West Virginia 2023 Regular Session

West Virginia House Bill HB3487

Introduced
2/14/23  

Caption

Relating to cost-sharing calculations for certain Health Savings Account-qualified High Deductible Health Plans

Impact

If enacted, HB3487 would significantly impact the insurance sector within West Virginia, particularly for those enrolled in Health Savings Account-qualified High Deductible Health Plans. By providing a clearer definition and method for calculating cost-sharing requirements, the bill seeks to enhance the transparency of insurance practices, ultimately leading to improved financial predictability for consumers navigating their healthcare costs. As the legislation aims to align state regulations with federal guidelines, it could also foster a more standardized approach across various insurance providers operating in the state.

Summary

House Bill 3487 focuses on amending several sections of the West Virginia Code related to cost-sharing calculations for certain Health Savings Account-qualified High Deductible Health Plans. The intent of the bill is to clarify how cost-sharing is calculated so that it reflects any amounts that the insured may have paid, either directly or through another party. These clarifications aim to ensure fairness in cost-sharing, benefiting the insured individuals and promoting accessibility to healthcare services.

Sentiment

The sentiment around HB3487 appears to be generally positive among healthcare advocates and insurance professionals who emphasize the need for clarity and fairness in healthcare cost-sharing. Stakeholders believe that the bill could alleviate some of the confusion that often accompanies high deductible plans. However, there are concerns from consumers and certain advocacy groups who fear that without stringent regulations, insurers might still exploit loopholes in the system that could negatively affect consumers' access to affordable healthcare.

Contention

Notable points of contention revolve around the interpretation of cost-sharing and its implications for eligibility under federal law. While the bill intends to safeguard consumers by incorporating payments made on their behalf, there are uncertainties regarding how these calculations will be enforced and monitored. Critics argue that without rigorous oversight, there is a risk that insurers may not fully comply with the inclusive cost-sharing provisions, potentially leaving consumers vulnerable to unexpected out-of-pocket expenses.

Companion Bills

No companion bills found.

Previously Filed As

WV SB594

Specifying fairness in cost sharing calculations for certain high deductible health plans

WV A05367

Relates to cost sharing requirements for high deductible health plans and health savings accounts.

WV S06895

Relates to cost sharing requirements for high deductible health plans and health savings accounts.

WV SB832

Providing for administration of cost-sharing calculations

WV HB1081

Health insurance; calculation of enrollee's contribution, high deductible health plan.

WV SB433

Health insurance; calculation of enrollee's contribution, high deductible health plan.

WV SB773

Health Benefit Plans - Calculation of Cost-Sharing Contribution - Requirements

WV HB05410

An Act Concerning High Deductible Health Plans.

WV HB06003

An Act Concerning Diabetes And High Deductible Health Plans.

WV SB354

Relative to insurance cost-sharing calculations.

Similar Bills

WV HB5379

Relating to financial assistance available for a prescription drug

WV HB3092

Relating to financial assistance available for a prescription drug

WV SB594

Specifying fairness in cost sharing calculations for certain high deductible health plans

WV SB831

Ensuring financial assistance availability for prescription drugs

MS HB880

Prescription drugs; provide for reduction of patients' cost for.

SC H3934

Cost sharing

SC S0330

Cost sharing

SC H3575

Pharmacy insurance benefits cost-sharing