ENROLLED
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ACT No. 595
Regular Session, 2010
HOUSE BILL NO. 717
BY REPRESENTATIVE ROY
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
accident insurer or any individual accident and health insurer from increasing its20
premium if the increase is applicable to all members of the group insurance plan, or21
all insureds who have the same individual accident and health plan or policy. except22
that no health insurance issuer or health maintenance organization issuing group or23
individual policies or subscriber agreements shall increase its premium rates or24 ENROLLEDHB NO. 717
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reduce covered benefits under any policy or subscriber agreement after the1
commencement of the minimum one-hundred-eighty-day period provided for in R.S.2
22:1068(C)(2)(a)(i) or 1074(C)(2)(a)(i).3
* * *4
§1068. Guaranteed renewability of coverage for employers in the group market5
* * *6
C.7
* * *8
(2)(a) In any case in which a health insurance issuer elects to discontinue9
offering all health insurance coverage in the small group market or the large group10
market, or both markets, in the state, health insurance coverage may be discontinued11
by the issuer if:12
* * *13
(iii) Prior to providing the notice required by Item (i) of this Subparagraph,14
the issuer files such notice and the insurance product being discontinued with the15
commissioner of insurance. the notice and the insurance product being discontinued16
for certification that the notice is in compliance with this Section. Notice shall not17
be issued to the insureds or enrollees until the expiration of twenty days after the18
notice and insurance product being discontinued have been filed unless the19
commissioner of insurance gives his written approval prior to that time.20
(b) In the case of a discontinuation in the small group market or large group21
market under Subparagraph (a) of this Paragraph, any plan sponsor’s policy or22
coverage that is not subject to renewal during the minimum one-hundred-eighty-day23
notice period shall remain in force until the termination date upon which the24
contracted period of coverage ends. Any plan sponsor’s policy or coverage whose25
renewal date falls within the minimum one-hundred-eighty-day notice period shall26
remain in force for one hundred eighty days from the date that the notice of27
discontinuation was issued.28
(c) In the case of a discontinuation under Subparagraph (a) of this Paragraph29
in a market, the issuer may not provide for the issuance of any health insurance30 ENROLLEDHB NO. 717
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coverage in the market and state during the five-year period beginning on the date1
of the discontinuation of the last health insurance coverage not so renewed.2
* * *3
§1074. Guaranteed renewability of individual health insurance coverage4
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C.6
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(2)(a) Subject to Subparagraph (b) of this Paragraph, in any case in which8
a health insurance issuer elects to discontinue offering all health insurance coverage9
in the individual market in a state, health insurance coverage may be discontinued10
by the issuer only if:11
* * *12
(iii) Prior to providing the notice required by Item (i) of this Subparagraph,13
the issuer files such notice and the insurance product being discontinued with the14
commissioner of insurance. the notice and the insurance product being discontinued15
for certification that the notice is in compliance with this Section. Notice shall not16
be issued to the insureds or enrollees until the expiration of twenty days after the17
notice and insurance product being discontinued have been filed unless the18
commissioner of insurance gives his written approval prior to that time.19
(b) In the case of a discontinuation in the individual market under20
Subparagraph (a) of this Paragraph, any individual's policy or coverage that is not21
subject to renewal during the minimum one-hundred-eighty-day notice period shall22
remain in force until the termination date upon which the contracted period of23
coverage ends. Any individual's policy or coverage whose renewal date falls within24
the minimum one-hundred-eighty-day notice period shall remain in force for one25
hundred eighty days from the date that the notice of discontinuation was issued.26
(c) In the case of a discontinuation under Subparagraph (a) of this Paragraph27
in the individual market, the issuer may not provide for the issuance of any health28
insurance coverage in the market and state involved during the five-year period29 ENROLLEDHB NO. 717
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beginning on the date of the discontinuation of the last health insurance coverage not1
so renewed.2
* * *3
§1096. Health and accident insurers; rate increases4
Health and accident insurers shall not increase their premium rates during the5
initial twelve months of coverage and not more than once in any six-month period6
following the initial twelve-month period, for any policy, rider, or amendment issued7
in or for residents of the state, no matter the date of commencement or renewal of the8
insurance coverage. except that no health insurance issuer or health maintenance9
organization issuing group or individual policies or subscriber agreements shall10
increase its premium rates or reduce the covered benefits under the policy or11
subscriber agreement after the commencement of the minimum one-hundred-eighty-12
day period described in R.S. 22:1068(C)(2)(a)(i) or 1074(C)(2)(a)(i). This Section13
does not affect increases in the premium amount due to the addition of a newly14
covered person or a change in age or geographic location of an individual insured or15
policyholder or an increase in the policy benefit level.16
SPEAKER OF THE HOUSE OF REPRESENTATI VES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: