SLS 21RS-329 ORIGINAL
2021 Regular Session
SENATE BILL NO. 106
BY SENATOR BOUDREAUX
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
PHARMACEUTICALS. Provides relative to health insurance issuers of health insurance
coverage. (8/1/21)
1 AN ACT
2 To amend and reenact R.S. 22:1068(D)(3) and 1074(D)(3), relative to guaranteed
3 renewability of health insurance coverage; to authorize the modification of drug
4 coverage with an increase of at least twenty-five percent under certain
5 circumstances; and to provide for related matters.
6 Be it enacted by the Legislature of Louisiana:
7 Section 1. R.S. 22:1068(D)(3) and 1074(D)(3) are hereby amended and reenacted
8 to read as follows:
9 §1068. Guaranteed renewability of coverage for employers in the group market
10 * * *
11 D. A health insurance issuer may modify health insurance coverage offered
12 to a group health plan if each of the following conditions is met:
13 * * *
14 (3) The issuer notifies, on a form approved by the Department of Insurance,
15 each affected covered small or large employer and enrollee of the modification,
16 including modification of coverage of a particular product or modification of drug
17 coverage, not later than the sixtieth day before the date the modification is effective.
Page 1 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 106
SLS 21RS-329 ORIGINAL
1 Notwithstanding the requirements of Paragraph (D)(1) of this Section,
2 modification of drug coverage for any drug costing over three hundred dollars
3 per prescription or refill with an increase in the wholesale acquisition cost of at
4 least twenty-five percent in the prior three hundred sixty-five days may occur
5 at any time provided a thirty-day notice is given of the modification of coverage.
6 * * *
7 §1074. Guaranteed renewability of individual health insurance coverage
8 * * *
9 D. A health insurance issuer may modify the health insurance coverage for
10 a policy form offered to individuals in the individual market if each of the following
11 conditions is met:
12 * * *
13 (3) The issuer notifies, on a form approved by the Department of Insurance,
14 each affected individual of the modification, including modification of coverage of
15 a particular product or modification of drug coverage, not later than the sixtieth day
16 before the date the modification is effective. Notwithstanding the requirements of
17 Paragraph (D)(1) of this Section, modification of drug coverage for any drug
18 costing over three hundred dollars per prescription or refill with an increase in
19 the wholesale acquisition cost of at least twenty-five percent in the prior three
20 hundred sixty-five days may occur at any time provided a thirty-day notice is
21 given of the modification of coverage.
22 * * *
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Cheryl Cooper.
DIGEST
SB 106 Original 2021 Regular Session Boudreaux
Present law provides for guaranteed renewability of health coverage for employees in the
group market and persons with individual health coverage.
Present law authorizes a health insurance issuer to modify the health insurance coverage for
a policy form offered to a group health plan or to individuals in the individual market if each
of the following conditions is met:
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 106
SLS 21RS-329 ORIGINAL
(1)The modification occurs at the time of coverage renewal.
(2)The modification is approved by the commissioner of insurance and is on a uniform
basis among all individuals and all small and large employers covered by the group
health plan.
(3)The insurer notifies each individual or group no later than the 60th day before the
modification is effective.
Proposed law retains these provisions in present law but as to the notification requirement,
modification of drug coverage is allowed at any time as to a drug costing over $300 per
prescription or refill with an increase in the wholesale acquisition cost of at least 25% in the
prior 365 days provided a 30-day notice is given of the modification of coverage.
Effective August 1, 2021.
(Amends R.S. 22:1068(D)(3) and 1074(D)(3))
Page 3 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.