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)]
HB 616 Engrossed 2024 Regular Session Green
Abstract: Requires legislative review and actuarial analysis of proposed, mandated healthcare
legislation.
Proposed law requires the La. Dept. of Insurance (LDI) to implement a process for actuarial reviews
of healthcare legislation. By Dec. 1, 2024, proposed law requires LDI to contract with one or more
entities with experience in actuarial reviews and healthcare policy for the purpose of performing
actuarial reviews of legislative proposals.
Proposed law requires at least one of the contracted entities to be an actuary or actuarial firm, or a
university department or academic faculty based in the state of La. with experience analyzing health
insurance premiums. Further requires contractors to be independent and free from conflicts of
interest.
Proposed law requires LDI to hold a public meeting no later than Sept. 1, 2024, to obtain input and
recommendations from stakeholders.
Proposed law requires legislators requesting actuarial reviews of legislative proposals to submit
requests to LDI no later than Dec. 1st of the year preceding the regular session of the legislature in
which the legislative proposal will be proposed.
Proposed law requires contractors to consider in actuarial reviews the predicted effects of the
legislative proposal during the 5 years immediately following the effective date of the proposal, or
during another time period if such consideration is more actuarially feasible. Predicted effects
include but are not limited to certain estimated cost changes with respect to consumer cost sharing,
premiums, out-of-pocket expenses, impacts to health benefit plans, and social and other economic
impacts.
Proposed law requires contractors to provide certain information regarding actuarial reviews
including but not limited to enrollment estimates of health benefit plans and certain disaggregated
demographic information.
Proposed law provides for qualitative analysis of the impact of legislative proposals. Authorizes a
legislator who requests an actuarial review to designate one or more persons to provide data to
contractors in order to inform the qualitative analysis. Authorizes contractors performing legislative
reviews to use data from any reasonable source, including data collected from insurers. Further
requires insurers to provide information to and cooperate with contractors and LDI. Proposed law provides that the reports of actuarial reviews are confidential, except to the requesting
legislator or the respective chairmen of the House and Senate committees on insurance, until the
legislative proposal is introduced in the following regular legislative session, or if no legislative
proposal is introduced, until after the end of the legislative session following the submission of the
request.
Proposed law requires LDI to provide written notification to the commissioner of administration and
the chairmen of the House appropriations committee and Senate finance committee of the estimated
defrayal cost. Upon receipt of the written notification, proposed law requires the commissioner of
administration to request an appropriation to pay the estimated defrayal cost of each enacted
legislative proposal prior to implementation in the subsequent plan year.
Proposed law requires insurers to provide actuarial estimates, based on appropriate claims and data
of the per-member, per-month amount necessary to defray the cost of the enacted mandate for the
subsequent plan year. Requires estimates to be actuarially sound. Requires LDI to notify the
commissioner of administration and the chairmen of the House appropriations committee and Senate
finance committee of the amounts needed to defray the cost of the enacted mandates for each health
benefit plan. Further requires the commissioner of administration to request an appropriation to pay
these amounts prior to implementation in the subsequent plan year.
Proposed law does not delegate state or federal authority to a non-state entity, including authority
to request fiscal impact analyses from the legislative fiscal office, or the authority to make
determinations regarding the legal status of state benefit mandates.
Proposed law prohibits LDI from engaging a contractor to perform an actuarial review unless LDI
determines adequate resources within existing appropriations for compensation.
Present law provides for the La. Mandated Health Benefits Commission. Proposed law repeals
present law and authorizes the La. State Law Institute to redesignate proposed law.
(Adds R.S. 22:2188; Repeals R.S. 22:2187)
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the original bill:
1. Add that a contractor may be a La.-based university department or academic faculty with
experience analyzing health insurance premiums.
2. Require the department to ensure that contractors are independent and free from conflicts
of interest that might affect neutrality of actuarial reviews.
3. Delete language relative to limiting the number of reviews to 6 legislative proposals. 4. Require the estimate of the amounts necessary to defray the cost of the mandates for
health insurance products to include an evaluation of whether the legislative proposal
includes a mandate requiring defrayal of costs. Authorize LDI to seek this evaluation
prior to requesting the remaining actuarial review required in proposed law.
5. Provide that proposed law does not delegate state or federal authority to a non-state
entity, including authority to request fiscal impact analyses from the legislative fiscal
office, or authority to make determinations regarding the legal status of state benefit
mandates pursuant to state and federal law.
6. Make technical changes.