08 LC 28 4066S
(SCS)
Senate
Bill 383
By:
Senators Hill of the 32nd, Chance of the 16th, Hudgens of the 47th, Thomas of
the 54th, Rogers of the 21st and others
AS
PASSED SENATE
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Title 33 of the Official Code of Georgia Annotated, relating to insurance,
so as to provide a short title; to provide for legislative intent; to provide
for the Commissioner of Insurance to adopt policies to promote, approve, and
encourage health savings account eligible high deductible plans in Georgia; to
provide for exemptions from certain unfair trade practices for certain wellness
and health promotion programs, condition or disease management programs, health
risk appraisal programs, and similar provisions in such plans; to provide for
certain requirements for such plans; to provide for health reimbursement
arrangement only plans that encourage employer financial support of health
insurance or health related expenses under certain circumstances; to provide for
related matters; to provide for an effective date; to repeal conflicting laws;
and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
This
Act shall be known and may be cited as the "Insuring Georgia´s Families
Act."
SECTION
2.
Title
33 of the Official Code of Georgia Annotated, relating to insurance, is amended
by striking Chapter 51 in its entirety and inserting in lieu thereof a new
Chapter 51 to read as follows:
"CHAPTER
51
33-51-1.
This
chapter shall be known and may be cited as the 'Georgia Affordable HSA Eligible
High Deductible Health Plan.'
33-51-2.
It
is the intent of the General Assembly:
(1)
To authorize the Commissioner to establish flexible guidelines for health
savings account eligible high deductible plan designs which will be affordable
to Georgians and to increase the availability of these types of plans by
accident and sickness insurers licensed to transact such insurance in this
state;
(2)
To encourage the offering of affordable health savings account eligible high
deductible plans, as required under the rules of the federal Internal Revenue
Service related to the establishment of health savings accounts, with the
specific intent of reaching many otherwise uninsured Georgians and the general
intent of creating affordable comprehensive health insurance for all Georgians;
and
(3)
To enhance the affordability of insurance with the flexible health savings
account eligible high deductible plans allowed under this chapter by allowing
rewards and incentives for participation in and adherence to health behaviors
that recognize the value of the personal responsibility of each citizen to
maintain good health, seek preventative care services, and comply with approved
treatments.
33-51-3.
(a)
The Commissioner shall develop flexible guidelines for coverage and approval of
health savings account eligible high deductible plans which are designed to
qualify under federal and state requirements as high deductible health plans for
use with health savings accounts which comply with federal requirements under
the applicable provisions of the federal Internal Revenue Code for high
deductible health plans sold in connection with health savings
accounts.
(b)
The Commissioner shall be authorized to encourage and promote the marketing of
health savings account eligible high deductible plans by accident and sickness
insurers in this state; provided, however, that nothing in this Code section
shall be construed to authorize the sale of insurance in violation of Chapter 3
of this title or interstate sales of insurance.
(c)
The Commissioner shall be authorized to conduct a national study of health
savings account eligible high deductible plans available in other states and to
determine if and how these products serve the uninsured and if they should be
made available to Georgians.
(d)
The Commissioner shall be authorized to develop an automatic or fast track
approval process for health savings account eligible high deductible plans
already approved under the laws and regulations of this state or other
states.
(e)
The Commissioner shall be authorized to promulgate such rules and regulations as
he or she deems necessary and appropriate for the design, promotion, and
regulation of health savings account eligible high deductible plans, including
rules and regulations for the expedited review of standardized policies,
advertisements and solicitations, and other matters deemed relevant by the
Commissioner.
33-51-4.
Insurers
that include and operate wellness and health promotion programs, disease and
condition management programs, health risk appraisal programs, and similar
provisions in their high deductible health policies in keeping with federal
requirements shall not be considered to be engaging in unfair trade practices
under Code Section 33-6-4 with respect to references to the practices of illegal
inducements, unfair discrimination, and rebating.
33-51-5.
There
shall be no required relationship between preferred provider and nonpreferred
provider plan reimbursements for health savings account eligible high deductible
plans using nonpreferred provider reimbursements. Such plans, however, shall
not:
(1)
Unfairly deny health benefits for medically necessary covered
services;
(2)
Have differences in benefit levels payable to preferred providers compared to
other providers that unfairly deny benefits for covered services;
(3)
Have a plan coinsurance percentage applicable to benefit levels for services
provided by nonpreferred providers that is less than 60 percent of the benefit
levels under the policy for such services; or
(4)
Have an adverse effect on the availability or the quality of
services.
33-51-6.
(a)
The Commissioner shall be authorized to allow health reimbursement arrangement
only plans that encourage employer financial support of health insurance or
health related expenses recognized under the rules of the federal Internal
Revenue Service to be approved for sale in connection with or packaged with
individual health insurance policies otherwise approved by the
Commissioner.
(b)
Health reimbursement arrangement only plans that are not sold in connection with
or packaged with individual health insurance policies shall not be considered
insurance under this title.
33-51-7.
The
provisions of Code Section 33-20A-9.1, relating to a consumer choice option,
shall apply to insurance products offered under this chapter.
33-51-8.
Notwithstanding
the provisions of paragraphs (2) and (3) of Code Section 33-51-5, health benefit
plans providing incentives for covered persons to use pharmaceutical or dental
services of preferred providers shall contain a provision which clearly
identifies that the payment or reimbursement for a noncontracting provider of
covered pharmaceutical or dental services shall be the same as the payment or
reimbursement for a preferred provider of covered pharmaceutical or dental
services; provided, however, that the health benefit plan shall not be required
to make payment or reimbursement in an amount which is greater than the actual
fee charged by the provider for the dental or pharmaceutical services
rendered."
SECTION
3.
This
Act shall become effective upon its approval by the Governor or upon its
becoming law without such approval.
SECTION
4.
All
laws and parts of laws in conflict with this Act are repealed.