Indiana 2022 Regular Session

Indiana House Bill HB1238 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	HB1238.1
	2	+	January 18, 2022
	3	+	HOUSE BILL No. 1238
	4	+	_____
	5	+	DIGEST OF HB 1238 (Updated January 18, 2022 11:55 am - DI 137)
	6	+	Citations Affected: IC 27-1; IC 27-2; IC 27-5.1; IC 27-8; IC 27-13.
	7	+	Synopsis: Insurance matters. Reduces, from 1% to 0.15%, the lowest
	8	+	interest rate that an insurer may use in determining the minimum
	9	+	nonforfeiture amounts for an annuity contract. Provides that, as a
	10	+	condition of license renewal for a two-year period, a limited lines
	11	+	producer with a title insurance qualification must complete at least
	12	+	seven hours of continuing education in any combination of the
	13	+	following subjects: (1) Ethical practices in the marketing and selling of
	14	+	title insurance, including provisions of the Dodd-Frank Wall Street
	15	+	Reform and Consumer Protection Act. (2) Title insurance underwriting.
	16	+	(3) Escrow matters. (4) Matters concerning regulation by the
	17	+	department of insurance. (Under current law, a limited lines producer
	18	+	with a title insurance qualification is required, in completing at least
	19	+	seven hours of continuing education, to take at least one hour of
	20	+	instruction in each of four particular subjects.) Adds provision allowing
	21	+	property and casualty insurance companies to offer commercial
	22	+	property and casualty insurance on a group basis. Amends the grounds
	23	+	for cancellation of a policy of insurance to require a substantial change
	24	+	(Continued next page)
	25	+	Effective: July 1, 2022.
	26	+	Lehman, Carbaugh
	27	+	January 6, 2022, read first time and referred to Committee on Financial Institutions and
	28	+	Insurance.
	29	+	January 18, 2022, amended, reported — Do Pass.
	30	+	HB 1238—LS 7172/DI 137 Digest Continued
	31	+	in the scale of risk that would cause the policy to fail to meet the
	32	+	eligibility requirements of the underwriting guidelines. Requires
	33	+	insurers that rely on external consumer data to provide a consumer,
	34	+	upon the consumer's written request, with the five most heavily
	35	+	weighed or primary factors the insurer uses to calculate a premium.
	36	+	Requires an insurer that takes an adverse action based on external
	37	+	consumer data to provide the consumer with the five factors that were
	38	+	the primary influence on the adverse action. Changes the cap on annual
	39	+	direct written premium to operate as a farm mutual insurance company
	40	+	from $10,000,000 to $15,000,000. Specifies services to be included as
	41	+	part of a colorectal cancer screening for policies of accident and
	42	+	sickness insurance and health maintenance organization contracts.
	43	+	HB 1238—LS 7172/DI 137HB 1238—LS 7172/DI 137 January 18, 2022
1	44		Second Regular Session of the 122nd General Assembly (2022)
2	45		PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
3	46		Constitution) is being amended, the text of the existing provision will appear in this style type,
4	47		additions will appear in this style type, and deletions will appear in this style type.
5	48		Additions: Whenever a new statutory provision is being enacted (or a new constitutional
6	49		provision adopted), the text of the new provision will appear in this style type. Also, the
7	50		word NEW will appear in that style type in the introductory clause of each SECTION that adds
8	51		a new provision to the Indiana Code or the Indiana Constitution.
9	52		Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
10	53		between statutes enacted by the 2021 Regular Session of the General Assembly.
11		-	HOUSE ENROLLED ACT No. 1238
12		-	AN ACT to amend the Indiana Code concerning insurance.
	54	+	HOUSE BILL No. 1238
	55	+	A BILL FOR AN ACT to amend the Indiana Code concerning
	56	+	insurance.
13	57		Be it enacted by the General Assembly of the State of Indiana:
14		-	SECTION 1. IC 25-1-9-23, AS AMENDED BY P.L.202-2021,
15		-	SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
16		-	JULY 1, 2022]: Sec. 23. (a) This section does not apply to emergency
17		-	services.
18		-	(b) As used in this section, "covered individual" means an
19		-	individual who is entitled to be provided health care services at a cost
20		-	established according to a network plan.
21		-	(c) As used in this section, "emergency services" means services
22		-	that are:
23		-	(1) furnished by a provider qualified to furnish emergency
24		-	services; and
25		-	(2) needed to evaluate or stabilize an emergency medical
26		-	condition.
27		-	(d) As used in this section, "in network practitioner" means a
28		-	practitioner who is required under a network plan to provide health
29		-	care services to covered individuals at not more than a preestablished
30		-	rate or amount of compensation.
31		-	(e) As used in this section, "network plan" means a plan under
32		-	which facilities and practitioners are required by contract to provide
33		-	health care services to covered individuals at not more than a
34		-	preestablished rate or amount of compensation.
35		-	(f) As used in this section, "out of network" means that the health
36		-	HEA 1238 — CC 1 2
37		-	care services provided by the practitioner to a covered individual are
38		-	not subject to the covered individual's health carrier network plan.
39		-	(g) As used in this section, "practitioner" means the following:
40		-	(1) An individual who holds:
41		-	(A) an unlimited license, certificate, or registration;
42		-	(B) a limited or probationary license, certificate, or
43		-	registration;
44		-	(C) a temporary license, certificate, registration, or permit;
45		-	(D) an intern permit; or
46		-	(E) a provisional license;
47		-	issued by the board (as defined in IC 25-0.5-11-1) regulating the
48		-	profession in question.
49		-	(2) An entity that:
50		-	(A) is owned by, or employs; or
51		-	(B) performs billing for professional health care services
52		-	rendered by;
53		-	an individual described in subdivision (1).
54		-	The term does not include a dentist licensed under IC 25-14, an
55		-	optometrist licensed under IC 25-24, or a provider facility (as defined
56		-	in IC 25-1-9.8-10).
57		-	(h) An in network practitioner who provides covered health care
58		-	services to a covered individual may not charge more for the covered
59		-	health care services than allowed according to the rate or amount of
60		-	compensation established by the individual's network plan.
61		-	(i) This subsection is effective beginning January 1, 2022. Except
62		-	as provided in subsection (n), a practitioner shall comply with the
63		-	requirements set forth in Section 2799B-6 of the Public Health Service
64		-	Act, as added by Public Law 116-260.
65		-	(j) (i) An out of network practitioner who provides health care
66		-	services at an in network facility to a covered individual may not be
67		-	reimbursed more for the health care services than allowed according to
68		-	the rate or amount of compensation established by the covered
69		-	individual's network plan unless all of the following conditions are met:
70		-	(1) At least five (5) business days before the health care services
71		-	are scheduled to be provided to the covered individual, the
72		-	practitioner provides to the covered individual, on a form separate
73		-	from any other form provided to the covered individual by the
74		-	practitioner, a statement in conspicuous type that meets the
75		-	following requirements:
76		-	(A) Includes a notice reading substantially as follows: "[Name
77		-	of practitioner] is an out of network practitioner providing
78		-	[type of care] with [name of in network facility], which is an
79		-	HEA 1238 — CC 1 3
80		-	in network provider facility within your health carrier's plan.
81		-	[Name of practitioner] will not be allowed to bill you the
82		-	difference between the price charged by the practitioner and
83		-	the rate your health carrier will reimburse for the services
84		-	during your care at [name of in network facility] unless you
85		-	give your written consent to the charge.".
86		-	(B) Sets forth the practitioner's good faith estimate of the
87		-	amount that the practitioner intends to charge for the health
88		-	care services provided to the covered individual.
89		-	(C) Includes a notice reading substantially as follows
90		-	concerning the good faith estimate set forth under clause (B):
91		-	"The estimate of our intended charge for [name or description
92		-	of health care services] set forth in this statement is provided
93		-	in good faith and is our best estimate of the amount we will
94		-	charge. If our actual charge for [name or description of health
95		-	care services] exceeds our estimate by the greater of:
96		-	(i) one hundred dollars ($100); or
97		-	(ii) five percent (5%);
98		-	we will explain to you why the charge exceeds the estimate.".
99		-	(2) The covered individual signs the statement provided under
100		-	subdivision (1), signifying the covered individual's consent to the
101		-	charge for the health care services being greater than allowed
102		-	according to the rate or amount of compensation established by
103		-	the network plan.
104		-	(k) (j) If an out of network practitioner does not meet the
105		-	requirements of subsection (j), (i), the out of network practitioner shall
106		-	include on any bill remitted to a covered individual a written statement
107		-	in conspicuous type stating that the covered individual is not
108		-	responsible for more than the rate or amount of compensation
109		-	established by the covered individual's network plan plus any required
110		-	copayment, deductible, or coinsurance.
111		-	(l) (k) If a covered individual's network plan remits reimbursement
112		-	to the covered individual for health care services subject to the
113		-	reimbursement limitation of subsection (j), (i), the network plan shall
114		-	provide with the reimbursement a written statement in conspicuous
115		-	type that states that the covered individual is not responsible for more
116		-	than the rate or amount of compensation established by the covered
117		-	individual's network plan and that is included in the reimbursement
118		-	plus any required copayment, deductible, or coinsurance.
119		-	(m) (l) If the charge of a practitioner for health care services
120		-	provided to a covered individual exceeds the estimate provided to the
121		-	covered individual under subsection (j)(1)(B) (i)(1)(B) by the greater
122		-	HEA 1238 — CC 1 4
123		-	of:
124		-	(1) one hundred dollars ($100); or
125		-	(2) five percent (5%);
126		-	the facility or practitioner shall explain in a writing provided to the
127		-	covered individual why the charge exceeds the estimate.
128		-	(n) (m) An in network practitioner is not required to provide a
129		-	covered individual with the good faith estimate required under
130		-	subsection (i) if the nonemergency health care service is scheduled to
131		-	be performed by the practitioner within five (5) business days after the
132		-	health care service is ordered.
133		-	(o) (n) The department of insurance shall adopt emergency rules
134		-	under IC 4-22-2-37.1 to specify the requirements of the notifications
135		-	set forth in subsections (k) (j) and (l). (k).
136		-	(o) A practitioner may satisfy the requirements of this section
137		-	by complying with the requirements set forth in Section 2799B-6
138		-	of the federal Public Health Service Act, as added by Public Law
139		-	116-260.
140		-	SECTION 2. IC 25-1-9.8-20 IS ADDED TO THE INDIANA CODE
141		-	AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
142		-	1, 2022]: Sec. 20. A practitioner may satisfy the requirements of
143		-	this chapter by complying with the requirements set forth in
144		-	Section 2799B-6 of the federal Public Health Service Act, as added
145		-	by Public Law 116-260.
146		-	SECTION 3. IC 27-1-12.5-3 IS AMENDED TO READ AS
147		-	FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 3. (a) The minimum
148		-	values as specified in sections 4, 5, 6, 7, and 9 of this chapter of any
149		-	paid-up annuity, cash surrender or death benefits available under an
150		-	annuity contract shall be based upon minimum nonforfeiture amounts
151		-	as defined in this section.
152		-	(b) With respect to any annuity contract, the minimum nonforfeiture
153		-	amounts at any time at or prior to the commencement of any annuity
154		-	payments shall be equal to an accumulation up to such time at an
155		-	annual rate of interest determined under subsections (d) and (e) of the
156		-	net considerations as set forth in subsection (c) paid prior to such time,
157		-	decreased by the sum of the following:
158		-	(1) Any prior withdrawals from or partial surrenders of the
159		-	annuity contract accumulated at an annual rate of interest
160		-	determined under subsections (d) and (e).
161		-	(2) The amount of any indebtedness to the company on the
162		-	annuity contract, including interest due and accrued.
163		-	(3) An annual contract charge of fifty dollars ($50), accumulated
164		-	at the annual rate of interest determined under subsections (d) and
165		-	HEA 1238 — CC 1 5
166		-	(e).
167		-	(c) The net considerations for a given contract year used to define
168		-	the minimum nonforfeiture amount shall be an amount equal to
169		-	eighty-seven and one-half percent (87.5%) of the gross considerations
170		-	credited to the annuity contract during that contract year.
171		-	(d) Except as provided in subsection (e), the interest rate used in
172		-	determining minimum nonforfeiture amounts is an annual rate of
173		-	interest determined under either of the following methods:
174		-	(1) The five-year constant maturity treasury rate, rounded to the
175		-	nearest five-hundredths of one percent (0.05%), as reported by the
176		-	Federal Reserve as of a date specified in the annuity contract.
177		-	Reduce this amount by one hundred twenty-five (125) basis
178		-	points.
179		-	(2) An average of the five-year constant maturity treasury rate as
180		-	reported by the Federal Reserve, rounded to the nearest
181		-	five-hundredths of one percent (0.05%), over a specified period
182		-	as set forth in the annuity contract. Reduce this amount by one
183		-	hundred twenty-five (125) basis points.
184		-	The date under subdivision (1) or the average period used under
185		-	subdivision (2) may not be longer than fifteen (15) months before the
186		-	annuity contract issue date or the redetermination date as determined
187		-	under subsection (f).
188		-	(e) If the rate of interest determined under subsection (d) is:
189		-	(1) less than one percent (1%), the interest rate used in
190		-	determining minimum nonforfeiture amounts is fifteen
191		-	one-hundredths of one percent (1%); (0.15%); or
192		-	(2) greater than three percent (3%), the interest rate used in
193		-	determining minimum nonforfeiture amounts is three percent
194		-	(3%).
195		-	(f) The interest rate determined under subsections (d) and (e)
196		-	applies for an initial period and may be redetermined for subsequent
197		-	periods. The redetermination date, basis, and period, if any, must be
198		-	specified in the annuity contract. The basis is:
199		-	(1) the date; or
200		-	(2) an average calculated over a specified period;
201		-	that produces the value of the five-year constant maturity treasury rate
202		-	reported by the Federal Reserve to be used at each redetermination
203		-	date.
204		-	(g) During the period or term that an annuity contract provides
205		-	substantive participation in an equity index benefit, the contract may
206		-	increase the basis point reduction described in subsection (d) by not
207		-	more than an additional one hundred (100) basis points to reflect the
208		-	HEA 1238 — CC 1 6
209		-	value of the equity index benefit. The present value at the annuity
210		-	contract issue date, and at each redetermination date after the annuity
211		-	contract issue date, of the additional reduction may not exceed the
212		-	market value of the benefit. The commissioner may require a
213		-	demonstration that the present value of the additional reduction does
214		-	not exceed the market value of the benefit. If the demonstration is not
215		-	acceptable to the commissioner, the commissioner may disallow or
216		-	limit the additional reduction.
217		-	(h) The commissioner may adopt rules under IC 4-22-2 to provide
218		-	for further adjustments to the calculation of minimum nonforfeiture
219		-	amounts for:
220		-	(1) annuity contracts that provide participation in an equity index
221		-	benefit; and
222		-	(2) other annuity contracts for which the commissioner
223		-	determines adjustments are justified.
224		-	SECTION 4. IC 27-1-15.7-2, AS AMENDED BY P.L.196-2021,
225		-	SECTION 18, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
226		-	JULY 1, 2022]: Sec. 2. (a) Except as provided in subsection (b), to
227		-	renew a license issued under IC 27-1-15.6, a resident insurance
228		-	producer must complete at least twenty-four (24) hours of credit in
229		-	continuing education courses, not more than four (4) hours of which
230		-	may be in courses concerning one (1) or a combination of the
231		-	following:
232		-	(1) Sales promotion.
233		-	(2) Sales technique.
234		-	(3) Motivation.
235		-	(4) Psychology.
236		-	(5) Time management.
237		-	If the insurance producer has a qualification described in
238		-	IC 27-1-15.6-7(a)(1), IC 27-1-15.6-7(a)(2), or IC 27-1-15.6-7(a)(5), for
239		-	a license renewal that occurs after June 30, 2014, at least three (3) of
240		-	the hours of credit required by this subsection must be related to ethical
241		-	practices in the marketing and sale of life, health, or annuity insurance
242		-	products. An attorney in good standing who is admitted to the practice
243		-	of law in Indiana and holds a license issued under IC 27-1-15.6 may
244		-	complete all or any number of hours of continuing education required
245		-	by this subsection by completing an equivalent number of hours in
246		-	continuing legal education courses that are related to the business of
247		-	insurance.
248		-	(b) Except as provided in subsection (c), to renew a license issued
249		-	under IC 27-1-15.6, a limited lines producer with a title qualification
250		-	under IC 27-1-15.6-7(a)(8) must complete at least seven (7) hours of
251		-	HEA 1238 — CC 1 7
252		-	credit in continuing education courses related to the business of title
253		-	insurance, with at least one (1) hour of instruction in a structured
254		-	setting or comparable self-study, in each any of the following or any
255		-	combination of the following:
256		-	(1) Ethical practices in the marketing and selling of title
257		-	insurance, including provisions of the Dodd-Frank Wall Street
258		-	Reform and Consumer Protection Act set forth in 12 U.S.C.
259		-	2608.
260		-	(2) Title insurance underwriting.
261		-	(3) Escrow issues. matters.
262		-	(4) Principles of the federal Real Estate Settlement Procedures
263		-	Act (12 U.S.C. 2608). Matters concerning regulation by the
264		-	department.
265		-	(5) Any other topic related to the marketing and selling of title
266		-	insurance.
267		-	An attorney in good standing who is admitted to the practice of law in
268		-	Indiana and holds a license issued under IC 27-1-15.6 with a title
269		-	qualification under IC 27-1-15.6-7(a)(8) may complete all or any
270		-	number of hours of continuing education required by this subsection by
271		-	completing an equivalent number of hours in continuing legal
272		-	education courses related to the business of title insurance or any
273		-	aspect of real property law.
274		-	(c) The following insurance producers are not required to complete
275		-	continuing education courses to renew a license under this chapter:
276		-	(1) A limited lines producer who is licensed without examination
277		-	under IC 27-1-15.6-18(1).
278		-	(2) A limited line credit insurance producer.
279		-	(3) A nonresident limited lines producer with a title qualification:
280		-	(A) whose home state requires continuing education for a title
281		-	qualification; and
282		-	(B) who has met the continuing education requirements
283		-	described in clause (A).
284		-	(d) Except as provided in section 2.2 of this chapter, to satisfy the
285		-	requirements of subsection (a) or (b), a licensee may use only those
286		-	credit hours earned in continuing education courses completed by the
287		-	licensee:
288		-	(1) after the effective date of the licensee's last renewal of a
289		-	license under this chapter; or
290		-	(2) if the licensee is renewing a license for the first time, after the
291		-	date on which the licensee was issued the license under this
292		-	chapter.
293		-	(e) If an insurance producer receives qualification for a license in
294		-	HEA 1238 — CC 1 8
295		-	more than one (1) line of authority under IC 27-1-15.6, the insurance
296		-	producer may not be required to complete a total of more than
297		-	twenty-four (24) hours of credit in continuing education courses to
298		-	renew the license.
299		-	(f) Except as provided in subsection (g), a licensee may receive
300		-	credit only for completing the following continuing education courses:
301		-	(1) Continuing education courses that have been approved by the
302		-	commissioner under section 4 of this chapter.
303		-	(2) Continuing education courses that are required for the licensee
304		-	under IC 27-19-4-14.
305		-	(g) A licensee who teaches a course approved by the commissioner
306		-	under section 4 of this chapter shall receive continuing education credit
307		-	for teaching the course.
308		-	(h) When a licensee renews a license issued under this chapter, the
309		-	licensee must submit:
310		-	(1) a continuing education statement that:
311		-	(A) is in a format authorized by the commissioner;
312		-	(B) is signed by the licensee under oath; and
313		-	(C) lists the continuing education courses completed by the
314		-	licensee to satisfy the continuing education requirements of
315		-	this section; and
316		-	(2) any other information required by the commissioner.
317		-	(i) A continuing education statement submitted under subsection (h)
318		-	may be reviewed and audited by the department.
319		-	(j) A licensee shall retain a copy of the original certificate of
320		-	completion received by the licensee for completion of a continuing
321		-	education course.
322		-	(k) A licensee who completes a continuing education course that:
323		-	(1) is approved by the commissioner under section 4 of this
324		-	chapter;
325		-	(2) is held in a classroom setting; and
326		-	(3) concerns ethics;
327		-	shall receive continuing education credit not to exceed four (4) hours
328		-	in a renewal period.
329		-	SECTION 5. IC 27-1-30.4 IS ADDED TO THE INDIANA CODE
	58	+	1 SECTION 1. IC 27-1-12.5-3 IS AMENDED TO READ AS
	59	+	2 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 3. (a) The minimum
	60	+	3 values as specified in sections 4, 5, 6, 7, and 9 of this chapter of any
	61	+	4 paid-up annuity, cash surrender or death benefits available under an
	62	+	5 annuity contract shall be based upon minimum nonforfeiture amounts
	63	+	6 as defined in this section.
	64	+	7 (b) With respect to any annuity contract, the minimum nonforfeiture
	65	+	8 amounts at any time at or prior to the commencement of any annuity
	66	+	9 payments shall be equal to an accumulation up to such time at an
	67	+	10 annual rate of interest determined under subsections (d) and (e) of the
	68	+	11 net considerations as set forth in subsection (c) paid prior to such time,
	69	+	12 decreased by the sum of the following:
	70	+	13 (1) Any prior withdrawals from or partial surrenders of the
	71	+	14 annuity contract accumulated at an annual rate of interest
	72	+	15 determined under subsections (d) and (e).
	73	+	16 (2) The amount of any indebtedness to the company on the
	74	+	17 annuity contract, including interest due and accrued.
	75	+	HB 1238—LS 7172/DI 137 2
	76	+	1 (3) An annual contract charge of fifty dollars ($50), accumulated
	77	+	2 at the annual rate of interest determined under subsections (d) and
	78	+	3 (e).
	79	+	4 (c) The net considerations for a given contract year used to define
	80	+	5 the minimum nonforfeiture amount shall be an amount equal to
	81	+	6 eighty-seven and one-half percent (87.5%) of the gross considerations
	82	+	7 credited to the annuity contract during that contract year.
	83	+	8 (d) Except as provided in subsection (e), the interest rate used in
	84	+	9 determining minimum nonforfeiture amounts is an annual rate of
	85	+	10 interest determined under either of the following methods:
	86	+	11 (1) The five-year constant maturity treasury rate, rounded to the
	87	+	12 nearest five-hundredths of one percent (0.05%), as reported by the
	88	+	13 Federal Reserve as of a date specified in the annuity contract.
	89	+	14 Reduce this amount by one hundred twenty-five (125) basis
	90	+	15 points.
	91	+	16 (2) An average of the five-year constant maturity treasury rate as
	92	+	17 reported by the Federal Reserve, rounded to the nearest
	93	+	18 five-hundredths of one percent (0.05%), over a specified period
	94	+	19 as set forth in the annuity contract. Reduce this amount by one
	95	+	20 hundred twenty-five (125) basis points.
	96	+	21 The date under subdivision (1) or the average period used under
	97	+	22 subdivision (2) may not be longer than fifteen (15) months before the
	98	+	23 annuity contract issue date or the redetermination date as determined
	99	+	24 under subsection (f).
	100	+	25 (e) If the rate of interest determined under subsection (d) is:
	101	+	26 (1) less than one percent (1%), the interest rate used in
	102	+	27 determining minimum nonforfeiture amounts is fifteen
	103	+	28 one-hundredths of one percent (1%); (0.15%); or
	104	+	29 (2) greater than three percent (3%), the interest rate used in
	105	+	30 determining minimum nonforfeiture amounts is three percent
	106	+	31 (3%).
	107	+	32 (f) The interest rate determined under subsections (d) and (e)
	108	+	33 applies for an initial period and may be redetermined for subsequent
	109	+	34 periods. The redetermination date, basis, and period, if any, must be
	110	+	35 specified in the annuity contract. The basis is:
	111	+	36 (1) the date; or
	112	+	37 (2) an average calculated over a specified period;
	113	+	38 that produces the value of the five-year constant maturity treasury rate
	114	+	39 reported by the Federal Reserve to be used at each redetermination
	115	+	40 date.
	116	+	41 (g) During the period or term that an annuity contract provides
	117	+	42 substantive participation in an equity index benefit, the contract may
	118	+	HB 1238—LS 7172/DI 137 3
	119	+	1 increase the basis point reduction described in subsection (d) by not
	120	+	2 more than an additional one hundred (100) basis points to reflect the
	121	+	3 value of the equity index benefit. The present value at the annuity
	122	+	4 contract issue date, and at each redetermination date after the annuity
	123	+	5 contract issue date, of the additional reduction may not exceed the
	124	+	6 market value of the benefit. The commissioner may require a
	125	+	7 demonstration that the present value of the additional reduction does
	126	+	8 not exceed the market value of the benefit. If the demonstration is not
	127	+	9 acceptable to the commissioner, the commissioner may disallow or
	128	+	10 limit the additional reduction.
	129	+	11 (h) The commissioner may adopt rules under IC 4-22-2 to provide
	130	+	12 for further adjustments to the calculation of minimum nonforfeiture
	131	+	13 amounts for:
	132	+	14 (1) annuity contracts that provide participation in an equity index
	133	+	15 benefit; and
	134	+	16 (2) other annuity contracts for which the commissioner
	135	+	17 determines adjustments are justified.
	136	+	18 SECTION 2. IC 27-1-15.7-2, AS AMENDED BY P.L.196-2021,
	137	+	19 SECTION 18, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	138	+	20 JULY 1, 2022]: Sec. 2. (a) Except as provided in subsection (b), to
	139	+	21 renew a license issued under IC 27-1-15.6, a resident insurance
	140	+	22 producer must complete at least twenty-four (24) hours of credit in
	141	+	23 continuing education courses, not more than four (4) hours of which
	142	+	24 may be in courses concerning one (1) or a combination of the
	143	+	25 following:
	144	+	26 (1) Sales promotion.
	145	+	27 (2) Sales technique.
	146	+	28 (3) Motivation.
	147	+	29 (4) Psychology.
	148	+	30 (5) Time management.
	149	+	31 If the insurance producer has a qualification described in
	150	+	32 IC 27-1-15.6-7(a)(1), IC 27-1-15.6-7(a)(2), or IC 27-1-15.6-7(a)(5), for
	151	+	33 a license renewal that occurs after June 30, 2014, at least three (3) of
	152	+	34 the hours of credit required by this subsection must be related to ethical
	153	+	35 practices in the marketing and sale of life, health, or annuity insurance
	154	+	36 products. An attorney in good standing who is admitted to the practice
	155	+	37 of law in Indiana and holds a license issued under IC 27-1-15.6 may
	156	+	38 complete all or any number of hours of continuing education required
	157	+	39 by this subsection by completing an equivalent number of hours in
	158	+	40 continuing legal education courses that are related to the business of
	159	+	41 insurance.
	160	+	42 (b) Except as provided in subsection (c), to renew a license issued
	161	+	HB 1238—LS 7172/DI 137 4
	162	+	1 under IC 27-1-15.6, a limited lines producer with a title qualification
	163	+	2 under IC 27-1-15.6-7(a)(8) must complete at least seven (7) hours of
	164	+	3 credit in continuing education courses related to the business of title
	165	+	4 insurance, with at least one (1) hour of instruction in a structured
	166	+	5 setting or comparable self-study, in each any of the following or any
	167	+	6 combination of the following:
	168	+	7 (1) Ethical practices in the marketing and selling of title
	169	+	8 insurance, including provisions of the Dodd-Frank Wall Street
	170	+	9 Reform and Consumer Protection Act set forth in 12 U.S.C.
	171	+	10 2608.
	172	+	11 (2) Title insurance underwriting.
	173	+	12 (3) Escrow issues. matters.
	174	+	13 (4) Principles of the federal Real Estate Settlement Procedures
	175	+	14 Act (12 U.S.C. 2608). Matters concerning regulation by the
	176	+	15 department.
	177	+	16 An attorney in good standing who is admitted to the practice of law in
	178	+	17 Indiana and holds a license issued under IC 27-1-15.6 with a title
	179	+	18 qualification under IC 27-1-15.6-7(a)(8) may complete all or any
	180	+	19 number of hours of continuing education required by this subsection by
	181	+	20 completing an equivalent number of hours in continuing legal
	182	+	21 education courses related to the business of title insurance or any
	183	+	22 aspect of real property law.
	184	+	23 (c) The following insurance producers are not required to complete
	185	+	24 continuing education courses to renew a license under this chapter:
	186	+	25 (1) A limited lines producer who is licensed without examination
	187	+	26 under IC 27-1-15.6-18(1).
	188	+	27 (2) A limited line credit insurance producer.
	189	+	28 (3) A nonresident limited lines producer with a title qualification:
	190	+	29 (A) whose home state requires continuing education for a title
	191	+	30 qualification; and
	192	+	31 (B) who has met the continuing education requirements
	193	+	32 described in clause (A).
	194	+	33 (d) Except as provided in section 2.2 of this chapter, to satisfy the
	195	+	34 requirements of subsection (a) or (b), a licensee may use only those
	196	+	35 credit hours earned in continuing education courses completed by the
	197	+	36 licensee:
	198	+	37 (1) after the effective date of the licensee's last renewal of a
	199	+	38 license under this chapter; or
	200	+	39 (2) if the licensee is renewing a license for the first time, after the
	201	+	40 date on which the licensee was issued the license under this
	202	+	41 chapter.
	203	+	42 (e) If an insurance producer receives qualification for a license in
	204	+	HB 1238—LS 7172/DI 137 5
	205	+	1 more than one (1) line of authority under IC 27-1-15.6, the insurance
	206	+	2 producer may not be required to complete a total of more than
	207	+	3 twenty-four (24) hours of credit in continuing education courses to
	208	+	4 renew the license.
	209	+	5 (f) Except as provided in subsection (g), a licensee may receive
	210	+	6 credit only for completing the following continuing education courses:
	211	+	7 (1) Continuing education courses that have been approved by the
	212	+	8 commissioner under section 4 of this chapter.
	213	+	9 (2) Continuing education courses that are required for the licensee
	214	+	10 under IC 27-19-4-14.
	215	+	11 (g) A licensee who teaches a course approved by the commissioner
	216	+	12 under section 4 of this chapter shall receive continuing education credit
	217	+	13 for teaching the course.
	218	+	14 (h) When a licensee renews a license issued under this chapter, the
	219	+	15 licensee must submit:
	220	+	16 (1) a continuing education statement that:
	221	+	17 (A) is in a format authorized by the commissioner;
	222	+	18 (B) is signed by the licensee under oath; and
	223	+	19 (C) lists the continuing education courses completed by the
	224	+	20 licensee to satisfy the continuing education requirements of
	225	+	21 this section; and
	226	+	22 (2) any other information required by the commissioner.
	227	+	23 (i) A continuing education statement submitted under subsection (h)
	228	+	24 may be reviewed and audited by the department.
	229	+	25 (j) A licensee shall retain a copy of the original certificate of
	230	+	26 completion received by the licensee for completion of a continuing
	231	+	27 education course.
	232	+	28 (k) A licensee who completes a continuing education course that:
	233	+	29 (1) is approved by the commissioner under section 4 of this
	234	+	30 chapter;
	235	+	31 (2) is held in a classroom setting; and
	236	+	32 (3) concerns ethics;
	237	+	33 shall receive continuing education credit not to exceed four (4) hours
	238	+	34 in a renewal period.
	239	+	35 SECTION 3. IC 27-1-30.4 IS ADDED TO THE INDIANA CODE
	240	+	36 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
	241	+	37 JULY 1, 2022]:
	242	+	38 Chapter 30.4. Commercial Group Property and Casualty
	243	+	39 Insurance
	244	+	40 Sec. 1. As used in this chapter, "property and casualty
	245	+	41 insurance" means the types of insurance described in IC 27-1-5-1,
	246	+	42 Class 2 and Class 3.
	247	+	HB 1238—LS 7172/DI 137 6
	248	+	1 Sec. 2. As used in this chapter, "property and casualty insurance
	249	+	2 company" means a company authorized to make one (1) or more
	250	+	3 types of property or casualty insurance.
	251	+	4 Sec. 3. An insurer authorized under IC 27-1-3-20 to transact
	252	+	5 business as a property and casualty insurance company may
	253	+	6 provide commercial property and casualty insurance coverage on
	254	+	7 a group basis.
	255	+	8 Sec. 4. The commissioner may adopt rules under IC 4-22-2 to
	256	+	9 implement and administer this chapter.
	257	+	10 SECTION 4. IC 27-1-31-2, AS AMENDED BY P.L.196-2021,
	258	+	11 SECTION 26, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	259	+	12 JULY 1, 2022]: Sec. 2. (a) An insurer may not cancel a policy of
	260	+	13 insurance that the insurer has written that has been in effect more than
	261	+	14 ninety (90) days unless:
	262	+	15 (1) the insured under the policy has failed to pay the premium;
	263	+	16 (2) there is a substantial change in the scale of risk covered by the
	264	+	17 policy that would cause the policy to fail to meet the eligibility
	265	+	18 requirements of the insurer's underwriting guidelines;
	266	+	19 (3) the insured has perpetrated a fraud or material
	267	+	20 misrepresentation upon the insurer;
	268	+	21 (4) the insured has failed to comply with reasonable safety
	269	+	22 recommendations; or
	270	+	23 (5) reinsurance of the risk associated with the policy has been
	271	+	24 cancelled.
	272	+	25 (b) An insurer shall mail a written notice of cancellation to a person
	273	+	26 insured under a policy issued by the insurer at least:
	274	+	27 (1) forty-five (45) days before cancelling the policy for any reason
	275	+	28 set forth in subsection (a)(2), (a)(4), or (a)(5);
	276	+	29 (2) twenty (20) days before cancelling the policy for the reason set
	277	+	30 forth in subsection (a)(3); or
	278	+	31 (3) ten (10) days before cancelling the policy for the reason set
	279	+	32 forth in subsection (a)(1).
	280	+	33 SECTION 5. IC 27-2-21-9.5 IS ADDED TO THE INDIANA CODE
	281	+	34 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
	282	+	35 1, 2022]: Sec. 9.5. As used in this chapter, "external consumer
	283	+	36 data" means data or information that is obtained from an external
	284	+	37 source and used by an insurer to supplement traditional
	285	+	38 underwriting.
	286	+	39 SECTION 6. IC 27-2-21-19.5 IS ADDED TO THE INDIANA
	287	+	40 CODE AS A NEW SECTION TO READ AS FOLLOWS
	288	+	41 [EFFECTIVE JULY 1, 2022]: Sec. 19.5. (a) If an insurer uses
	289	+	42 external consumer data to underwrite and rate risks, the insurer,
	290	+	HB 1238—LS 7172/DI 137 7
	291	+	1 upon a written request by a consumer, must disclose to the
	292	+	2 consumer the five (5) most heavily weighed or primary factors the
	293	+	3 insurer uses in calculating a premium.
	294	+	4 (b) If an insurer takes an adverse action based on external
	295	+	5 consumer data, the insurer must provide notice to the consumer
	296	+	6 explaining the reason for the adverse action. The notice must
	297	+	7 include:
	298	+	8 (1) sufficiently clear and specific language so the consumer is
	299	+	9 able to identify the basis for the insurer's decision to take an
	300	+	10 adverse action; and
	301	+	11 (2) the five (5) factors that were the primary influences on the
	302	+	12 adverse action.
	303	+	13 SECTION 7. IC 27-5.1-2-6 IS AMENDED TO READ AS
	304	+	14 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 6. A farm mutual
	305	+	15 insurance company with an annual direct written premium of more than
	306	+	16 ten million dollars ($10,000,000) fifteen million dollars ($15,000,000)
	307	+	17 may not function as a farm mutual insurance company and shall be
	308	+	18 regulated as a domestic mutual insurance company described in
	309	+	19 IC 27-1-6-15.
	310	+	20 SECTION 8. IC 27-8-14.8-3, AS AMENDED BY P.L.36-2020,
	311	+	21 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	312	+	22 JULY 1, 2022]: Sec. 3. (a) As used in this section, "follow-up
	313	+	23 colonoscopy" means a colonoscopy that is performed as a
	314	+	24 follow-up to a colorectal cancer screening test, other than a
	315	+	25 colonoscopy, that is assigned a grade of "A" or "B" by the United
	316	+	26 States Preventive Services Task Force and for which the result was
	317	+	27 positive.
	318	+	28 (a) (b) Except as provided in subsection (d), (e), an insurer shall
	319	+	29 provide coverage for colorectal cancer examinations and laboratory
	320	+	30 tests for cancer for any nonsymptomatic insured in any accident and
	321	+	31 sickness insurance policy that the insurer issues in Indiana or issues for
	322	+	32 delivery in Indiana. Except as provided in subsection (f), covered
	323	+	33 services must include:
	324	+	34 (1) a colorectal cancer screening test assigned either an "A"
	325	+	35 or "B" grade by the United States Preventive Services Task
	326	+	36 Force; and
	327	+	37 (2) a follow-up colonoscopy.
	328	+	38 (b) (c) For an insured who is:
	329	+	39 (1) at least forty-five (45) years of age; or
	330	+	40 (2) less than forty-five (45) years of age and at high risk for
	331	+	41 colorectal cancer;
	332	+	42 the coverage required under this section must meet the requirements set
	333	+	HB 1238—LS 7172/DI 137 8
	334	+	1 forth in subsection (c), (d), except as provided in subsection (e). (f).
	335	+	2 (c) (d) An insured may not be required to pay an additional annual
	336	+	3 deductible or coinsurance for the colorectal cancer examination and
	337	+	4 laboratory testing benefit required by this section that is greater than an
	338	+	5 annual deductible or coinsurance established for similar benefits under
	339	+	6 the accident and sickness insurance policy under which the insured is
	340	+	7 covered. If the accident and sickness insurance policy does not cover
	341	+	8 a similar benefit, a deductible or coinsurance for the colorectal cancer
	342	+	9 examination and laboratory testing benefit may not be set at a level that
	343	+	10 materially diminishes the value of the colorectal cancer examination
	344	+	11 and laboratory testing benefit.
	345	+	12 (d) (e) In the case of an accident and sickness insurance policy that
	346	+	13 is not employer based, the insurer shall offer to provide the coverage
	347	+	14 described in this section.
	348	+	15 (e) (f) The requirements imposed under this section do not apply to
	349	+	16 A high deductible health plan, as defined by Section 223 of the Internal
	350	+	17 Revenue Code, High deductible health plans described in this
	351	+	18 subsection may not excuse may impose a deductible requirement with
	352	+	19 respect to colorectal cancer screening in a manner for a follow-up
	353	+	20 colonoscopy if the requirements imposed under subsection (b)(2)
	354	+	21 would be inconsistent with Section 223(c)(2)(C) of the Internal
	355	+	22 Revenue Code.
	356	+	23 SECTION 9. IC 27-13-7-17, AS AMENDED BY P.L.36-2020,
	357	+	24 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	358	+	25 JULY 1, 2022]: Sec. 17. (a) As used in this section, "colorectal cancer
	359	+	26 testing" means examinations and laboratory tests for cancer for any
	360	+	27 nonsymptomatic enrollee.
	361	+	28 (b) As used in this section, "follow-up colonoscopy" means a
	362	+	29 colonoscopy that is performed as a follow-up to a colorectal cancer
	363	+	30 screening test, other than a colonoscopy, that is assigned a grade of
	364	+	31 "A" or "B" by the United States Preventive Services Task Force
	365	+	32 and for which the result was positive.
	366	+	33 (b) (c) Except as provided in subsection (e), (f), a health
	367	+	34 maintenance organization issued a certificate of authority in Indiana
	368	+	35 shall provide colorectal cancer testing, including:
	369	+	36 (1) a colorectal cancer screening test assigned either an "A"
	370	+	37 or "B" grade by the United States Preventive Services Task
	371	+	38 Force; and
	372	+	39 (2) a follow-up colonoscopy.
	373	+	40 as a covered service under every group contract that provides coverage
	374	+	41 for basic health care services.
	375	+	42 (c) (d) For an enrollee who is:
	376	+	HB 1238—LS 7172/DI 137 9
	377	+	1 (1) at least forty-five (45) years of age; or
	378	+	2 (2) less than forty-five (45) years of age and at high risk for
	379	+	3 colorectal cancer;
	380	+	4 the colorectal cancer testing required under this section must meet the
	381	+	5 requirements set forth in subsection (d), (e), except as provided in
	382	+	6 subsection (f). (g).
	383	+	7 (d) (e) An enrollee may not be required to pay a copayment for the
	384	+	8 colorectal cancer testing benefit required by this section that is greater
	385	+	9 than a copayment established for similar benefits under the group
	386	+	10 contract under which the enrollee is entitled to services. If the group
	387	+	11 contract does not cover a similar covered service, the copayment for the
	388	+	12 colorectal cancer testing benefit may not be set at a level that materially
	389	+	13 diminishes the value of the colorectal cancer testing benefit.
	390	+	14 (e) (f) In the case of coverage that is not employer based, the health
	391	+	15 maintenance organization is required only to offer to provide colorectal
	392	+	16 cancer testing as a covered service under a proposed group contract
	393	+	17 providing coverage for basic health care services.
	394	+	18 (f) (g) The requirements imposed under this section do not apply to
	395	+	19 A high deductible health plan, as defined by Section 223 of the Internal
	396	+	20 Revenue Code, High deductible health plans described in this
	397	+	21 subsection may not excuse may impose a deductible requirement with
	398	+	22 respect to colorectal cancer screening in a manner for a follow-up
	399	+	23 colonoscopy if the requirements imposed under subsection (c)(2)
	400	+	24 would be inconsistent with Section 223(c)(2)(C) of the Internal
	401	+	25 Revenue Code.
	402	+	HB 1238—LS 7172/DI 137 10
	403	+	COMMITTEE REPORT
	404	+	Mr. Speaker: Your Committee on Financial Institutions and
	405	+	Insurance, to which was referred House Bill 1238, has had the same
	406	+	under consideration and begs leave to report the same back to the
	407	+	House with the recommendation that said bill be amended as follows:
	408	+	Page 4, delete lines 33 through 35.
	409	+	Page 5, between lines 37 and 38, begin a new paragraph and insert:
	410	+	"SECTION 3. IC 27-1-30.4 IS ADDED TO THE INDIANA CODE
330	411		AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
331	412		JULY 1, 2022]:
332		-	Chapter 30.4. Group Property and Casualty Insurance for
333		-	Permitted Groups
334		-	Sec. 1. As used in this chapter, "permitted group" means a
335		-	group of ten (10) or more commercial, business, or not-for-profit
336		-	entities that have a preexisting relationship to one another
337		-	HEA 1238 — CC 1 9
338		-	through:
339		-	(1) a common trade;
340		-	(2) an association;
341		-	(3) an affiliation; or
342		-	(4) another organizational relationship that is separate and
343		-	distinct from any group insurance arrangement of the group.
344		-	Sec. 2. As used in this chapter, "property and casualty
345		-	insurance" means one (1) or more of the types of insurance
346		-	described in IC 27-1-5-1, Class 2 and Class 3.
347		-	Sec. 3. As used in this chapter, "property and casualty insurance
	413	+	Chapter 30.4. Commercial Group Property and Casualty
	414	+	Insurance
	415	+	Sec. 1. As used in this chapter, "property and casualty
	416	+	insurance" means the types of insurance described in IC 27-1-5-1,
	417	+	Class 2 and Class 3.
	418	+	Sec. 2. As used in this chapter, "property and casualty insurance
348	419		company" means a company authorized to make one (1) or more
349	420		types of property or casualty insurance.
350		-	Sec. 4. ~~(a)~~ An insurer authorized under IC 27-1-3-20 to transact
	421	+	Sec. 3. An insurer authorized under IC 27-1-3-20 to transact
351	422		business as a property and casualty insurance company may
352		-	provide property and casualty insurance ~~to a permitted group~~ on
	423	+	provide commercial property and casualty insurance coverage on
353	424		a group basis.
354		-	(b) A policy may not be issued or renewed to provide group
355		-	coverage under this chapter to a group that includes fewer than ten
356		-	(10) commercial, business, or not-for-profit entities as part of the
357		-	group.
358		-	Sec. 5. The commissioner may adopt rules under IC 4-22-2 to
359		-	implement and administer this chapter.
360		-	SECTION 6. IC 27-1-44.5-2, AS AMENDED BY P.L.195-2021,
361		-	SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
362		-	UPON PASSAGE]: Sec. 2. As used in this chapter, "health payer"
363		-	includes the following:
364		-	(1) Medicare.
365		-	(2) Medicaid or a managed care organization (as defined in
366		-	IC 12-7-2-126.9) that has contracted with Medicaid to provide
367		-	services to a Medicaid recipient.
368		-	(3) An insurer that issues a policy of accident and sickness
369		-	insurance (as defined in IC 27-8-5-1), except for the following
370		-	types of coverage:
371		-	(A) Accident only, credit, dental, vision, Medicare
372		-	supplement, long term care, or disability income insurance.
373		-	(B) Coverage issued as a supplement to liability insurance.
374		-	(C) Automobile medical payment insurance.
375		-	(D) A specified disease policy.
376		-	(E) A policy that provides indemnity benefits not based on any
377		-	expense incurred requirements, including a plan that provides
378		-	coverage for:
379		-	(i) hospital confinement, critical illness, or intensive care; or
380		-	HEA 1238 — CC 1 10
381		-	(ii) gaps for deductibles or copayments.
382		-	(F) Worker's compensation or similar insurance.
383		-	(G) A student health plan.
384		-	(H) A supplemental plan that always pays in addition to other
385		-	coverage.
386		-	(I) An employer sponsored health benefit plan that is:
387		-	(i) provided to individuals who are eligible for Medicare;
388		-	and
389		-	(ii) not marketed as, or held out to be, a Medicare
390		-	supplement policy.
391		-	(4) A health maintenance organization (as defined in
392		-	IC 27-13-1-19).
393		-	(5) A pharmacy benefit manager (as defined in IC 27-1-24.5-12).
394		-	(6) An administrator (as defined in IC 27-1-25-1).
395		-	(7) A multiple employer welfare arrangement (as defined in
396		-	IC 27-1-34-1).
397		-	(7) (8) Any other person identified by the commissioner for
398		-	participation in the data base described in this chapter.
399		-	SECTION 7. IC 27-1-45-7, AS AMENDED BY P.L.202-2021,
400		-	SECTION 9, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
401		-	JULY 1, 2022]: Sec. 7. (a) This section is effective beginning January
402		-	1, 2022.
403		-	(b) Except as provided in subsection (c), a:
404		-	(1) facility; and
405		-	(2) practitioner;
406		-	shall comply with the requirements of Section 2799B-6 of the Public
407		-	Health Service Act, as added by Public Law 116-260.
408		-	(c) (b) A facility or a practitioner is not required to provide the good
409		-	faith estimate required in subsection (b) if the health care service to be
410		-	provided to the covered individual is scheduled to be performed within
411		-	five (5) business days after the health care service is ordered.
412		-	SECTION 8. IC 27-1-45-8, AS AMENDED BY P.L.202-2021,
413		-	SECTION 10, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
414		-	JULY 1, 2022]: Sec. 8. (a) An out of network practitioner who provides
415		-	health care services at an in network facility to a covered individual
416		-	may not be reimbursed more for the health care services than allowed
417		-	according to the rate or amount of compensation established by the
418		-	covered individual's network plan as described in subsection (b) unless
419		-	all of the following conditions are met:
420		-	(1) At least five (5) business days before the health care service
421		-	is scheduled to be provided to the covered individual, the facility
422		-	or practitioner provides to the covered individual, on a form
423		-	HEA 1238 — CC 1 11
424		-	separate from any other form provided to the covered individual
425		-	by the facility or practitioner, a statement in conspicuous type that
426		-	meets the following requirements:
427		-	(A) Includes a notice reading substantially as follows: "[Name
428		-	of facility or practitioner] is an out of network practitioner
429		-	providing [type of care], with [name of in network facility],
430		-	which is an in network provider facility within your health
431		-	carrier's plan. [Name of facility or practitioner] will not be
432		-	allowed to bill you the difference between the price charged
433		-	for the services and the rate your health carrier will reimburse
434		-	for the services during your care at [name of in network
435		-	facility] unless you give your written consent to the charge.".
436		-	(B) Sets forth the facility's or practitioner's good faith estimate
437		-	of the established fee for the health care services provided to
438		-	the covered individual.
439		-	(C) Includes a notice reading substantially as follows
440		-	concerning the good faith estimate set forth under clause (B):
441		-	"The estimate of our intended charge for [name or description
442		-	of health care services] set forth in this statement is provided
443		-	in good faith and is our best estimate of the amount we will
444		-	charge. If the actual charge for [name or description of health
445		-	care services] exceeds our estimate by the greater of:
446		-	(i) one hundred dollars ($100); or
447		-	(ii) five percent (5%);
448		-	we will explain to you why the charge exceeds the estimate.".
449		-	(2) The covered individual signs the statement provided under
450		-	subdivision (1), signifying the covered individual's consent to the
451		-	charge for the health care services being greater than allowed
452		-	according to the rate or amount of compensation established by
453		-	the network plan.
454		-	(b) If an out of network practitioner does not meet the requirements
455		-	of subsection (a), the out of network practitioner shall include on any
456		-	bill remitted to a covered individual a written statement in conspicuous
457		-	type stating that the covered individual is not responsible for more than
458		-	the rate or amount of compensation established by the covered
459		-	individual's network plan plus any required copayment, deductible, or
460		-	coinsurance.
461		-	(c) If a covered individual's network plan remits reimbursement to
462		-	the covered individual for health care services that did not meet the
463		-	requirements of subsection (a), the network plan shall provide with the
464		-	reimbursement a written statement in conspicuous type that states that
465		-	the covered individual is not responsible for more than the rate or
466		-	HEA 1238 — CC 1 12
467		-	amount of compensation established by the covered individual's
468		-	network plan and that is included in the reimbursement plus any
469		-	required copayment, deductible, or coinsurance.
470		-	(d) If the charge of a facility or practitioner for health care services
471		-	provided to a covered individual exceeds the estimate provided to the
472		-	covered individual under subsection (a)(1)(B) by an amount greater
473		-	than:
474		-	(1) one hundred dollars ($100); or
475		-	(2) five percent (5%);
476		-	the facility or practitioner shall explain in a writing provided to the
477		-	covered individual why the charge exceeds the estimate.
478		-	(e) The department shall adopt emergency rules under
479		-	IC 4-22-2-37.1 to specify the requirements of the notifications set forth
480		-	in:
481		-	(1) subsections (b) and (c); and
482		-	(2) IC 25-1-9-23(j) and IC 25-1-9-23(k). and IC 25-1-9-23(l).
483		-	SECTION 9. IC 27-1-45-10 IS ADDED TO THE INDIANA CODE
484		-	AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
485		-	1, 2022]: Sec. 10. A facility or a practitioner may satisfy the
486		-	requirements of this chapter by complying with the requirements
487		-	set forth in Section 2799B-6 of the federal Public Health Service
488		-	Act, as added by Public Law 116-260.
489		-	SECTION 10. IC 27-1-46-18 IS ADDED TO THE INDIANA
490		-	CODE AS A NEW SECTION TO READ AS FOLLOWS
491		-	[EFFECTIVE JULY 1, 2022]: Sec. 18. A provider facility may satisfy
492		-	the requirements of this chapter by complying with the
493		-	requirements set forth in Section 2799B-6 of the federal Public
494		-	Health Service Act, as added by Public Law 116-260.
495		-	SECTION 11. IC 27-5.1-2-6 IS AMENDED TO READ AS
	425	+	Sec. 4. The commissioner may adopt rules under IC 4-22-2 to
	426	+	implement and administer this chapter.".
	427	+	Page 6, delete lines 41 through 42, begin a new paragraph and
	428	+	insert:
	429	+	"SECTION 7. IC 27-5.1-2-6 IS AMENDED TO READ AS
496	430		FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 6. A farm mutual
497	431		insurance company with an annual direct written premium of more than
498	432		ten million dollars ($10,000,000) fifteen million dollars ($15,000,000)
499	433		may not function as a farm mutual insurance company and shall be
500	434		regulated as a domestic mutual insurance company described in
501		-	IC 27-1-6-15.
502		-	SECTION 12. IC 27-8-14.8-3, AS AMENDED BY P.L.36-2020,
	435	+	IC 27-1-6-15.".
	436	+	Delete pages 7 through 8.
	437	+	Page 9, delete lines 1 through 21, begin a new paragraph and insert:
	438	+	"SECTION 8. IC 27-8-14.8-3, AS AMENDED BY P.L.36-2020,
503	439		SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
504	440		JULY 1, 2022]: Sec. 3. (a) As used in this section, "follow-up
505	441		colonoscopy" means a colonoscopy that is performed as a
506	442		follow-up to a colorectal cancer screening test, other than a
507	443		colonoscopy, that is assigned a grade of "A" or "B" by the United
508	444		States Preventive Services Task Force and for which the result was
509		-	~~HEA~~ 1238 ~~— CC 1 13~~
	445	+	HB 1238—LS 7172/DI 137 11
510	446		positive.
511	447		(a) (b) Except as provided in subsection (d), (e), an insurer shall
512	448		provide coverage for colorectal cancer examinations and laboratory
513	449		tests for cancer for any nonsymptomatic insured in any accident and
514	450		sickness insurance policy that the insurer issues in Indiana or issues for
515	451		delivery in Indiana. Except as provided in subsection (f), covered
516	452		services must include:
517	453		(1) a colorectal cancer screening test assigned either an "A"
518	454		or "B" grade by the United States Preventive Services Task
519	455		Force; and
520	456		(2) a follow-up colonoscopy.
521	457		(b) (c) For an insured who is:
522	458		(1) at least forty-five (45) years of age; or
523	459		(2) less than forty-five (45) years of age and at high risk for
524	460		colorectal cancer;
525	461		the coverage required under this section must meet the requirements set
526	462		forth in subsection (c), (d), except as provided in subsection (e). (f).
527	463		(c) (d) An insured may not be required to pay an additional annual
528	464		deductible or coinsurance for the colorectal cancer examination and
529	465		laboratory testing benefit required by this section that is greater than an
530	466		annual deductible or coinsurance established for similar benefits under
531	467		the accident and sickness insurance policy under which the insured is
532	468		covered. If the accident and sickness insurance policy does not cover
533	469		a similar benefit, a deductible or coinsurance for the colorectal cancer
534	470		examination and laboratory testing benefit may not be set at a level that
535	471		materially diminishes the value of the colorectal cancer examination
536	472		and laboratory testing benefit.
537	473		(d) (e) In the case of an accident and sickness insurance policy that
538	474		is not employer based, the insurer shall offer to provide the coverage
539	475		described in this section.
540	476		(e) (f) The requirements imposed under this section do not apply to
541	477		A high deductible health plan, as defined by Section 223 of the Internal
542		-	Revenue Code. High deductible health plans described in this
543		-	subsection may not excuse a deductible requirement with ~~respect to~~
544		-	colorectal cancer screening in a manner ~~inconsistent with Section~~
545		-	~~223~~(c)(2)~~(C) of the Internal Revenue Code. The requirements~~
546		-	~~imposed under subsection~~ (b)(2) ~~do not apply to grandfathered~~
547		-	~~health plans as defined in 45 CFR 147~~.~~140.~~
548		-	SECTION 13. IC 27-13-7-17, AS AMENDED BY P.L.36-2020,
	478	+	Revenue Code, High deductible health plans described in this
	479	+	subsection may not excuse may impose a deductible requirement with
	480	+	respect to colorectal cancer screening in a manner for a follow-up
	481	+	colonoscopy if the requirements imposed under subsection (b)(2)
	482	+	would be inconsistent with Section 223(c)(2)(C) of the Internal
	483	+	Revenue Code.
	484	+	SECTION 9. IC 27-13-7-17, AS AMENDED BY P.L.36-2020,
549	485		SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
550	486		JULY 1, 2022]: Sec. 17. (a) As used in this section, "colorectal cancer
551	487		testing" means examinations and laboratory tests for cancer for any
552		-	~~HEA~~ 1238 ~~— CC 1 14~~
	488	+	HB 1238—LS 7172/DI 137 12
553	489		nonsymptomatic enrollee.
554	490		(b) As used in this section, "follow-up colonoscopy" means a
555	491		colonoscopy that is performed as a follow-up to a colorectal cancer
556	492		screening test, other than a colonoscopy, that is assigned a grade of
557	493		"A" or "B" by the United States Preventive Services Task Force
558	494		and for which the result was positive.
559	495		(b) (c) Except as provided in subsection (e), (f), a health
560	496		maintenance organization issued a certificate of authority in Indiana
561	497		shall provide colorectal cancer testing, including:
562	498		(1) a colorectal cancer screening test assigned either an "A"
563	499		or "B" grade by the United States Preventive Services Task
564	500		Force; and
565		-	(2) a follow-up colonoscopy;
	501	+	(2) a follow-up colonoscopy.
566	502		as a covered service under every group contract that provides coverage
567	503		for basic health care services.
568	504		(c) (d) For an enrollee who is:
569	505		(1) at least forty-five (45) years of age; or
570	506		(2) less than forty-five (45) years of age and at high risk for
571	507		colorectal cancer;
572	508		the colorectal cancer testing required under this section must meet the
573	509		requirements set forth in subsection (d), (e), except as provided in
574	510		subsection (f). (g).
575	511		(d) (e) An enrollee may not be required to pay a copayment for the
576	512		colorectal cancer testing benefit required by this section that is greater
577	513		than a copayment established for similar benefits under the group
578	514		contract under which the enrollee is entitled to services. If the group
579	515		contract does not cover a similar covered service, the copayment for the
580	516		colorectal cancer testing benefit may not be set at a level that materially
581	517		diminishes the value of the colorectal cancer testing benefit.
582	518		(e) (f) In the case of coverage that is not employer based, the health
583	519		maintenance organization is required only to offer to provide colorectal
584	520		cancer testing as a covered service under a proposed group contract
585	521		providing coverage for basic health care services.
586	522		(f) (g) The requirements imposed under this section do not apply to
587	523		A high deductible health plan, as defined by Section 223 of the Internal
588		-	Revenue Code. High deductible health plans described in this
589		-	subsection may not excuse a deductible requirement with ~~respect to~~
590		-	colorectal cancer screening in a manner ~~inconsistent with Section~~
591		-	~~223~~(c)(2)~~(C) of the Internal Revenue Code. The requirements~~
592		-	~~imposed under subsection~~ (c)(2) ~~do not apply to grandfathered~~
593		-	~~health plans as defined in 45 CFR 147~~.~~140~~.
594		-	~~SECTION 14.~~ ~~An emergency is declared for this act.~~
595		-	~~HEA 1238 — CC 1 Speaker of the House of Representatives~~
596		-	~~President of the Senate~~
597		-	~~President Pro Tempore~~
598		-	~~Governor of the State of Indiana~~
599		-	~~Date~~: ~~Time:~~
600		-	~~HEA~~ 1238 ~~— CC 1~~
	524	+	Revenue Code, High deductible health plans described in this
	525	+	subsection may not excuse may impose a deductible requirement with
	526	+	respect to colorectal cancer screening in a manner for a follow-up
	527	+	colonoscopy if the requirements imposed under subsection (c)(2)
	528	+	would be inconsistent with Section 223(c)(2)(C) of the Internal
	529	+	Revenue Code.".
	530	+	HB 1238—LS 7172/DI 137 13
	531	+	Renumber all SECTIONS consecutively.
	532	+	and when so amended that said bill do pass.
	533	+	(Reference is to HB 1238 as introduced.)
	534	+	CARBAUGH
	535	+	Committee Vote: yeas 12, nays 0.
	536	+	HB 1238—LS 7172/DI 137