SLS 12RS-1789 ORIGINAL
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Regular Session, 2012
SENATE BILL NO. 718
BY SENATOR DORSEY-COLOMB
HEALTH/ACC INSURANCE. Provides for legislation relative to health insurance. (gov
sig)
AN ACT1
To amend and reenact R.S. 22:1060.3(A) and 1074(D)(2), relative to health insurance; to2
provide with respect to coverage by a health benefit plan of prescription drugs; to3
provide relative to guaranteed renewability of coverage in the group and individual4
market with regard to modifications affecting drug coverage; to provide for5
applicability; and to provide for related matters.6
Be it enacted by the Legislature of Louisiana:7
Section 1. R.S. 22:1060.3(A) and 1074(D)(2) are hereby amended and reenacted to8
read as follows:9
§1060.3. Continuation of coverage required; other drugs not precluded10
A. A health insurance issuer of a health benefit plan that covers prescription11
drugs shall offer to each enrollee at the contracted benefit level and until the12
enrollee's plan renewal date any prescription drug that was approved or covered13
under the plan for a medical condition or medical illness, regardless of whether the14
drug has been removed from the health benefit plan's drug formulary before the plan15
renewal date. Such offer shall be made in writing and made at least sixty days16
prior to any formulary change that affects coverage of that prescription drug.17 SB NO. 718
SLS 12RS-1789 ORIGINAL
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Nothing herein shall prohibit the health insurance issuer from providing1
information to the enrollee regarding alternative covered drugs.2
* * *3
§1074. Guaranteed renewability of individual health insurance coverage4
* * *5
D. A health insurance issuer may modify the health insurance coverage for6
a policy form offered to individuals in the individual market if each of the following7
conditions is met:8
* * *9
(2) The Such modification is approved by the commissioner, is consistent10
with state law, and is effective on a uniform basis among all individuals with that11
policy form.12
* * *13
Section 2. Any provision of Regulation 100 promulgated by the Department of14
Insurance or any other regulation, rule, directive, advisory letter, or other instrument issued15
in conflict with provisions of this Act shall be null and void.16
Section 3. This Act shall become effective upon signature by the governor or, if not17
signed by the governor, upon expiration of the time for bills to become law without signature18
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If19
vetoed by the governor and subsequently approved by the legislature, this Act shall become20
effective on the day following such approval.21
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Michael Bell.
DIGEST
Present law provides that a health insurance issuer of a health benefit plan that covers
prescription drugs shall offer to each enrollee at the contracted benefit level and until the
enrollee's plan renewal date any prescription drug that was approved or covered under the
plan for a medical condition or medical illness, regardless of whether the drug has been
removed from the health benefit plan's drug formulary before the plan renewal date.
Proposed law provides that a prescription drug plan shall make the offer required by present
law in writing at least 60 days prior to any formulary change that affects coverage of that
prescription drug. Further provides that nothing shall prohibit the health insurance issuer
from providing information to the enrollee regarding alternative covered drugs. SB NO. 718
SLS 12RS-1789 ORIGINAL
Page 3 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Present law relative to guaranteed renewability of individual health insurance coverage
allows a health insurance issuer, at the time of coverage renewal, to modify coverage for a
product offered to a group health plan in the large group market provided certain conditions
are met.
Proposed law provides for a health insurance issuer to modify the health insurance coverage
for a policy form offered to individuals in the individual market at the time of coverage
renewal if the modification is consistent with state law, and is effective on a uniform basis
among all individuals with that policy form.
Proposed law provides that any regulation, rule, directive, advisory letter, or other instrument
issued in conflict with proposed law shall be null and void.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Amends R.S. 22:1060.3(A) and 1074(D)(2))