The bill aims to strengthen consumer protections in the health insurance market by providing a clear mechanism for crediting previously incurred expenses to a new health plan. This change is particularly important given the volatility in the health insurance market, where carriers may exit unexpectedly. The proposed rule-making authority granted to the insurance commissioner will allow for the development of detailed protocols to guide carriers on how to apply these credits. This institutional support could lead to more standardized practices across carriers in the event of insolvencies.
Summary
House Bill 1113 seeks to address the issue of health insurance carrier insolvency by ensuring that individuals who have incurred out-of-pocket expenses under their health benefit plans are not financially penalized when their carrier exits the market. Specifically, the bill mandates that when a health insurance carrier becomes insolvent during a plan year, a new carrier must credit the individual's previous out-of-pocket expenses, ensuring continuity of benefits and reducing financial burdens on consumers. This provision is designed to support small group and individual plans, thereby enhancing protection for those enrolled in such health benefit plans.
Contention
The discussion around HB 1113 may highlight differing perspectives on the regulatory responsibilities of insurers and the potential financial implications for them. Supporters may argue that this bill is a necessary step to protect consumers in an unpredictable insurance landscape, while opponents may raise concerns about the financial feasibility for insurers and the administrative burden of implementing these changes. Additionally, the bill includes an effective date that is contingent upon a referendum, which could lead to public scrutiny and debate regarding its necessity and implementation.
Requires third-party discounts and payments for individuals covered by health benefits plans to apply to copayments, coinsurance, deductibles, or other out-of-pocket costs for covered benefits.
Requires third-party discounts and payments for individuals covered by health benefits plans to apply to copayments, coinsurance, deductibles, or other out-of-pocket costs for covered benefits.