GREEN SHEET REDIGEST
HB 616 2024 Regular Session Green
INSURANCE/HEALTH: Provides relative to actuarial reviews of healthcare
legislation.
DIGEST
Proposed law requires the La. Dept. of Insurance (LDI) to implement a process for actuarial
reviews of healthcare legislation. By Feb. 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 legislators requesting actuarial reviews of legislative proposals to
submit requests to LDI no later than Feb.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 year 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, social and
other economic impacts and the amounts necessary to defray the cost of the mandate.
Provides the dept. may seek an evaluation relative to the legislative proposal being a mandate
prior to requesting the remainder of the actuarial review.
Proposed law requires contractors to provide certain information regarding actuarial reviews
including but not limited to enrollment estimates of health benefit plans and certain
desegregated 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 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
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Prepared by Beth O'Quin. 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 requires data and other records disclosed by a health insurer, health plan, or
other health insurance issuer pursuant to proposed law to be kept confidential.
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.
The Committee Amendments Proposed by House Committee on Appropriations to the
engrossed bill:
1. Require data and records disclosed by a health insurer, health plan, or other
health insurance issuer pursuant to proposed law to be kept confidential.
2. Make technical changes.
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Insurance to the reengrossed
bill
1. Makes technical changes.
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Prepared by Beth O'Quin. 2. Changes the date to request an actuarial review of legislative proposals from Dec.
1st to Feb. 1st.
3. Changes the predicted effects of the legislative proposal from 5 years to a year.
4. Provides the dept. may first request an actuarial review as to whether the
legislative proposal is a mandate under federal law.
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Prepared by Beth O'Quin.