (2, T. Thompson) - Provide that upon request an insurer must offer an employer-organized association a health benefit plan that excludes coverage for any state-mandated health insurance benefits; change "limited" health benefit plan to "modified" health benefit plan; clarify that an employer-organized association may request information from an insurer pertaining to the association's plan; provide that the uniform employee application form be used in the association and employer-organized association insurance markets; clarify that a person is eligible for Kentucky Access coverage if the person is eligible to be enrolled in a small group of two to ten employees that is eligible for participation in an employer-organized association health benefit plan and the person has voluntarily waived the association group coverage pursuant to this Act; provide that this Act may be cited as the Small Business Health Insurance Relief Act of 2004.
HFA (3, B. Crall) - Delete provisions that expand eligibility for Kentucky Access coverage to persons who refuse coverage in groups of two (2) to ten (10) persons.
HFA (4, B. Crall) - Provide that effective January 1, 2005, an insurer that offers, renews, or delivers a health benefit plan in Kentucky may offer as an option a plan that excludes from coverage state mandated health insurance benefits; provide that an insurer shall not be required to utilize the experience of enrollees of plans that contain mandated benefits to develop the insurer's index rate for plans offered under this section that exclude mandated benefits.
HFA (5, B. Crall) - Delete provision that permits employer-organized association plan to request the insurer of the plan to provide detailed claim and expense information as the plan may request; permit the insurer to charge a reasonable fee per page to cover its administrative costs in providing the requested information to the plan.
HFA (6, B. Crall) - Delete provision that allows a rebate or return of funds, including but not limited to drug rebates, under certain circumstances.
HFA (7, T. Thompson) - Provide that upon request an insurer shall offer a small employer, association, or employer-organized association a health benefit plan that excludes coverage for any state-mandated health insurance benefits, except coverage for diabetes and those benefits mandated by federal law; change limited health benefit plan to modified health benefit plan; clarify that an employer-organized association may request information from an insurer pertaining to the association's plan but that the insurer shall not be required to provide confidential network pricing information; provide that the uniform employee application form be used in the association and employer-organized association insurance markets; clarify that a person is eligible for Kentucky Access coverage if the person is eligible to be enrolled in a small group of two (2) to ten (10) employees which is eligible for participation in an employer-organized association health benefit plan and the person has voluntarily waived the association group coverage pursuant to this Act; provide that this Act may be cited as the Small Business Health Insurance Relief Act of 2004.
HFA (8, B. Smith) - Provide that upon request an insurer must offer a small employer, association, or employer-organized association a health benefit plan that excludes coverage for any state-mandated health insurance benefits, except coverage for diabetes and those benefits mandated by federal law; change "limited" health benefit plan to "modified" health benefit plan; clarify that an employer-organized association may request information from an insurer pertaining to the association's plan but that the insurer shall not be required to provide confidential network pricing information; provide that the uniform employee application form be used in the association and employer-organized association insurance markets; clarify that a person is eligible for Kentucky Access coverage if the person is eligible to be enrolled in a small group of two to ten employees which is eligible for participation in an employer-organized association health benefit plan and the person has voluntarily waived the association group coverage pursuant to this Act; provide that this Act may be cited as the Small Business Health Insurance Relief Act of 2004.
HFA (9/HM, S. Nunn) - Require an insurer, upon request, to offer a small employer, association, or employer-organized association a benefit plan that excludes coverage for any state-mandated health insurance benefits, except for antipsychotic medications prescribed to treat mental illness and prescription drugs prescribed to treat human immunodeficiency virus or acquired immunodeficiency syndrome; and create a new section of Subtitle 17A of KRS Chapter 304 to prohibit a health benefit plan from restricting or denying access to antipsychotic medications prescribed to treat a mental illness or prescription drugs prescribed to treat human immunodeficiency virus or acquired immunodeficiency syndrome.
HFA (10, J. Wayne) - Permit eligibility for Kentucky Access to an individual enrolled or eligible to be enrolled in a small group of 2 to 10 employees which is eligible for participation in an employer-organized association plan and the individual has a high-cost health condition.
HFA (11, P. Bather) - Provide that as to a health benefit plan that waives mandated benefits, mandated benefits excluded shall be deemed to include the payment, indemnity, or reimbursement of specified health care providers unless authorized in writing by the health benefit plan prior to delivery of services.
Jan 26-introduced in House
Jan 27-to Banking and Insurance (H)
Jan 29-posted in committee
Feb 4-reported favorably, 1st reading, to Calendar with Committee Substitute
Feb 5-2nd reading, to Rules
Feb 6-floor amendment (1) filed to Committee Substitute
Feb 9-floor amendment (2) filed to Committee Substitute
Feb 10-floor amendments (3) (4) (5) (6) and (7) filed to Committee Substitute
Feb 11-floor amendment (8) filed to Committee Substitute ; posted for passage in the Regular Orders of the Day for Thursday, February 12, 2004
Feb 12-floor amendment (9) filed to Committee Substitute
Feb 17-floor amendment (10) filed to Committee Substitute
Feb 19-floor amendment (11) filed to Committee Substitute ; 3rd reading; floor amendment (4) ruled out of order ; floor amendment (5) rejected ; passed 89-4 with Committee Substitute, floor amendments (8) and (10)
Feb 20-received in Senate
Feb 25-to Appropriations and Revenue (S)
Mar 3-reassigned to Banking and Insurance (S)
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