Legislative Session number- 82

Bill Name: SF1615

Providing for greater flexibility and simplifying regulation of health care
coverage products ARTICLE 1 PRODUCT FLEXIBILITY Providing for greater
flexibility in health maintenance organization (HMO) enrollee cost sharing;
specifying certain copayment and deductible limits and certain annual out of
pocket and lifetime benefit maximums; excepting certain small employer plans,
certain preventive care and public health care programs from the regulations;
noncovered services out of pocket costs not to count toward deductibles or
maximums ARTICLE 2 IMPROVED CONSUMER CHOICE AND REDUCED REGULATORY
BURDENSModifying a certain provision regulating the continuation of accident and
health insurance benefits to disabled employees; authorizing termination of
continuation coverage for survivors, terminated or laid off employees and
current or former spouses and children for failing to pay premiums or fees or
upon eligibility for medicare, extending the time limit for employer notice of
continuation coverage options to terminated or laid off employees, restricting
the right to terminate upon survivor, spouse or child medicare eligibility and
authorizing termination of survivors and former spouses and children after a
certain enrollment period; eliminating the premium rate limit for individual
health plans offered to persons previously covered by group plans; reducing the
frequency requirement for commissioner of commerce examination of the financial
condition of nonprofit health service plan corporations; conforming nonprofit
health service plan corporation and health maintenance organization continuing
coverage requirements for former spouses and children to the included
requirement changes for accident and health insurers; eliminating the
requirement for HMOs to notify the commissioner of health of certain changes and
increasing the time limit for notice to the commissioner of provider
terminations; exempting medicare choice products offered by HMOs from state laws
and rules; authorizing HMOs to cancel or fail to renew coverage for intentional
provision of false health status information at the time of enrollment,
specifying a cancellation or nonrenewal time limit; reducing the frequency
requirement for commissioner examination of the affairs of health maintenance
organizations and clarifying the data classification requirement; clarifying
policy conversion rights under the comprehensive health insurance plan (MCHA);
clarifying the definition of utilization review organization; providing for the
recognition of health plan company accreditation or certification by private
accreditation organizations; eliminating certain health plan company action plan
content requirements; clarifying the general authority of health plan companies
to cancel health plans; requiring the commissioner of health to amend certain
rules ARTICLE 3 REGULATORY REFORM AND CONFORMANCE TO FEDERAL ERISA
STANDARDSRequiring the commissioners of health and commerce to report to the
legislature by a certain date with recommendations for health plan regulatory
reform including proposed legislation to create a uniform set of state
regulations for all health plan companies and products based on certain
regulatory principles; requiring the commissioners of commerce, health, human
services and employee relations (DOER) to jointly convene an interagency task
force to coordinate state agency activities relating to health plan regulation,
contracting and purchasing to avoid duplication, inconsistency and excessive
administrative and reporting burdens on health plans(ra)