AK
Alaska Senate Bill SB4

Alaska 2025-2026 Regular Session

Alaska Senate Bill SB4 Compare Versions

OldNewDifferences
11
2-SB0004B -1- CSSB 4(L&C)
2+SB0004A -1- SB 4
33 New Text Underlined [DELETED TEXT BRACKETED]
44
5-34-LS0040\H
5+34-LS0040\N
66
77
88
99
10-CS FOR SENATE BILL NO. 4(L&C)
10+
11+ SENATE BILL NO. 4
1112
1213 IN THE LEGISLATURE OF THE STATE OF ALASKA
1314
1415 THIRTY-FOURTH LEGISLATURE - FIRST SESSION
1516
16-BY THE SENATE LABOR AND COMMERCE COMMITTEE
17+BY SENATOR HUGHES
1718
18-Offered: 4/11/25
19-Referred: Health & Social Services
19+Introduced: 1/10/25
20+Referred: Prefiled
2021
21-Sponsor(s): SENATOR HUGHES
22+
2223 A BILL
2324
2425 FOR AN ACT ENTITLED
2526
2627 "An Act relating to a health care insurance policy incentive program; relating to health 1
2728 care services; and providing for an effective date." 2
2829 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
2930 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 4
3031 to read: 5
3132 SHORT TITLE. This Act may be known as the Alaska Health Care Consumer's Right 6
3233 to Shop Act. 7
33- * Sec. 2. AS 21.36.100 is amended to read: 8
34-Sec. 21.36.100. Rebates. Except as provided in AS 21.96.220 or otherwise
35-9
36-expressly provided by law, a person may not knowingly permit or offer to make or 10
37-make a contract of life insurance, life annuity or health insurance, or agreement under 11
38-the contract other than as plainly expressed in the contract, or pay, allow, give or offer 12
39-to pay, allow, or give, directly or indirectly, as inducement to the insurance, or 13
40-annuity, a rebate of premiums payable on the contract, or a special favor or advantage 14 34-LS0040\H
41-CSSB 4(L&C) -2- SB0004B
34+ * Sec. 2. AS 21.06.110 is amended to read: 8
35+Sec. 21.06.110. Director's annual report. As early in each calendar year as is 9
36+reasonably possible, the director shall prepare and deliver an annual report to the 10
37+commissioner, who shall notify the legislature that the report is available, showing, 11
38+with respect to the preceding calendar year, 12
39+(1) a list of the authorized insurers transacting insurance in this state, 13
40+with a summary of their financial statement as the director considers appropriate; 14 34-LS0040\N
41+SB 4 -2- SB0004A
4242 New Text Underlined [DELETED TEXT BRACKETED]
4343
44-in the dividends or other benefits, or paid employment or contract for services of any 1
45-kind, or any valuable consideration or inducement whatever not specified in the 2
46-contract; or directly or indirectly give, sell, purchase or offer to agree to give, sell, 3
47-purchase, or allow as inducement to the insurance or annuity or in connection 4
48-therewith, whether or not to be specified in the policy or contract, an agreement of any 5
49-form or nature promising returns, profits, stocks, bonds, or other securities, or interest 6
50-present or contingent in the contract or as measured by the contract, of an insurance 7
51-company or other corporation, association, or partnership, or dividends or profits 8
52-accrued or to accrue under the contract; or offer, promise, or give anything of value 9
53-that is not specified in the contract. 10
54- * Sec. 3. AS 21.96 is amended by adding new sections to read: 11
55-Article 2. Health Care Insurance Policy Incentive Program. 12
56-Sec. 21.96.210. Access to payment information. A health care insurer that 13
57-offers a health care insurance policy in the group or individual market shall provide 14
58-comprehensive comparison guidance by telephone and make available on the Internet 15
59-website of the insurer a price comparison tool that, to the extent practicable, allows an 16
60-individual enrolled in or covered under a health care insurance policy to compare the 17
61-amount of cost sharing that the individual would be responsible for paying under the 18
62-policy for a specific item or service provided in the same policy year and geographic 19
63-region by each provider participating in the policy. At a minimum, the health care 20
64-insurer shall comply with 42 U.S.C. 300gg-114. 21
65-Sec. 21.96.220. Incentive program. (a) A health care insurer that offers a 22
66-health care insurance policy in the group or individual market shall develop and 23
67-implement a program that provides a monetary incentive for a covered person enrolled 24
68-in a health care insurance policy to elect to receive a covered health care service under 25
69-the health care insurance policy from a health care provider that charges less than the 26
70-median contracted rate recognized by the health care insurer for that health care 27
71-service. 28
72-(b) A health care insurer that offers a health care insurance policy in the group 29
73-or individual market shall provide an incentive payment to a covered person as 30
74-provided in this subsection. An incentive may be calculated as a percentage of the 31 34-LS0040\H
75-SB0004B -3- CSSB 4(L&C)
44+(2) the name of each insurer whose certificate of authority was 1
45+surrendered, suspended, or revoked during the year and the cause of surrender, 2
46+suspension, or revocation; 3
47+(3) the name of each insurer authorized to do business in this state 4
48+against which delinquency or similar proceedings were instituted and, if against an 5
49+insurer domiciled in this state, a concise statement of the facts with respect to each 6
50+proceeding and its present status; 7
51+(4) a statement in regard to examination of rating organizations, 8
52+advisory organizations, joint underwriters, and joint reinsurers as required by 9
53+AS 21.39.120; 10
54+(5) the receipts [RECEIPT] and expenses of the division for the year; 11
55+(6) recommendations of the director as to amendments or 12
56+supplementation of laws affecting insurance or the office of the director; 13
57+(7) statistical information regarding health insurance, including the 14
58+number of individual and group policies sold or terminated in the state; this paragraph 15
59+does not authorize the director to require an insurer to release proprietary information; 16
60+(8) the annual percentage of health claims paid in the state that meet 17
61+[MEETS] the requirements of AS 21.36.495(a) and (d); 18
62+(9) the total amount of contributions reported and the total amount of 19
63+credit claimed under AS 21.96.070; 20
64+(10) the total number of public comments received and the director's 21
65+efforts, to the extent allowable by law, to improve or maintain public access to 22
66+information on individual health insurance rate filings before they become effective; 23
67+[AND] 24
68+(11) the most recent incentive program report compiled under 25
69+AS 21.96.260; and 26
70+(12) other pertinent information and matters the director considers 27
71+proper. 28
72+ * Sec. 3. AS 21.36.100 is amended to read: 29
73+Sec. 21.36.100. Rebates. Except as provided in AS 21.96.220 or otherwise 30
74+expressly provided by law, a person may not knowingly permit or offer to make or 31 34-LS0040\N
75+SB0004A -3- SB 4
7676 New Text Underlined [DELETED TEXT BRACKETED]
7777
78-difference in price as a flat dollar amount or by another reasonable methodology 1
79-adopted by the director by regulation. A health care insurer is not required to provide 2
80-an incentive payment to a covered person if the cost saved by the health care insurer is 3
81-$200 or less. 4
82-(c) If a covered person receives coverage under a group health care insurance 5
83-policy offered by an employer, a health care insurer shall provide the covered person 6
84-with an incentive of at least 33.4 percent of the costs saved by the health care insurer 7
85-resulting from the covered person's election to receive a health care service from a 8
86-health care provider that charges less than the median of the contracted rates 9
87-recognized by the health care insurer for that health care service. The health care 10
88-insurer shall provide the employer with at least 33.3 percent of the costs saved by the 11
89-health care insurer resulting from the covered person's election. 12
90-(d) If a covered person receives coverage under a health care insurance policy 13
91-offered in the individual market, a health care insurer shall provide the covered person 14
92-with an incentive of at least 50 percent of the costs saved by the health care insurer 15
93-resulting from the covered person's election. 16
94-(e) An incentive payment to a covered person under this section is not 17
95-(1) a violation of AS 21.36.100; or 18
96-(2) an administrative expense of the health care insurer for rate 19
97-development or rate filing purposes. 20
98-Sec. 21.96.230. Program availability. A health care insurer that offers a 21
99-health care insurance policy in the group or individual market shall make an incentive 22
100-program under AS 21.96.220 available as a component of a health care insurance 23
101-policy offered in this state. Annually, at enrollment or renewal, a health care insurer 24
102-shall provide notice about the availability of the program to a person covered under a 25
103-health care insurance policy eligible for the program. 26
104-Sec. 21.96.240. Filing requirements. Before offering an incentive program 27
105-under AS 21.96.220, a health care insurer that offers a health care insurance policy in 28
106-the group or individual market shall file a description of the program with the director 29
107-in the manner determined by the director. The director may review the filing to 30
108-determine whether the incentive program complies with the requirements of 31 34-LS0040\H
109-CSSB 4(L&C) -4- SB0004B
78+make a contract of life insurance, life annuity or health insurance, or agreement under 1
79+the contract other than as plainly expressed in the contract, or pay, allow, give or offer 2
80+to pay, allow, or give, directly or indirectly, as inducement to the insurance, or 3
81+annuity, a rebate of premiums payable on the contract, or a special favor or advantage 4
82+in the dividends or other benefits, or paid employment or contract for services of any 5
83+kind, or any valuable consideration or inducement whatever not specified in the 6
84+contract; or directly or indirectly give, sell, purchase or offer to agree to give, sell, 7
85+purchase, or allow as inducement to the insurance or annuity or in connection 8
86+therewith, whether or not to be specified in the policy or contract, an agreement of any 9
87+form or nature promising returns, profits, stocks, bonds, or other securities, or interest 10
88+present or contingent in the contract or as measured by the contract, of an insurance 11
89+company or other corporation, association, or partnership, or dividends or profits 12
90+accrued or to accrue under the contract; or offer, promise, or give anything of value 13
91+that is not specified in the contract. 14
92+ * Sec. 4. AS 21.96 is amended by adding new sections to read: 15
93+Article 2. Health Care Insurance Policy Incentive Program. 16
94+Sec. 21.96.210. Access to payment information. A health care insurer that 17
95+offers a health care insurance policy in the group or individual market shall provide 18
96+comprehensive comparison guidance by telephone and make available on the Internet 19
97+website of the insurer a price comparison tool that, to the extent practicable, allows an 20
98+individual enrolled in or covered under a health care insurance policy to compare the 21
99+amount of cost sharing that the individual would be responsible for paying under the 22
100+policy for a specific item or service provided in the same policy year and geographic 23
101+region by each provider participating in the policy. At a minimum, the health care 24
102+insurer shall comply with 42 U.S.C. 300gg-114. 25
103+Sec. 21.96.220. Incentive program. (a) A health care insurer that offers a 26
104+health care insurance policy in the group or individual market shall develop and 27
105+implement a program that provides a monetary incentive for a covered person enrolled 28
106+in a health care insurance policy to elect to receive a covered health care service under 29
107+the health care insurance policy from a health care provider that charges less than the 30
108+median contracted rate recognized by the health care insurer fo
109+r that health care 31 34-LS0040\N
110+SB 4 -4- SB0004A
110111 New Text Underlined [DELETED TEXT BRACKETED]
111112
112-AS 21.96.210 - 21.96.300. 1
113-Sec. 21.96.250. Out-of-network health care providers. If a covered person 2
114-participates in an incentive program under AS 21.96.220 and elects to receive a health 3
115-care service under AS 21.96.220(a) from an out-of-network health care provider that 4
116-results in a savings for the health care insurer, the health care insurer shall apply the 5
117-amount paid for the health care service toward the cost sharing owed by the covered 6
118-person as specified in the applicable health care insurance policy as if the health care 7
119-services were provided by an in-network health care provider. 8
120-Sec. 21.96.260. Reporting requirements. A health care insurer shall, at the 9
121-request of the director, annually provide information to the director relating to an 10
122-incentive program under AS 21.96.220 for the most recent calendar year that includes 11
123-(1) the total number of incentive payments; 12
124-(2) information on the use of the incentive program by category of 13
125-service; 14
126-(3) the total amount of incentive payments; 15
127-(4) the average amount of each incentive payment for each category of 16
128-service; 17
129-(5) the total savings achieved below the average price of the health 18
130-care service in each category of service; and 19
131-(6) the total number and percentage of covered persons who 20
132-participated in the incentive program. 21
133-Sec. 21.96.270. Applicability. (a) Except as provided in (b) of this section, 22
134-AS 21.96.210 - 21.96.300 apply to a health care insurance policy or contract but do 23
135-not apply to excepted benefits. 24
136-(b) AS 21.96.210 - 21.96.300 apply to excepted benefits provided under a 25
137-dental insurance policy or a vision insurance policy. 26
138-(c) In this section, "excepted benefits" has the meaning given in AS 21.54.160. 27
139-Sec. 21.96.300. Definitions. In AS 21.96.210 - 21.96.300, 28
140-(1) "health care insurance" has the meaning given in AS 21.12.050; 29
141-(2) "health care insurer" has the meaning given in AS 21.54.500; 30
142-(3) "health care provider" has the meaning given in AS 18.23.400(n); 31 34-LS0040\H
143-SB0004B -5- CSSB 4(L&C)
113+service. 1
114+(b) A health care insurer that offers a health care insurance policy in the group 2
115+or individual market shall provide an incentive payment to a covered person as 3
116+provided in this subsection. An incentive may be calculated as a percentage of the 4
117+difference in price as a flat dollar amount or by another reasonable methodology 5
118+adopted by the director by regulation. A health care insurer is not required to provide 6
119+an incentive payment to a covered person if the cost saved by the health care insurer is 7
120+$200 or less. 8
121+(c) If a covered person receives coverage under a group health care insurance 9
122+policy offered by an employer, a health care insurer shall provide the covered person 10
123+with an incentive of at least 33.4 percent of the costs saved by the health care insurer 11
124+resulting from the covered person's election to receive a health care service from a 12
125+health care provider that charges less than the median of the contracted rates 13
126+recognized by the health care insurer for that health care service. The health care 14
127+insurer shall provide the employer with at least 33.3 percent of the costs saved by the 15
128+health care insurer resulting from the covered person's election. 16
129+(d) If a covered person receives coverage under a health care insurance policy 17
130+offered in the individual market, a health care insurer shall provide the covered person 18
131+with an incentive of at least 50 percent of the costs saved by the health care insurer 19
132+resulting from the covered person's election. 20
133+(e) An incentive payment to a covered person under this section is not 21
134+(1) a violation of AS 21.36.100; or 22
135+(2) an administrative expense of the health care insurer for rate 23
136+development or rate filing purposes. 24
137+Sec. 21.96.230. Program availability. A health care insurer that offers a 25
138+health care insurance policy in the group or individual market shall make an incentive 26
139+program under AS 21.96.220 available as a component of a health care insurance 27
140+policy offered in this state. Annually, at enrollment or renewal, a health care insurer 28
141+shall provide notice about the availability of the program to a person covered under a 29
142+health care insurance policy eligible for the program. 30
143+Sec. 21.96.240. Filing requirements. Before offering an incentive program 31 34-LS0040\N
144+SB0004A -5- SB 4
144145 New Text Underlined [DELETED TEXT BRACKETED]
145146
146-(4) "health care service" has the meaning given in AS 18.23.400(n); 1
147-(5) "policy" has the meaning given in AS 21.97.900. 2
148- * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 3
149-read: 4
150-TRANSITION: REGULATIONS. The director of the division of insurance may adopt 5
151-regulations necessary to implement this Act. The regulations take effect under AS 44.62 6
152-(Administrative Procedure Act), but not before the effective date of the law implemented by 7
153-the regulation. 8
154- * Sec. 5. Section 4 of this Act takes effect immediately under AS 01.10.070(c). 9
155- * Sec. 6. Except as provided in sec. 5 of this Act, this Act takes effect January 1, 2026. 10
147+under AS 21.96.220, a health care insurer that offers a health care insurance policy in 1
148+the group or individual market shall file a description of the program with the director 2
149+in the manner determined by the director. The director may review the filing to 3
150+determine whether the incentive program complies with the requirements of 4
151+AS 21.96.210 - 21.96.300. 5
152+Sec. 21.96.250. Out-of-network health care providers. If a covered person 6
153+participates in an incentive program under AS 21.96.220 and elects to receive a health 7
154+care service under AS 21.96.220(a) from an out-of-network health care provider that 8
155+results in a savings for the health care insurer, the health care insurer shall apply the 9
156+amount paid for the health care service toward the cost sharing owed by the covered 10
157+person as specified in the applicable health care insurance policy as if the health care 11
158+services were provided by an in-network health care provider. 12
159+Sec. 21.96.260. Reporting requirements. (a) A health care insurer shall, at the 13
160+request of the director, annually provide information to the director relating to an 14
161+incentive program under AS 21.96.220 for the most recent calendar year that includes 15
162+(1) the total number of incentive payments; 16
163+(2) information on the use of the incentive program by category of 17
164+service; 18
165+(3) the total amount of incentive payments; 19
166+(4) the average amount of each incentive payment for each category of 20
167+service; 21
168+(5) the total savings achieved below the average price of the health 22
169+care service in each category of service; and 23
170+(6) the total number and percentage of covered persons who 24
171+participated in the incentive program. 25
172+(b) The director shall include the information provided under this section in 26
173+the director's annual report under AS 21.06.110 and shall submit the annual report to 27
174+the chairs of the committee in each house of the legislature with jurisdiction over labor 28
175+and commerce. 29
176+Sec. 21.96.270. Applicability. (a) Except as provided in (b) of this section, 30
177+AS 21.96.210 - 21.96.300 apply to a health care insurance policy or contract but do 31 34-LS0040\N
178+SB 4 -6- SB0004A
179+ New Text Underlined [DELETED TEXT BRACKETED]
180+
181+not apply to excepted benefits. 1
182+(b) AS 21.96.210 - 21.96.300 apply to excepted benefits provided under a 2
183+dental insurance policy or a vision insurance policy. 3
184+(c) In this section, "excepted benefits" has the meaning given in AS 21.54.160. 4
185+Sec. 21.96.300. Definitions. In AS 21.96.210 - 21.96.300, 5
186+(1) "health care insurance" has the meaning given in AS 21.12.050; 6
187+(2) "health care insurer" has the meaning given in AS 21.54.500; 7
188+(3) "health care provider" has the meaning given in AS 18.23.400(n); 8
189+(4) "health care service" has the meaning given in AS 18.23.400(n); 9
190+(5) "policy" has the meaning given in AS 21.97.900. 10
191+ * Sec. 5. AS 29.10.200 is amended by adding a new paragraph to read: 11
192+(68) AS 29.35.142 (disclosure and reporting of health care services and 12
193+price information). 13
194+ * Sec. 6. AS 29.35 is amended by adding a new section to read: 14
195+Sec. 29.35.142. Regulation of disclosure and reporting of health care 15
196+services and price information. (a) The authority to regulate the disclosure or 16
197+reporting of price information for health care services by health care providers, health 17
198+care facilities, or health care insurers is reserved to the state, and, except as 18
199+specifically provided by statute, a municipality may not enact or enforce an ordinance 19
200+regulating the disclosure or reporting of price information for health care services by 20
201+health care providers, health care facilities, or health care insurers. 21
202+(b) This section applies to home rule and general law municipalities. 22
203+(c) In this section, 23
204+(1) "health care facility" has the meaning given in AS 18.23.400(n); 24
205+(2) "health care insurer" has the meaning given in AS 21.54.500; 25
206+(3) "health care provider" has the meaning given in AS 18.23.400(n); 26
207+(4) "health care service" has the meaning given in AS 18.23.400(n). 27
208+ * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to 28
209+read: 29
210+DEPARTMENT OF ADMINISTRATION ANALYSIS; REPORT TO 30
211+LEGISLATURE. The Department of Administration shall analyze whether the state or 31 34-LS0040\N
212+SB0004A -7- SB 4
213+ New Text Underlined [DELETED TEXT BRACKETED]
214+
215+employees covered by a group health care insurance policy for a participating governmental 1
216+unit would benefit if a group health care insurance policy obtained or provided under 2
217+AS 39.30.090 or 39.30.091 were required to comply with the provisions of AS 21.96.210 - 3
218+21.96.300, added by sec. 4 of this Act. The Department of Administration shall complete the 4
219+analysis and compile the information into a report to the legislature, submit the report to the 5
220+senate secretary and chief clerk of the house of representatives before January 31, 2026, and 6
221+notify the legislature that the report is available. 7
222+ * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to 8
223+read: 9
224+TRANSITION: REGULATIONS. The director of the division of insurance may adopt 10
225+regulations necessary to implement this Act. The regulations take effect under AS 44.62 11
226+(Administrative Procedure Act), but not before the effective date of the law implemented by 12
227+the regulation. 13
228+ * Sec. 9. Sections 7 and 8 of this Act take effect immediately under AS 01.10.070(c). 14
229+ * Sec. 10. Except as provided in sec. 9 of this Act, this Act takes effect January 1, 2026. 15