HLS 13RS-1044 ENGROSSED
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Regular Session, 2013
HOUSE BILL NO. 524
BY REPRESENTATIVE BURRELL
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
INSURANCE/HEALTH: Provides relative to group blanket health and accident insurance
AN ACT1
To amend and reenact R.S. 22:1000(A)(3)(a), (b), (c), (d), (f), (g), and (h) and to enact R.S.2
22:1000(A)(3)(i) through (p), relative to group blanket health and accident3
insurance; to provide additional special groups relative to group blanket health and4
accident insurance; to clarify provisions relative to policies of group blanket health5
and accident insurance; to provide for applicability; and to provide for related6
matters.7
Be it enacted by the Legislature of Louisiana:8
Section 1. R.S. 22:1000(A)(3)(a), (b), (c), (d), (f), (g), and (h) are hereby amended9
and reenacted and R.S. 22:1000(A)(3)(i) through (p) are hereby enacted to read as follows:10
ยง1000. Group, family group, blanket, and association health and accident insurance11
A. Any insurer authorized to write health and accident insurance in this state12
shall have the power to issue policies described in this Section., provided that no13
policy issued pursuant to this Section shall conflict with other provisions of this Title14
or with federal law including but not limited to relevant provisions of law governing15
major medical health and accident policies.16
* * *17
(3) Blanket health and accident insurance is any policy covering special18
groups of persons as enumerated in one of the following Subparagraphs (a) through19
(g): (o):20 HLS 13RS-1044 ENGROSSED
HB NO. 524
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
(a) Under a policy or contract issued to any common carrier or to any1
operator, owner, or lessee of a means of transportation which operates as a common2
carrier, which shall be deemed the policyholder, covering a group defined as all3
persons who may become passengers on such common carrier or means of4
transportation.5
(b) Under a policy issued to an employer, who shall be deemed the6
policyholder, covering any group of employees , dependents or guests defined by7
reference to exceptional hazards incident to activities or operations of the8
policyholder such employment.9
(c) Under a policy issued to a college, school, or other institution of learning,10
a school district or districts or school jurisdictional unit, or to the head, or principal,11
or governing board thereof, of that institution who or which shall be deemed the12
policyholder, covering students, or teachers, employees, or volunteers.13
(d) Under a policy issued in the name of any volunteer or governmental fire14
department, first aid, civil defense, or other such volunteer group, which shall be15
deemed the policyholder, covering any group all of the members, participants, or16
volunteers incident to any activities or operations sponsored or supervised by of such17
department or group.18
* * *19
(f) Under a policy or contract issued to a sports team, camp, or sponsor20
thereof which shall be deemed the policyholder, covering members, campers,21
employees, officials, supervisors, or volunteers.22
(g) Under a policy or contract issued to a religious, charitable, recreational,23
educational, or civic organization or branch thereof, which shall be deemed the24
policyholder, covering any group of members, participants, or volunteers defined by25
reference to specified hazards incident to any activities or operations sponsored or26
supervised by or on the premises of such policyholder.27
(h) Under a policy or contract issued to a newspaper or other publisher,28
which shall be deemed the policyholder, covering its carriers.29 HLS 13RS-1044 ENGROSSED
HB NO. 524
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
(i) Under a policy or contract issued to a restaurant, hotel, motel, resort,1
innkeeper, or other group with a high degree of potential customer liability, which2
shall be deemed the policyholder, covering patrons, guests, or volunteers.3
(j) Under a policy or contract issued to a health maintenance organization,4
a health care provider or other arranger of health services, which shall be deemed the5
policyholder, covering subscribers, patients, donors, and surrogates, provided that6
the coverage is not made a condition of receiving care or that major medical health7
and accident coverage may not be provided to subscribers or other enrollees pursuant8
to this Section.9
(k) Under a policy or contract issued to a bank or other financial association10
or institution, vendor, or to a parent holding company or to the trustee, trustees, or11
agent designated by one or more banks or other financial associations or institutions12
or vendors under which account holders, credit card holders, debtors, guarantors, or13
purchasers are insured.14
(l) Under a policy or contract issued to an incorporated or unincorporated15
association of persons having a common interest or calling, formed for purposes16
other than obtaining insurance, which association shall be deemed the policyholder,17
covering members or participants of such association.18
(m) Under a policy or contract issued to a travel agency or other organization19
that provides travel related services, which organization shall be deemed the20
policyholder, to cover all persons for which travel related services are provided.21
(f) (n) Under a policy issued to any other substantially similar group risk or22
class of risks which, in the discretion of the commissioner of insurance, may be23
subject to the issuance of a blanket health and accident policy. The discretion of the24
commissioner may be exercised on an individual risk basis or class of risks, or both.25
(g) (o) Under a policy or contract issued to the Department of Health and26
Hospitals, which shall be deemed the policyholder, covering a group defined as all27
persons who are eligible for medical assistance pursuant to a coverage program28
implemented pursuant to approval of the secretary of the United States Department29 HLS 13RS-1044 ENGROSSED
HB NO. 524
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of Health and Human Services using authority granted under Section 1115 of the1
Social Security Act.2
(h) (p) An individual application shall not be required from a person covered3
under such a blanket policy. The insurer shall furnish to the policyholder for4
delivery to the insured a certificate of insurance which shall disclose the benefits,5
limitations, exclusions, and reductions contained in the policy and the provisions6
relating to notice of claim, proof of loss, time of payment of claim, and any other7
relevant information, including the name and address of the insurer. All benefits8
under any such blanket policy shall be payable to the person insured, or to his9
designated beneficiary or beneficiaries, if the policy permits the designation of10
named beneficiaries, or to his estate, except that if the person insured be a minor11
such benefits may be made payable to his parent, guardian, or other person actually12
supporting him.13
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)]
Burrell HB No. 524
Abstract: Adds categories of special groups to the enumerated list of special groups which
may be covered by blanket health and accident insurance.
(1)Present law authorizes any health and accident insurer in the state to issue policies
described in present law.
Proposed law clarifies that those insurers can issue those policies if such policies do
not conflict with state or federal law.
(2)Present law recognizes group health and accident insurance as a policy of health and
accident insurance which covers more than one person, with certain exceptions.
(3)Present law recognizes blanket health and accident insurance as a type of group
health and accident insurance that covers special groups of persons. Present law
further lists these special groups.
Proposed law retains present law and adds to the list of special groups with respect
to blanket health and accident insurance.
(4)Present law lists common carriers as a special group.
Proposed law retains present law and clarifies that the special group of "common
carriers" includes any operator, owner, or lessee of a means of transportation that
operates as a common carrier. HLS 13RS-1044 ENGROSSED
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(5)Present law lists employers as a special group, and states that the policy of insurance
shall cover employees defined by reference to exceptional hazards incident to
employment.
Proposed law alters present law to include coverage for dependents or guests of an
employer, as defined by reference to hazards incident to any activities or operations
of the employer-policyholder.
(6)Present law lists colleges, schools, and other institutions of learning as a special
group, stating that the head or principal of such institution of learning is the
policyholder. Present law states that coverage may extend to students and teachers.
Proposed law retains present law and adds school districts and school jurisdiction
units to the type of institutions of learning which may be recognized as a special
group; further includes a governing board of such institution as a potential
policyholder. Proposed law further extends coverage to employees and volunteers
of such institutions.
(7)Present law lists volunteer fire departments, first aid groups, and other such groups
as a special group. Present law states that coverage extends to all members of such
fire departments and first aid groups.
Proposed law retains present law and adds governmental fire departments, as well
as civil defense groups. Proposed law further extends coverage to "participants" and
"volunteers" of such departments and first aid or civil defense group, incident to
sponsored or supervised activities.
(8)Proposed law adds sports teams, camps, and their sponsors to the list of special
groups, with coverage extended to members, campers, employees, officials,
supervisors, and volunteers.
(9)Proposed law adds religious, charitable, recreational, educational, and civic
organizations to the list of special groups, with coverage extended to members
participants, and volunteers.
(10)Proposed law adds newspapers and their publishers to the list of special groups, with
coverage extended to carriers of such newspapers.
(11)Proposed law adds restaurants, hotels, motels, resorts, innkeepers, and establishments
with a high degree of customer liability to the list of special groups, with coverage
extended to patrons, guests, and volunteers.
(12)Proposed law adds health maintenance organizations, health care providers and other
arrangers of health services, with coverage extended to subscribers, patients, donors,
and surrogates. Proposed law stipulates that such coverage shall not be made a
condition precedent to such individuals receipt of care. Proposed law further
stipulates that major medical health and accident coverage may not be provided to
subscribers or other enrollees.
(13)Proposed law adds banks and other financial associations or institutions to the list of
special groups, with coverage extended to account holders, credit card holders,
debtors, guarantors, and purchasers.
(14)Proposed law adds incorporated and unincorporated associations of persons who
have a common interest other than the purpose of obtaining insurance to the list of
special groups. Coverage extends to members and participants of such associations.
(15)Proposed law adds travel agencies and organizations that provide travel related
services to the list of special groups, with coverage extended to all persons for which
travel related services are provided. HLS 13RS-1044 ENGROSSED
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(16)Present law lists "substantially similar groups" as a special group which, subject to
the discretion of the commissioner of insurance.
Proposed law changes "substantially similar group" to "risk or class of risks" and
authorizes the commissioner to exercise his discretion on an individual risk basis or
as a class of risks, or both.
(17)Present law lists policies issued to the Department of Health and Hospitals as a
special group.
Proposed law retains present law.
(18)Present law states that an individual application shall not be required of a person
covered by such a group blanket policy.
Proposed law retains present law.
(Amends R.S. 22:1000(A)(3)(a), (b), (c), (d), (f), (g), and (h); Adds R.S. 22:1000(A)(3)(i)-
(p))
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Insurance to the original
bill.
1. Clarified that no policy issued pursuant to the provisions of proposed law shall
conflict with other provisions of Title 22 of the Louisiana Revised Statutes of
1950 or with other provisions of federal law.
2. With respect to policies or contracts issued to health maintenance organization,
clarified that major medical health and accident coverage may not be provided
to subscribers or other enrollees pursuant to proposed law.