*HB1296.1*
January 24, 2022
HOUSE BILL No. 1296
_____
DIGEST OF HB 1296 (Updated January 24, 2022 10:31 am - DI 137)
Citations Affected: IC 27-1; IC 27-4.
Synopsis: Multiple employer welfare arrangements. Amends the law
concerning multiple employer welfare arrangements (MEWA) to
require a MEWA to provide each participating employer access to
claims data that is specific to that employer. Amends the definition of
"health payer" for purposes of the all payer claims data base to include
a MEWA. Makes the violation of any requirement of the MEWA law
an unfair method of competition or unfair or deceptive act or practice.
Effective: Upon passage; July 1, 2022.
Carbaugh
January 10, 2022, read first time and referred to Committee on Financial Institutions and
Insurance.
January 24, 2022, amended, reported — Do Pass.
HB 1296—LS 7013/DI 55 January 24, 2022
Second Regular Session of the 122nd General Assembly (2022)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2021 Regular Session of the General Assembly.
HOUSE BILL No. 1296
A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 27-1-34-2 IS AMENDED TO READ AS
2 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 2. (a) An arrangement
3 must annually obtain a certificate of registration from the department
4 under rules adopted by the commissioner.
5 (b) An arrangement that does not obtain a certificate of registration
6 described in subsection (a) or violates the requirements a requirement
7 of this chapter is subject to IC 27-4.
8 SECTION 2. IC 27-1-34-3.5 IS ADDED TO THE INDIANA CODE
9 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
10 1, 2022]: Sec. 3.5. An arrangement providing benefits under this
11 chapter shall provide each employer access to claims data specific
12 to that employer.
13 SECTION 3. IC 27-1-34-5 IS AMENDED TO READ AS
14 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 5. Except as provided
15 by this chapter, and by IC 27-4, and IC 27-9, Indiana insurance law
16 does not apply to the operation of multiple employer welfare
17 arrangements.
HB 1296—LS 7013/DI 55 2
1 SECTION 4. IC 27-1-44.5-2, AS AMENDED BY P.L.195-2021,
2 SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 UPON PASSAGE]: Sec. 2. As used in this chapter, "health payer"
4 includes the following:
5 (1) Medicare.
6 (2) Medicaid or a managed care organization (as defined in
7 IC 12-7-2-126.9) that has contracted with Medicaid to provide
8 services to a Medicaid recipient.
9 (3) An insurer that issues a policy of accident and sickness
10 insurance (as defined in IC 27-8-5-1), except for the following
11 types of coverage:
12 (A) Accident only, credit, dental, vision, Medicare
13 supplement, long term care, or disability income insurance.
14 (B) Coverage issued as a supplement to liability insurance.
15 (C) Automobile medical payment insurance.
16 (D) A specified disease policy.
17 (E) A policy that provides indemnity benefits not based on any
18 expense incurred requirements, including a plan that provides
19 coverage for:
20 (i) hospital confinement, critical illness, or intensive care; or
21 (ii) gaps for deductibles or copayments.
22 (F) Worker's compensation or similar insurance.
23 (G) A student health plan.
24 (H) A supplemental plan that always pays in addition to other
25 coverage.
26 (I) An employer sponsored health benefit plan that is:
27 (i) provided to individuals who are eligible for Medicare;
28 and
29 (ii) not marketed as, or held out to be, a Medicare
30 supplement policy.
31 (4) A health maintenance organization (as defined in
32 IC 27-13-1-19).
33 (5) A pharmacy benefit manager (as defined in IC 27-1-24.5-12).
34 (6) An administrator (as defined in IC 27-1-25-1).
35 (7) A multiple employer welfare arrangement (as defined in
36 IC 27-1-34-1).
37 (7) (8) Any other person identified by the commissioner for
38 participation in the data base described in this chapter.
39 SECTION 5. IC 27-4-1-4, AS AMENDED BY P.L.196-2021,
40 SECTION 34, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
41 JULY 1, 2022]: Sec. 4. (a) The following are hereby defined as unfair
42 methods of competition and unfair and deceptive acts and practices in
HB 1296—LS 7013/DI 55 3
1 the business of insurance:
2 (1) Making, issuing, circulating, or causing to be made, issued, or
3 circulated, any estimate, illustration, circular, or statement:
4 (A) misrepresenting the terms of any policy issued or to be
5 issued or the benefits or advantages promised thereby or the
6 dividends or share of the surplus to be received thereon;
7 (B) making any false or misleading statement as to the
8 dividends or share of surplus previously paid on similar
9 policies;
10 (C) making any misleading representation or any
11 misrepresentation as to the financial condition of any insurer,
12 or as to the legal reserve system upon which any life insurer
13 operates;
14 (D) using any name or title of any policy or class of policies
15 misrepresenting the true nature thereof; or
16 (E) making any misrepresentation to any policyholder insured
17 in any company for the purpose of inducing or tending to
18 induce such policyholder to lapse, forfeit, or surrender the
19 policyholder's insurance.
20 (2) Making, publishing, disseminating, circulating, or placing
21 before the public, or causing, directly or indirectly, to be made,
22 published, disseminated, circulated, or placed before the public,
23 in a newspaper, magazine, or other publication, or in the form of
24 a notice, circular, pamphlet, letter, or poster, or over any radio or
25 television station, or in any other way, an advertisement,
26 announcement, or statement containing any assertion,
27 representation, or statement with respect to any person in the
28 conduct of the person's insurance business, which is untrue,
29 deceptive, or misleading.
30 (3) Making, publishing, disseminating, or circulating, directly or
31 indirectly, or aiding, abetting, or encouraging the making,
32 publishing, disseminating, or circulating of any oral or written
33 statement or any pamphlet, circular, article, or literature which is
34 false, or maliciously critical of or derogatory to the financial
35 condition of an insurer, and which is calculated to injure any
36 person engaged in the business of insurance.
37 (4) Entering into any agreement to commit, or individually or by
38 a concerted action committing any act of boycott, coercion, or
39 intimidation resulting or tending to result in unreasonable
40 restraint of, or a monopoly in, the business of insurance.
41 (5) Filing with any supervisory or other public official, or making,
42 publishing, disseminating, circulating, or delivering to any person,
HB 1296—LS 7013/DI 55 4
1 or placing before the public, or causing directly or indirectly, to
2 be made, published, disseminated, circulated, delivered to any
3 person, or placed before the public, any false statement of
4 financial condition of an insurer with intent to deceive. Making
5 any false entry in any book, report, or statement of any insurer
6 with intent to deceive any agent or examiner lawfully appointed
7 to examine into its condition or into any of its affairs, or any
8 public official to which such insurer is required by law to report,
9 or which has authority by law to examine into its condition or into
10 any of its affairs, or, with like intent, willfully omitting to make a
11 true entry of any material fact pertaining to the business of such
12 insurer in any book, report, or statement of such insurer.
13 (6) Issuing or delivering or permitting agents, officers, or
14 employees to issue or deliver, agency company stock or other
15 capital stock, or benefit certificates or shares in any common law
16 corporation, or securities or any special or advisory board
17 contracts or other contracts of any kind promising returns and
18 profits as an inducement to insurance.
19 (7) Making or permitting any of the following:
20 (A) Unfair discrimination between individuals of the same
21 class and equal expectation of life in the rates or assessments
22 charged for any contract of life insurance or of life annuity or
23 in the dividends or other benefits payable thereon, or in any
24 other of the terms and conditions of such contract. However,
25 in determining the class, consideration may be given to the
26 nature of the risk, plan of insurance, the actual or expected
27 expense of conducting the business, or any other relevant
28 factor.
29 (B) Unfair discrimination between individuals of the same
30 class involving essentially the same hazards in the amount of
31 premium, policy fees, assessments, or rates charged or made
32 for any policy or contract of accident or health insurance or in
33 the benefits payable thereunder, or in any of the terms or
34 conditions of such contract, or in any other manner whatever.
35 However, in determining the class, consideration may be given
36 to the nature of the risk, the plan of insurance, the actual or
37 expected expense of conducting the business, or any other
38 relevant factor.
39 (C) Excessive or inadequate charges for premiums, policy
40 fees, assessments, or rates, or making or permitting any unfair
41 discrimination between persons of the same class involving
42 essentially the same hazards, in the amount of premiums,
HB 1296—LS 7013/DI 55 5
1 policy fees, assessments, or rates charged or made for:
2 (i) policies or contracts of reinsurance or joint reinsurance,
3 or abstract and title insurance;
4 (ii) policies or contracts of insurance against loss or damage
5 to aircraft, or against liability arising out of the ownership,
6 maintenance, or use of any aircraft, or of vessels or craft,
7 their cargoes, marine builders' risks, marine protection and
8 indemnity, or other risks commonly insured under marine,
9 as distinguished from inland marine, insurance; or
10 (iii) policies or contracts of any other kind or kinds of
11 insurance whatsoever.
12 However, nothing contained in clause (C) shall be construed to
13 apply to any of the kinds of insurance referred to in clauses (A)
14 and (B) nor to reinsurance in relation to such kinds of insurance.
15 Nothing in clause (A), (B), or (C) shall be construed as making or
16 permitting any excessive, inadequate, or unfairly discriminatory
17 charge or rate or any charge or rate determined by the department
18 or commissioner to meet the requirements of any other insurance
19 rate regulatory law of this state.
20 (8) Except as otherwise expressly provided by IC 27-1-47 or
21 another law, knowingly permitting or offering to make or making
22 any contract or policy of insurance of any kind or kinds
23 whatsoever, including but not in limitation, life annuities, or
24 agreement as to such contract or policy other than as plainly
25 expressed in such contract or policy issued thereon, or paying or
26 allowing, or giving or offering to pay, allow, or give, directly or
27 indirectly, as inducement to such insurance, or annuity, any rebate
28 of premiums payable on the contract, or any special favor or
29 advantage in the dividends, savings, or other benefits thereon, or
30 any valuable consideration or inducement whatever not specified
31 in the contract or policy; or giving, or selling, or purchasing or
32 offering to give, sell, or purchase as inducement to such insurance
33 or annuity or in connection therewith, any stocks, bonds, or other
34 securities of any insurance company or other corporation,
35 association, limited liability company, or partnership, or any
36 dividends, savings, or profits accrued thereon, or anything of
37 value whatsoever not specified in the contract. Nothing in this
38 subdivision and subdivision (7) shall be construed as including
39 within the definition of discrimination or rebates any of the
40 following practices:
41 (A) Paying bonuses to policyholders or otherwise abating their
42 premiums in whole or in part out of surplus accumulated from
HB 1296—LS 7013/DI 55 6
1 nonparticipating insurance, so long as any such bonuses or
2 abatement of premiums are fair and equitable to policyholders
3 and for the best interests of the company and its policyholders.
4 (B) In the case of life insurance policies issued on the
5 industrial debit plan, making allowance to policyholders who
6 have continuously for a specified period made premium
7 payments directly to an office of the insurer in an amount
8 which fairly represents the saving in collection expense.
9 (C) Readjustment of the rate of premium for a group insurance
10 policy based on the loss or expense experience thereunder, at
11 the end of the first year or of any subsequent year of insurance
12 thereunder, which may be made retroactive only for such
13 policy year.
14 (D) Paying by an insurer or insurance producer thereof duly
15 licensed as such under the laws of this state of money,
16 commission, or brokerage, or giving or allowing by an insurer
17 or such licensed insurance producer thereof anything of value,
18 for or on account of the solicitation or negotiation of policies
19 or other contracts of any kind or kinds, to a broker, an
20 insurance producer, or a solicitor duly licensed under the laws
21 of this state, but such broker, insurance producer, or solicitor
22 receiving such consideration shall not pay, give, or allow
23 credit for such consideration as received in whole or in part,
24 directly or indirectly, to the insured by way of rebate.
25 (9) Requiring, as a condition precedent to loaning money upon the
26 security of a mortgage upon real property, that the owner of the
27 property to whom the money is to be loaned negotiate any policy
28 of insurance covering such real property through a particular
29 insurance producer or broker or brokers. However, this
30 subdivision shall not prevent the exercise by any lender of the
31 lender's right to approve or disapprove of the insurance company
32 selected by the borrower to underwrite the insurance.
33 (10) Entering into any contract, combination in the form of a trust
34 or otherwise, or conspiracy in restraint of commerce in the
35 business of insurance.
36 (11) Monopolizing or attempting to monopolize or combining or
37 conspiring with any other person or persons to monopolize any
38 part of commerce in the business of insurance. However,
39 participation as a member, director, or officer in the activities of
40 any nonprofit organization of insurance producers or other
41 workers in the insurance business shall not be interpreted, in
42 itself, to constitute a combination in restraint of trade or as
HB 1296—LS 7013/DI 55 7
1 combining to create a monopoly as provided in this subdivision
2 and subdivision (10). The enumeration in this chapter of specific
3 unfair methods of competition and unfair or deceptive acts and
4 practices in the business of insurance is not exclusive or
5 restrictive or intended to limit the powers of the commissioner or
6 department or of any court of review under section 8 of this
7 chapter.
8 (12) Requiring as a condition precedent to the sale of real or
9 personal property under any contract of sale, conditional sales
10 contract, or other similar instrument or upon the security of a
11 chattel mortgage, that the buyer of such property negotiate any
12 policy of insurance covering such property through a particular
13 insurance company, insurance producer, or broker or brokers.
14 However, this subdivision shall not prevent the exercise by any
15 seller of such property or the one making a loan thereon of the
16 right to approve or disapprove of the insurance company selected
17 by the buyer to underwrite the insurance.
18 (13) Issuing, offering, or participating in a plan to issue or offer,
19 any policy or certificate of insurance of any kind or character as
20 an inducement to the purchase of any property, real, personal, or
21 mixed, or services of any kind, where a charge to the insured is
22 not made for and on account of such policy or certificate of
23 insurance. However, this subdivision shall not apply to any of the
24 following:
25 (A) Insurance issued to credit unions or members of credit
26 unions in connection with the purchase of shares in such credit
27 unions.
28 (B) Insurance employed as a means of guaranteeing the
29 performance of goods and designed to benefit the purchasers
30 or users of such goods.
31 (C) Title insurance.
32 (D) Insurance written in connection with an indebtedness and
33 intended as a means of repaying such indebtedness in the
34 event of the death or disability of the insured.
35 (E) Insurance provided by or through motorists service clubs
36 or associations.
37 (F) Insurance that is provided to the purchaser or holder of an
38 air transportation ticket and that:
39 (i) insures against death or nonfatal injury that occurs during
40 the flight to which the ticket relates;
41 (ii) insures against personal injury or property damage that
42 occurs during travel to or from the airport in a common
HB 1296—LS 7013/DI 55 8
1 carrier immediately before or after the flight;
2 (iii) insures against baggage loss during the flight to which
3 the ticket relates; or
4 (iv) insures against a flight cancellation to which the ticket
5 relates.
6 (14) Refusing, because of the for-profit status of a hospital or
7 medical facility, to make payments otherwise required to be made
8 under a contract or policy of insurance for charges incurred by an
9 insured in such a for-profit hospital or other for-profit medical
10 facility licensed by the state department of health.
11 (15) Refusing to insure an individual, refusing to continue to issue
12 insurance to an individual, limiting the amount, extent, or kind of
13 coverage available to an individual, or charging an individual a
14 different rate for the same coverage, solely because of that
15 individual's blindness or partial blindness, except where the
16 refusal, limitation, or rate differential is based on sound actuarial
17 principles or is related to actual or reasonably anticipated
18 experience.
19 (16) Committing or performing, with such frequency as to
20 indicate a general practice, unfair claim settlement practices (as
21 defined in section 4.5 of this chapter).
22 (17) Between policy renewal dates, unilaterally canceling an
23 individual's coverage under an individual or group health
24 insurance policy solely because of the individual's medical or
25 physical condition.
26 (18) Using a policy form or rider that would permit a cancellation
27 of coverage as described in subdivision (17).
28 (19) Violating IC 27-1-22-25, IC 27-1-22-26, or IC 27-1-22-26.1
29 concerning motor vehicle insurance rates.
30 (20) Violating IC 27-8-21-2 concerning advertisements referring
31 to interest rate guarantees.
32 (21) Violating IC 27-8-24.3 concerning insurance and health plan
33 coverage for victims of abuse.
34 (22) Violating IC 27-8-26 concerning genetic screening or testing.
35 (23) Violating IC 27-1-15.6-3(b) concerning licensure of
36 insurance producers.
37 (24) Violating IC 27-1-38 concerning depository institutions.
38 (25) Violating IC 27-8-28-17(c) or IC 27-13-10-8(c) concerning
39 the resolution of an appealed grievance decision.
40 (26) Violating IC 27-8-5-2.5(e) through IC 27-8-5-2.5(j) (expired
41 July 1, 2007, and removed) or IC 27-8-5-19.2 (expired July 1,
42 2007, and repealed).
HB 1296—LS 7013/DI 55 9
1 (27) Violating IC 27-2-21 concerning use of credit information.
2 (28) Violating IC 27-4-9-3 concerning recommendations to
3 consumers.
4 (29) Engaging in dishonest or predatory insurance practices in
5 marketing or sales of insurance to members of the United States
6 Armed Forces as:
7 (A) described in the federal Military Personnel Financial
8 Services Protection Act, P.L.109-290; or
9 (B) defined in rules adopted under subsection (b).
10 (30) Violating IC 27-8-19.8-20.1 concerning stranger originated
11 life insurance.
12 (31) Violating IC 27-2-22 concerning retained asset accounts.
13 (32) Violating IC 27-8-5-29 concerning health plans offered
14 through a health benefit exchange (as defined in IC 27-19-2-8).
15 (33) Violating a requirement of the federal Patient Protection and
16 Affordable Care Act (P.L. 111-148), as amended by the federal
17 Health Care and Education Reconciliation Act of 2010 (P.L.
18 111-152), that is enforceable by the state.
19 (34) After June 30, 2015, violating IC 27-2-23 concerning
20 unclaimed life insurance, annuity, or retained asset account
21 benefits.
22 (35) Willfully violating IC 27-1-12-46 concerning a life insurance
23 policy or certificate described in IC 27-1-12-46(a).
24 (36) Violating IC 27-1-37-7 concerning prohibiting the disclosure
25 of health care service claims data.
26 (37) Violating IC 27-4-10-10 concerning virtual claims payments.
27 (38) Violating IC 27-1-24.5 concerning pharmacy benefit
28 managers.
29 (39) Violating any requirement of IC 27-1-34 concerning a
30 multiple employer welfare arrangement.
31 (b) Except with respect to federal insurance programs under
32 Subchapter III of Chapter 19 of Title 38 of the United States Code, the
33 commissioner may, consistent with the federal Military Personnel
34 Financial Services Protection Act (10 U.S.C. 992 note), adopt rules
35 under IC 4-22-2 to:
36 (1) define; and
37 (2) while the members are on a United States military installation
38 or elsewhere in Indiana, protect members of the United States
39 Armed Forces from;
40 dishonest or predatory insurance practices.
41 SECTION 6. An emergency is declared for this act.
HB 1296—LS 7013/DI 55 10
COMMITTEE REPORT
Mr. Speaker: Your Committee on Financial Institutions and
Insurance, to which was referred House Bill 1296, has had the same
under consideration and begs leave to report the same back to the
House with the recommendation that said bill be amended as follows:
Delete page 2.
Page 3, delete lines 1 through 5.
Page 3, between lines 5 and 6, begin a new paragraph and insert:
"SECTION 4. IC 27-1-44.5-2, AS AMENDED BY P.L.195-2021,
SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 2. As used in this chapter, "health payer"
includes the following:
(1) Medicare.
(2) Medicaid or a managed care organization (as defined in
IC 12-7-2-126.9) that has contracted with Medicaid to provide
services to a Medicaid recipient.
(3) An insurer that issues a policy of accident and sickness
insurance (as defined in IC 27-8-5-1), except for the following
types of coverage:
(A) Accident only, credit, dental, vision, Medicare
supplement, long term care, or disability income insurance.
(B) Coverage issued as a supplement to liability insurance.
(C) Automobile medical payment insurance.
(D) A specified disease policy.
(E) A policy that provides indemnity benefits not based on any
expense incurred requirements, including a plan that provides
coverage for:
(i) hospital confinement, critical illness, or intensive care; or
(ii) gaps for deductibles or copayments.
(F) Worker's compensation or similar insurance.
(G) A student health plan.
(H) A supplemental plan that always pays in addition to other
coverage.
(I) An employer sponsored health benefit plan that is:
(i) provided to individuals who are eligible for Medicare;
and
(ii) not marketed as, or held out to be, a Medicare
supplement policy.
(4) A health maintenance organization (as defined in
IC 27-13-1-19).
(5) A pharmacy benefit manager (as defined in IC 27-1-24.5-12).
HB 1296—LS 7013/DI 55 11
(6) An administrator (as defined in IC 27-1-25-1).
(7) A multiple employer welfare arrangement (as defined in
IC 27-1-34-1).
(7) (8) Any other person identified by the commissioner for
participation in the data base described in this chapter.".
Page 10, delete lines 8 through 30.
Page 10, after line 30, begin a new paragraph and insert:
"SECTION 6. An emergency is declared for this act.".
Renumber all SECTIONS consecutively.
and when so amended that said bill do pass.
(Reference is to HB 1296 as introduced.)
CARBAUGH
Committee Vote: yeas 11, nays 0.
HB 1296—LS 7013/DI 55