Arizona 2022 Regular Session

Arizona House Bill HB2209 Compare Versions

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

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1	1	REFERENCE TITLE: insurance; preexisting conditions; essential benefits State of Arizona House of Representatives Fifty-fifth Legislature Second Regular Session 2022 HB 2209 Introduced by Representatives Butler: Andrade, Blackwater-Nygren, Cano, Fernandez B, Powers Hannley, Solorio AN ACT Amending title 20, chapter 1, article 1, Arizona Revised Statutes, by adding section 20-110; relating to health care insurance. (TEXT OF BILL BEGINS ON NEXT PAGE)
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9	9	REFERENCE TITLE: insurance; preexisting conditions; essential benefits
10	10	State of Arizona House of Representatives Fifty-fifth Legislature Second Regular Session 2022
11	11	HB 2209
12	12	Introduced by Representatives Butler: Andrade, Blackwater-Nygren, Cano, Fernandez B, Powers Hannley, Solorio
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14	14	REFERENCE TITLE: insurance; preexisting conditions; essential benefits
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24	24	State of Arizona
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40	40	HB 2209
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44	44	Introduced by
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46	46	Representatives Butler: Andrade, Blackwater-Nygren, Cano, Fernandez B, Powers Hannley, Solorio
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52	52	AN ACT
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56	56	Amending title 20, chapter 1, article 1, Arizona Revised Statutes, by adding section 20-110; relating to health care insurance.
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62	62	(TEXT OF BILL BEGINS ON NEXT PAGE)
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66	66	Be it enacted by the Legislature of the State of Arizona: Section 1. Title 20, chapter 1, article 1, Arizona Revised Statutes, is amended by adding section 20-110, to read: START_STATUTE20-110. Essential benefits; preexisting condition exclusions or limitations prohibition; health care insurer prohibitions; definitions A. Notwithstanding any other law, Every health care insurer that offers an individual or small employer group health plan in this state: 1. Shall provide coverage for at least the following ten essential benefits: (a) Ambulatory services. (b) Emergency services. (c) Hospitalization. (d) Maternity and newborn care. (e) Mental health and substance abuse disorder services. (f) Prescription drugs. (g) Rehabilitative and habilitative services and devices. (h) Laboratory services. (i) Preventive and wellness services. (j) Pediatric services, including oral and vision care. 2. may not: (a) Prohibit or deny a health plan for an individual under an individual or small employer group plan based solely on the individual's health status. (b) include preexisting condition exclusions or limitations in any health plan. (c) Cancel or refuse to renew a health plan based solely on an individual's preexisting condition. (d) Use an individual's or small employer group's health status to establish premiums. (e) Refuse to cover services that are necessary to treat a preexisting condition. (f) Impose annual or lifetime dollar limits on the essential benefits listed in paragraph 1 of this subsection. (g) Apply any additional deductible, copayment or coinsurance based solely on an individual's preexisting condition. (h) unfairly discriminate against an individual in Establishing or adjusting premium rates based on the individual's age or sex. B. For the purposes of this section: 1. "health care insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation. 2. "Health plan" means a policy, evidence of coverage or contract issue by a health care insurer. 3. "Preexisting condition exclusion or limitation" means an exclusion or limitation of benefits, including a denial of coverage, based on the fact that the condition was present before the effective date of coverage, or if coverage is denied, the date of the denial, under an individual, group or small employer health plan. 4. "Small employer group" means an employer who employs at least two but not more than fifty eligible employees on a typical business day during any one calendar year. END_STATUTE
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68	68	Be it enacted by the Legislature of the State of Arizona:
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70	70	Section 1. Title 20, chapter 1, article 1, Arizona Revised Statutes, is amended by adding section 20-110, to read:
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72	72	START_STATUTE20-110. Essential benefits; preexisting condition exclusions or limitations prohibition; health care insurer prohibitions; definitions
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74	74	A. Notwithstanding any other law, Every health care insurer that offers an individual or small employer group health plan in this state:
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76	76	1. Shall provide coverage for at least the following ten essential benefits:
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78	78	(a) Ambulatory services.
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80	80	(b) Emergency services.
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82	82	(c) Hospitalization.
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84	84	(d) Maternity and newborn care.
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86	86	(e) Mental health and substance abuse disorder services.
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88	88	(f) Prescription drugs.
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90	90	(g) Rehabilitative and habilitative services and devices.
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92	92	(h) Laboratory services.
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94	94	(i) Preventive and wellness services.
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96	96	(j) Pediatric services, including oral and vision care.
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98	98	2. may not:
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100	100	(a) Prohibit or deny a health plan for an individual under an individual or small employer group plan based solely on the individual's health status.
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102	102	(b) include preexisting condition exclusions or limitations in any health plan.
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104	104	(c) Cancel or refuse to renew a health plan based solely on an individual's preexisting condition.
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106	106	(d) Use an individual's or small employer group's health status to establish premiums.
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108	108	(e) Refuse to cover services that are necessary to treat a preexisting condition.
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110	110	(f) Impose annual or lifetime dollar limits on the essential benefits listed in paragraph 1 of this subsection.
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112	112	(g) Apply any additional deductible, copayment or coinsurance based solely on an individual's preexisting condition.
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114	114	(h) unfairly discriminate against an individual in Establishing or adjusting premium rates based on the individual's age or sex.
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116	116	B. For the purposes of this section:
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118	118	1. "health care insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation.
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120	120	2. "Health plan" means a policy, evidence of coverage or contract issue by a health care insurer.
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122	122	3. "Preexisting condition exclusion or limitation" means an exclusion or limitation of benefits, including a denial of coverage, based on the fact that the condition was present before the effective date of coverage, or if coverage is denied, the date of the denial, under an individual, group or small employer health plan.
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124	124	4. "Small employer group" means an employer who employs at least two but not more than fifty eligible employees on a typical business day during any one calendar year. END_STATUTE