HLS 10RS-1070 ENGROSSED
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Regular Session, 2010
HOUSE BILL NO. 717
BY REPRESENTATIVE ROY
INSURANCE/HEALTH-ACCID: Provides for conditions and prohibitions during
withdrawal from health insurance markets in this state
AN ACT1
To amend and reenact R.S. 22:979, 1068(C)(2)(a)(iii) and (b), 1074(C)(2)(a)(iii) and (b),2
and 1096 and to enact R.S. 22:1068(C)(2)(c) and 1074(C)(2)(c), relative to3
withdrawal from health insurance markets in this state; to prohibit the increase of4
premiums and reduction of benefits during withdrawal; to require prior approval of5
the notice of withdrawal; to clarify periods of coverage during withdrawal; and to6
provide for related matters.7
Be it enacted by the Legislature of Louisiana:8
Section 1. R.S. 22:979, 1068(C)(2)(a)(iii) and (b), 1074(C)(2)(a)(iii) and (b), and9
1096 are hereby amended and reenacted and R.S. 22:1068(C)(2)(c) and 1074(C)(2)(c) are10
hereby enacted to read as follows: 11
§979. Covered claim; prohibition of cancellation12
No health and accident insurer may unilaterally cancel a policy of insurance13
except for nonpayment of premiums, increase the premium for such policy, or reduce14
the benefits provided by such insurance policy after receipt or notice of any covered15
claim. The insurer may cancel the policy, as otherwise provided by law, after the16
claimant has been discharged from treatment for that condition and no further claims17
for that condition are expected, provided there has been no other receipt or notice of18
claim under that policy. This Section shall not prohibit any group health and19 HLS 10RS-1070 ENGROSSED
HB NO. 717
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accident insurer or any individual accident and health insurer from increasing its1
premium if the increase is applicable to all members of the group insurance plan, or2
all insureds who have the same individual accident and health plan or policy. except3
that no health insurance issuer or health maintenance organization issuing group or4
individual policies or subscriber agreements shall increase its premium rates or5
reduce covered benefits under any policy or subscriber agreement after the6
commencement of the minimum one-hundred-eighty-day period provided for in R.S.7
22:1068(C)(2)(a)(i) or 1074(C)(2)(a)(i).8
* * *9
§1068. Guaranteed renewability of coverage for employers in the group market10
* * *11
C.12
* * *13
(2)(a) In any case in which a health insurance issuer elects to discontinue14
offering all health insurance coverage in the small group market or the large group15
market, or both markets, in the state, health insurance coverage may be discontinued16
by the issuer if:17
* * *18
(iii) Prior to providing the notice required by Item (i) of this Subparagraph,19
the issuer files such notice and the insurance product being discontinued with the20
commissioner of insurance. the notice and the insurance product being discontinued21
for certification that the notice is in compliance with this Section. Notice shall not22
be issued to the insureds or enrollees until the expiration of twenty days after the23
notice and insurance product being discontinued have been filed unless the24
commissioner of insurance gives his written approval prior to that time.25
(b) In the case of a discontinuation in the small group market or large group26
market under Subparagraph (a) of this Paragraph, any plan sponsor’s policy or27
coverage that is not subject to renewal during the minimum one-hundred-eighty-day28
notice period shall remain in force until the renewal or termination date upon which29 HLS 10RS-1070 ENGROSSED
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the contracted period of coverage ends. Any plan sponsor’s policy or coverage1
whose renewal date falls within the minimum one-hundred-eighty-day notice period2
shall remain in force for one hundred eighty days from the date that the notice of3
discontinuation was issued.4
(c) In the case of a discontinuation under Subparagraph (a) of this Paragraph5
in a market, the issuer may not provide for the issuance of any health insurance6
coverage in the market and state during the five-year period beginning on the date7
of the discontinuation of the last health insurance coverage not so renewed.8
* * *9
§1074. Guaranteed renewability of individual health insurance coverage10
* * *11
C.12
* * *13
(2)(a) Subject to Subparagraph (b) of this Paragraph, in any case in which14
a health insurance issuer elects to discontinue offering all health insurance coverage15
in the individual market in a state, health insurance coverage may be discontinued16
by the issuer only if:17
* * *18
(iii) Prior to providing the notice required by Item (i) of this Subparagraph,19
the issuer files such notice and the insurance product being discontinued with the20
commissioner of insurance. the notice and the insurance product being discontinued21
for certification that the notice is in compliance with this Section. Notice shall not22
be issued to the insureds or enrollees until the expiration of twenty days after the23
notice and insurance product being discontinued have been filed unless the24
commissioner of insurance gives his written approval prior to that time.25
(b) In the case of a discontinuation in the individual market under26
Subparagraph (a) of this Paragraph, any individual's policy or coverage that is not27
subject to renewal during the minimum one-hundred-eighty-day notice period shall28
remain in force until the renewal or termination date upon which the contracted29 HLS 10RS-1070 ENGROSSED
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period of coverage ends. Any individual's policy or coverage whose renewal date1
falls within the minimum one-hundred-eighty-day notice period shall remain in force2
for one hundred eighty days from the date that the notice of discontinuation was3
issued.4
(c) In the case of a discontinuation under Subparagraph (a) of this Paragraph5
in the individual market, the issuer may not provide for the issuance of any health6
insurance coverage in the market and state involved during the five-year period7
beginning on the date of the discontinuation of the last health insurance coverage not8
so renewed.9
* * *10
§1096. Health and accident insurers; rate increases11
Health and accident insurers shall not increase their premium rates during the12
initial twelve months of coverage and not more than once in any six-month period13
following the initial twelve-month period, for any policy, rider, or amendment issued14
in or for residents of the state, no matter the date of commencement or renewal of the15
insurance coverage. except that no health insurance issuer or health maintenance16
organization issuing group or individual policies or subscriber agreements shall17
increase its premium rates or reduce the covered benefits under the policy or18
subscriber agreement after the commencement of the minimum one-hundred-eighty-19
day period described in R.S. 22:1068(C)(2)(a)(i) or 1074(C)(2)(a)(i). This Section20
does not affect increases in the premium amount due to the addition of a newly21
covered person or a change in age or geographic location of an individual insured or22
policyholder or an increase in the policy benefit level.23 HLS 10RS-1070 ENGROSSED
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are additions.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Roy HB No. 717
Abstract: Provides for conditions and prohibitions during withdrawal from health
insurance markets in this state, including a prohibition on increasing premium rates
and reducing benefits.
Present law provides for withdrawal of a health insurance issuer from the individual or small
or large group health insurance market in this state and places certain conditions upon such
withdrawal. Specifically requires that the health insurance issuer file prior notice with the
the commissioner of insurance and requires notice to each plan sponsor and covered
participants and beneficiaries at least 180 days prior to the date of such discontinuation.
Proposed law additionally requires that, prior to notice to the plan sponsor and covered
participants and beneficiaries, the health insurance issuer file with the commissioner notice
and the insurance product being discontinued for certification that the notice is in
compliance with present law relative to withdrawal. Provides that notice shall not be issued
to the insureds or enrollees until the expiration of 20 days after this filing unless the
commissioner of insurance gives his written approval prior to that time.
Proposed law provides that in the case of a discontinuation in any health insurance market,
any policy or coverage that is not subject to renewal during the minimum 180-day notice
period shall remain in force until the renewal or termination date upon which the contracted
period of coverage ends. Further provides that any policy or coverage whose renewal date
falls within the minimum 180-day notice period shall remain in force for 180 days from the
date that the notice of discontinuation was issued.
Proposed law also prohibits a health insurance issuer or health maintenance organization
issuing group or individual policies or subscriber agreements from increasing its premium
rates or reduce covered benefits under any policy or subscriber agreement after the
commencement of the minimum 180-day period prior to the date of withdrawal.
(Amends R.S. 22:979, 1068(C)(2)(a)(iii) and (b), 1074(C)(2)(a)(iii) and (b), and 1096; Adds
R.S. 22:1068(C)(2)(c) and 1074(C)(2)(c))