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are additions.
Regular Session, 2014
HOUSE BILL NO. 852
BY REPRESENTATIVE TALBOT
INSURANCE/GROUP: Provides relative to the disclosure of insurance claims data
AN ACT1
To amend and reenact R.S. 22:978(E)(1)(introductory paragraph) and (a), (7), and (8) and2
to enact R.S. 22:978(G), relative to insurance claims data; to provide for the release3
of claims data to agents; to require the agent receiving the claims data to certify the4
limited use of the data; to provide that an insurer shall not be required to release5
information protected as confidential by federal law; and to provide for related6
matters.7
Be it enacted by the Legislature of Louisiana:8
Section 1. R.S. 22:978(E)(1)(introductory paragraph) and (a), (7), and (8) are hereby9
amended and reenacted and R.S. 22:978(G) is enacted to read as follows: 10
ยง978. Group, family group, blanket, and association health and accident insurance;11
notice required for certain premium increase, cancellation, or nonrenewal12
* * *13
E.(1) Not less than ninety days prior to the renewal of a policy, every health14
and accident insurance issuer, including a health maintenance organization, shall,15
upon request, release to each group policyholder or and agent of a policyholder16
claims data and shall provide this data within no more than fourteen business days17
of receipt of the request, which shall include the following items:18
(a) The net claims paid by month during the current and the two immediately19
preceding policy period periods.20
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HB NO. 852
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are additions.
(7) A plan sponsor is and the plan sponsor's agent are entitled to receive1
protected health information under this Section only after an appropriately2
authorized representative of the plan sponsor or agent makes to the health and3
accident insurer a certification substantially similar to the following certification:4
'I hereby certify and have demonstrated that the plan5
documents comply with the requirements of 45 C.F.R.6
Section 164.504(f)(2) and that the plan sponsor will safeguard7
and limit the use and disclosure of protected health8
information that the plan sponsor or agent may receive from9
the group health plan to perform the plan administration10
functions.'11
(8) A plan sponsor or agent that does not provide the certification required12
in Paragraph (7) of this Subsection is not entitled to receive the protected health13
information described in Subparagraphs (1)(d) and (e) of this Subsection, but is14
entitled to receive a report of claim information that includes the other information15
required by this Subsection.16
* * *17
G. Nothing in this Section shall be construed to require an insurer to provide18
information protected as confidential by the Health Insurance Portability and19
Accountability Act of 1996 or any other provision of federal law.20
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)]
Talbot HB No. 852
Abstract: Requires the release of claims data to the agent of a group policyholder, in
addition to the policyholder, within 90 days of renewal of the policy after the agent
certifies he will limit the use and disclosure of the claims data as provided by federal
regulation.
Present law provides for the release of claims data by a health and accident insurer within
90 days of renewal of the group policy to the group policyholder upon certification that the
policyholder will only use and disclose the data in compliance with federal regulation. HLS 14RS-1306 ENGROSSED
HB NO. 852
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are additions.
Proposed law retains present law but also provides for the release of the claims data to the
agent of the policyholder, and limits the claims data that must be released to the current and
two immediately preceding policy periods.
Proposed law provides that insurer shall not be required to release information protected as
confidential by federal law.
(Amends R.S. 22:978(E)(1)(intro.para.) and (a), (7), and (8); Adds R.S. 22:978(G))
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Insurance to the original
bill.
1. Provided that an insurer shall not be required to release information protected as
confidential by federal law.