HB 418 (BR 1417) - K. Upchurch
AN ACT relating to health benefit plans.
Amend KRS 304.17A-005 to add to the definition of "creditable coverage" and "excepted benefits," and to define "dependent," "employee benefit plan," "group health plan," and "participant"; amend KRS 304.17A-220 to clarify the pre-existing condition exclusion for members of a group health plan, including a requirement that the pre-existing condition be diagnosed and treated by a licensed medical professional; require notice requirements for the exclusion; define the method for calculation of creditable coverage for a pre-existing condition exclusion period; define "enrollment date," "first day of coverage," "late enrollee," "late enrollment," and "significant break in coverage"; exempt children from the pre-existing condition exclusion without a significant break in coverage; exempt children 30 days after adoption from the pre-existing condition exclusion without a significant break in coverage; prohibit imposing a pre-existing condition exclusion relating to a condition based solely on genetic information; require that a certificate of creditable coverage be provided without charge; add events qualifying for special enrollment in a group plan; allow 30 days for special enrollment of an employee or the employee's dependent after the specified event occurs; require an employer to provide employees with a notice of special enrollment rights when initially offered the opportunity to enroll; establish the requirements regarding creditable coverage; amend KRS 304.17A-230 to authorize the Office of Insurance to promulgate regulations; amend KRS 304.17A-096, 304.17A-430, 304.175-001, and 304.38A-010 to conform.
HB 418 - AMENDMENTS
HCS - Retain original provisions; include an association plan in the definition of "individual market"; make technical change in Section 2(7)(a)1; add section 9 which amends KRS 304.17A-617 to allow a health insurer 10 days rather than 5 days in which to respond to the Office of Insurance concerning a request for a review of a coverage denial.
HFA (1, K. Upchurch) - Make change to Section 2(2)(c) to provide that except for individuals who apply for coverage in the individual market, the period of any pre-existing condition exclusion that would otherwise apply to an individual may be reduced by the number of days of creditable coverage the individual has as of the effective date of coverage under the policy; make change to Section 9(3)(b) to change 10 days to 10 business days.
SCA (1, T. Buford) - Create new sections of subtitles 17A, 17B, and 17C of KRS Chapter 304 to provide that a health insurer offering a health benefit plan, including Kentucky Access or a limited health service benefit plan, shall not impose a copayment or coinsurance amount for services rendered by a chiropractor, optometrist, osteopath, or podiatrist that is greater than copayments charged for services of a primary care provider for the same or similar condition.
SFA (1, T. Shaughnessy) - Retain original provisions and add new sections to prohibit insurers, health benefit plans under Kentucky Access, and limited health benefit plans from imposing a greater copayment for services rendered by a chiropractor or optometrist than the copayment for the same service provided by a physician or osteopath.
SFA (2, R. Roeding) - Create new sections of subtitles 17A, 17B and 17C of KRS Chapter 304 to provide that a health insurer offering a health benefit plan, including Kentucky Access or a limited health service benefit plan, shall not impose a copayment or coinsurance amount for services rendered by a chiropractor, optometrist, osteopath, or podiatrist that is greater than copayments charged for services of a primary care provider for the same or similar condition; provide that notwithstanding this amendment an insurer may offer one or more health benefit plans that contain deductibles, coinsurance, or copayments without any restriction or limitation thereon or without any limits on the level of reimbursement for contracted health care providers or non-contracted health care providers.
Jan 19-introduced in House
Jan 20-to Banking and Insurance (H)
Feb 14-posting waived
Feb 22-reported favorably, 1st reading, to Calendar with Committee Substitute
Feb 23-2nd reading, to Rules
Feb 28-floor amendment (1) filed to Committee Substitute
Mar 1-posted for passage in the Regular Orders of the Day for Thursday, March 2, 2006
Mar 8-3rd reading, passed 96-0 with Committee Substitute, floor amendment (1)
Mar 9-received in Senate
Mar 13-to Banking and Insurance (S)
Mar 17-reported favorably, 1st reading, to Calendar with committee amendment (1)
Mar 20-2nd reading, to Rules; floor amendment (1) filed
Mar 22-posted for passage in the Regular Orders of the Day for Wednesday, March 22, 2006; floor amendment (2) filed ; 3rd reading; committee amendment (1) withdrawn ; passed 36-1 with floor amendment (1)
Mar 23-received in House; to Rules (H)
Mar 24-posted for passage for concurrence in Senate floor amendment (1)
Apr 10-House concurred in Senate floor amendment (1) ; passed 96-0; enrolled, signed by each presiding officer; delivered to Governor
Apr 25-became law without Governor's signature (Acts ch. 253)