04RS HB227


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HB 227 (BR 873) - J. Higdon, J. Bruce, T. Edmonds, B. Farmer, J. Gooch, M. Harmon, R. Palumbo, S. Westrom

     AN ACT relating to catastrophic health benefit plans.
     Create a new section of Subtitle 17A of KRS Chapter 304 to permit a health insurer that offers, renews, or delivers a health benefit plan in Kentucky to offer as an option a limited health benefit plan that excludes any or all of the state-mandated health benefits; require the applicant at the time of application, and the policyholder upon renewal, to sign a written disclosure statement and return it to the insurer; provide that the disclosure statement must clearly state that the limited health benefit plan does not cover all state-mandated benefits and list each covered mandated benefit and each excluded mandated benefit; require the insurer to retain the disclosure statement for a reasonable period of time as determined by the commissioner.


     HCS - Retain original provisions; permit insurer to offer a health benefit plan, rather than a catastrophic health benefit plan, that excludes any or all state mandated benefits except for federal mandated benefits and except for mandated benefits that mandate the payment, indemnification, or reimbursement of providers licensed under KRS Chapter 312 or any other specified health care provider as defined in KRS 304.17A-005(19); provide that an insurer shall not be required to utilize the experience of enrollees of health benefit plans that contain the mandated benefits to develop the insurer's index rate for health benefit plans offered, renewed, or delivered under this section; permit the insurer to meet the requiremet of retaining the disclosure statement in its records by retaining an electronic copy of the disclosure statement.

     HCA (1/Title, J. Higdon) - Make title amendment.

     HFA (1, R. Palumbo) - Prohibit the waiver of mandated benefits for diabetes.

     HFA (2, C. Miller) - Require the optional health benefit plan to cover mammography screenings and breast cancer treatment.

     HFA (3, J. Higdon) - Prohibit the waiver of mandated benefits for diabetes; require a disclosure statement be signed by prospective policyholder or insured prior to application or renewal; provide that any advertisement of a policy that waives mandated benefits clearly state that the policy does not cover all mandated health benefits.

     SFA (1, T. Shaughnessy) - Amend KRS 304.17A-200 to permit an individual to refuse coverage under a small employer group of two to ten employees within an employer-organized association; create new sections of Subtitle 17A of KRS Chapter 304 to permit an insurer to not include any additional state-mandated benefits between January 1, 2005, and December 31, 2007; require the commissioner of insurance to promulgate administrative regulations setting forth standards and procedures for disclosure of information, including protected health information, required by insurers; create a new section of Subtitle 18 of KRS Chapter 304 to provide that beginning no later than August 1, 2004, every insurer offering or issuing health benefit plans must use the uniform employee application form developed by the commissioner of insurance when a person or employer applies for coverage under a health benefit plan offered by the employer insurer; amend KRS 304.17B-015 to provide that a person is eligible for coverage under Kentucky Access if the person has been a Kentucky resident for 12 months, and the individual is eligible to be enrolled in a small group of two to ten employees which is eligible for participation in an employer-organized association health benefit plan, and the individual has voluntarily waived the coverage, and the individual has a high-cost condition, and the individual's employer will pay the same percentage or dollar amount of premium as the employer pays for his or her other employees.

     SFA (2, T. Shaughnessy) - Add a list of the state health mandates that may be excluded by health insurers pursuant to this Act.

     SFA (3, C. Borders) - Amend Section 1(1)(a) of GA bill to include benefit for hospice care under KRS 304.17A-250(8).

     SFA (4, J. Denton) - Direct the Legislative Research Commission to create a Task Force on Health Care Cost Containment; direct the task force to study health care cost increases and potential solutions; direct the task force to review legislation in other states on limited benefit or mandate-free health insurance plans, the impact of such plans on premiums in Kentucky, and the effect of such plans on competition in the health insurance market; direct the task force to review how health savings accounts or other health care reimbursement accounts may affect premiums; direct the task force to report by December 1, 2004; direct the Legislative Research Commission to contract with a health insurance actuary to assist the task force.

     Jan 8-introduced in House
     Jan 9-to Banking and Insurance (H)
     Jan 12-posted in committee
     Feb 25-reported favorably, 1st reading, to Calendar with Committee Substitute, committee amendment (1-title)
     Feb 26-2nd reading, to Rules
     Mar 3-posted for passage in the Regular Orders of the Day for Thursday, March 4, 2004
     Mar 4-floor amendments (1) (2) and (3) filed to Committee Substitute
     Mar 17-3rd reading, passed 81-6 with Committee Substitute, committee amendment (1-title), floor amendments (2) and (3)
     Mar 18-received in Senate
     Mar 19-to Banking and Insurance (S)
     Mar 24-reported favorably, 1st reading, to Calendar; floor amendments (1) and (2) filed
     Mar 25-2nd reading, to Rules; posted for passage in the Regular Orders of the Day for Friday, March 26, 2004
     Mar 26-floor amendments (3) and (4) filed
     Apr 13-passed over and retained in the Orders of the Day

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