The original instrument was prepared by Martha Hess. The following digest, which
does not constitute a part of the legislative instrument, was prepared by LG Sullivan.
DIGEST
SB 122 Reengrossed 2020 Regular Session Carter
Present law provides for eligibility in programs sponsored by the Office of Group Benefits, subject
to certain limitations.
Present law authorizes the Office of Group Benefits to procure private contracts of policies of group
health, accident, accidental death and dismemberment, and hospital, surgical, or medical expense
benefits and to contract for all or a portion of the administration, operation, or both of a self-funded
program for that purpose.
Present law provides that the respective limiting age of a child or grandchild of an enrollee shall not
terminate the coverage of the child or grandchild if they are incapable of self-sustaining employment
by reason of physical or mental disability prior to attaining the respective limiting age.
Present law further provides that before the child or grandchild reaches the limiting age, but no
earlier than six months before, an application for continued coverage is filed and subsequently
approved.
Present law stipulates the application shall be accompanied by an attestation from the dependent's
attending physician specifying the physical or mental disability and certifying that the child or
grandchild is incapable of self-sustaining employment by reason of that disability. The office may
require additional medical or other supporting documentation regarding the disability to process the
application.
Present law also provides that after the initial approval, the office may require the submission of
additional medical or other supporting documentation substantiating continued disability, but not
more frequently than annually, as a precondition to continued coverage.
Proposed law provides that no later than seven months before the child or grandchild reaches
limiting age, the health plan shall send notice to the parent or grandparent that coverage expires
unless an application for continued coverage is filed. Proposed law stipulates that the notice shall
specify that if the application for continued coverage is not filed prior to the date the child or
grandchild reaches the respective limiting age, the child or grandchild shall lose coverage.
Proposed law requires that the notice contain an explanation of the right of the parent or grandparent
to appeal for an administrative review if the documentation is not submitted timely. Proposed law
requires that the application be submitted no earlier than six months prior to the child or grandchild
attaining the respective limiting age.
Proposed law provides that if continued coverage is denied due to failure to obtain the additional required documentation, upon submitting documentation, the parent or grandparent shall have the
right to appeal for an administrative review to reinstate the coverage. The administrative review
panel may decide, after consideration of the totality of circumstances and for good cause, to reinstate
coverage.
Proposed law further provides that if the parent or grandparent does not submit the application for
continued coverage prior to the date the child or grandchild reaches the respective limiting age, they
shall have the right to appeal for an administrative review and to explain the reasons for untimely
filing. Authorizes the administrative review panel to decide, after consideration of the totality of
circumstances and for good cause, to reinstate coverage.
Proposed law applies to any health plan under the purview of present law.
Proposed law provides that proposed law may be referred to or cited as "Arielle's Law".
Effective August 1, 2020.
(Amends R.S. 42:808(F))
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Finance to the original bill
1. Changes time period for the health plan to give notice to the parent or grandparent
that coverage shall expire unless an application for continued coverage is received
and approved from eight months to seven months.
2. Provides that the entity giving the notice to the parent or grandparent shall be the
health plan authorized by current law.
3. Changes references from "appeal review panel" to "administrative review".
Summary of Amendments Adopted by Senate
Senate Floor Amendments to engrossed bill
1. Provide that proposed law may be referred to or cited as "Arielle's Law".