Alabama 2025 Regular Session

Alabama House Bill HB400 Compare Versions

Only one version of the bill is available at this time.

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1	1	HB400INTRODUCED
2	2	Page 0
3	3	HB400
4	4	MJDUWW1-1
5	5	By Representative Rigsby
6	6	RFD: Insurance
7	7	First Read: 06-Mar-25
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12	12	5 MJDUWW1-1 02/19/2025 JC (L)lg 2024-3195
13	13	Page 1
14	14	First Read: 06-Mar-25
15	15	SYNOPSIS:
16	16	Under current practice, an insurance policy
17	17	covering dental care may limit the available maximum
18	18	dollar amount of benefits for use to the year that the
19	19	policy is in effect.
20	20	This bill would require insurers that provide
21	21	dental coverage in the State of Alabama to allow
22	22	covered beneficiaries to roll over unused benefits into
23	23	subsequent years, within certain conditions.
24	24	A BILL
25	25	TO BE ENTITLED
26	26	AN ACT
27	27	Relating to dental insurance; to require contracts for
28	28	dental care coverage to provide that a beneficiary may carry
29	29	over an unused amount of available benefits into the
30	30	succeeding year; to set conditions on the right to carry over
31	31	available benefits; and to amend Sections 10A-20-6.16 and
32	32	27-21A-23, Code of Alabama 1975, to make conforming changes.
33	33	BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
34	34	Section 1. (a) For the purposes of this section, the
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64	64	Section 1. (a) For the purposes of this section, the
65	65	following terms have the following meanings:
66	66	(1) ANNUAL BENEFIT MAXIMUM. The total dollar amount of
67	67	dental care services benefits available to an individual
68	68	enrolled as a beneficiary under a dental benefit plan or
69	69	health benefit plan for a year.
70	70	(2) DENTAL BENEFIT PLAN. Any stand-alone individual or
71	71	group plan, policy, or contract issued, delivered, or renewed
72	72	in this state which is limited to paying or reimbursing the
73	73	costs of dental care services.
74	74	(3) DENTAL CARE SERVICES. Any services furnished to a
75	75	beneficiary for the purpose of preventing, managing,
76	76	alleviating, curing, or healing dental illness, disease, or
77	77	injury.
78	78	(4) HEALTH BENEFIT PLAN. a. Any individual or group
79	79	plan, policy, or contract issued, delivered, or renewed in
80	80	this state which, in addition to paying or reimbursing for
81	81	hospitalization, physician care, treatment, surgery, therapy,
82	82	drugs, equipment, and other medical expenses, also includes
83	83	coverage for some dental care services.
84	84	b. The term does not include accident-only, specified
85	85	disease, individual hospital indemnity, credit, Medicare
86	86	supplement, long-term care, disability income, or other
87	87	limited benefit health insurance policies, or coverage issued
88	88	as supplemental to liability insurance, workers' compensation,
89	89	or automobile medical payment insurance.
90	90	(5) INSURER. A person as defined in Section 27-1-2,
91	91	Code of Alabama 1975, that issues, delivers, or renews a
92	92	dental benefit plan or a health benefit plan.
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122	122	dental benefit plan or a health benefit plan.
123	123	(6) UNSPENT ANNUAL BENEFIT MAXIMUM DOLLARS. The portion
124	124	of an annual benefit maximum that was not paid out or
125	125	reimbursed on claims for a beneficiary during a year.
126	126	(7) YEAR. A calendar year or other 12-month period that
127	127	a dental benefit plan or health care plan is in effect.
128	128	(b) On or after January 1, 2026, any insurer that
129	129	issues, delivers, or renews a dental benefit plan or a health
130	130	benefit plan shall include a provision that allows a
131	131	beneficiary to carry over the amount of unspent annual benefit
132	132	maximum dollars into the succeeding year for payment or
133	133	reimbursement of dental care services.
134	134	(c) The unspent annual benefit maximum dollars carried
135	135	over shall be added to the annual benefit maximum for the
136	136	succeeding year as limited by subdivision (e)(2).
137	137	(d) Claims incurred during the current year but not
138	138	paid until the succeeding year shall be subtracted from the
139	139	current year annual benefit maximum.
140	140	(e)(1) An insurer may in its discretion prescribe
141	141	terms, limitations, and conditions governing the exercise by
142	142	the beneficiary of the contractual provision required under
143	143	subsection (b), but shall require the limitation described in
144	144	subdivision (2).
145	145	(2) The aggregate dollar amount that may be accumulated
146	146	by a covered individual to carry over is limited to two times
147	147	the annual benefit maximum that is in effect for the preceding
148	148	year.
149	149	(f) The Department of Insurance of the State of Alabama
150	150	may adopt rules necessary to implement this section.
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180	180	may adopt rules necessary to implement this section.
181	181	Section 2. Sections 10A-20-6.16 and 27-21A-23, Code of
182	182	Alabama 1975, are amended to read as follows:
183	183	"§10A-20-6.16
184	184	(a) No statute of this state applying to insurance
185	185	companies shall be applicable to any corporation organized
186	186	under this article and amendments thereto or to any contract
187	187	made by the corporation; except the corporation shall be
188	188	subject to the following:
189	189	(1) The provisions regarding annual premium tax to be
190	190	paid by insurers on insurance premiums.
191	191	(2) Chapter 55 of Title 27.
192	192	(3) Article 2 and Article 3 of Chapter 19 of Title 27.
193	193	(4) Section 27-1-17.
194	194	(5) Chapter 56 of Title 27.
195	195	(6) Rules adopted by the Commissioner of Insurance
196	196	pursuant to Sections 27-7-43 and 27-7-44.
197	197	(7) Chapter 54 of Title 27.
198	198	(8) Chapter 57 of Title 27.
199	199	(9) Chapter 58 of Title 27.
200	200	(10) Chapter 59 of Title 27.
201	201	(11) Chapter 54A of Title 27.
202	202	(12) Chapter 12A of Title 27.
203	203	(13) Chapter 2B of Title 27.
204	204	(14) Chapter 29 of Title 27.
205	205	(15) Chapter 62 of Title 27.
206	206	(16) Chapter 63 of Title 27.
207	207	(17) Chapter 45A of Title 27.
208	208	(18) Section 1 of the act amending this section.
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238	238	(18) Section 1 of the act amending this section.
239	239	(b) The provisions in subsection (a) that require
240	240	specific types of coverage to be offered or provided shall not
241	241	apply when the corporation is administering a self-funded
242	242	benefit plan or similar plan, fund, or program that it does
243	243	not insure."
244	244	"§27-21A-23
245	245	(a) Except as otherwise provided in this chapter,
246	246	provisions of the insurance law and provisions of health care
247	247	service plan laws shall not be applicable to any health
248	248	maintenance organization granted a certificate of authority
249	249	under this chapter. This provision shall not apply to an
250	250	insurer or health care service plan licensed and regulated
251	251	pursuant to the insurance law or the health care service plan
252	252	laws of this state except with respect to its health
253	253	maintenance organization activities authorized and regulated
254	254	pursuant to this chapter.
255	255	(b) Solicitation of enrollees by a health maintenance
256	256	organization granted a certificate of authority shall not be
257	257	construed to violate any provision of law relating to
258	258	solicitation or advertising by health professionals.
259	259	(c) Any health maintenance organization authorized
260	260	under this chapter shall not be deemed to be practicing
261	261	medicine and shall be exempt from the provisions of Section
262	262	34-24-310, et seq., relating to the practice of medicine.
263	263	(d) No person participating in the arrangements of a
264	264	health maintenance organization other than the actual provider
265	265	of health care services or supplies directly to enrollees and
266	266	their families shall be liable for negligence, misfeasance,
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296	296	their families shall be liable for negligence, misfeasance,
297	297	nonfeasance, or malpractice in connection with the furnishing
298	298	of such services and supplies.
299	299	(e) Nothing in this chapter shall be construed in any
300	300	way to repeal or conflict with any provision of the
301	301	certificate of need law.
302	302	(f) Notwithstanding the provisions of subsection (a), a
303	303	health maintenance organization shall be subject to all of the
304	304	following:
305	305	(1) Section 27-1-17.
306	306	(2) Chapter 56.
307	307	(3) Chapter 54.
308	308	(4) Chapter 57.
309	309	(5) Chapter 58.
310	310	(6) Chapter 59.
311	311	(7) Rules adopted by the Commissioner of Insurance
312	312	pursuant to Sections 27-7-43 and 27-7-44.
313	313	(8) Chapter 12A.
314	314	(9) Chapter 54A.
315	315	(10) Chapter 2B.
316	316	(11) Chapter 29.
317	317	(12) Chapter 62.
318	318	(13) Chapter 63.
319	319	(14) Chapter 45A
320	320	(15) Section 1 of the act amending this section ."
321	321	Section 3. This act shall become effective on October
322	322	1, 2025.
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