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SB0004B -1- CSSB 4(L&C)
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CS FOR SENATE BILL NO. 4(L&C)
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-FOURTH LEGISLATURE - FIRST SESSION
BY THE SENATE LABOR AND COMMERCE COMMITTEE
Offered: 4/11/25
Referred: Health & Social Services
Sponsor(s): SENATOR HUGHES
A BILL
FOR AN ACT ENTITLED
"An Act relating to a health care insurance policy incentive pr ogram; relating to health 1
care services; and providing for an effective date." 2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
* Section 1. The uncodified law of the State o f Alaska is amended by adding a new section 4
to read: 5
SHORT TITLE. This Act may be known as the Alaska Health Care Co nsumer's Right 6
to Shop Act. 7
* Sec. 2. AS 21.36.100 is amended to read: 8
Sec. 21.36.100. Rebates. Except as provided in AS 21.96.220 or o t h e r w i s e 9
expressly provided by law, a person may not knowingly permit or offer to make or 10
make a contract of life insurance, life annuity or health insur ance, or agreement under 11
the contract other than as plainly expressed in the contract, or pay, allow, give or offer 12
to pay, allow, or give, directly or indirectly, as inducement t o the insurance, or 13
annuity, a rebate of premiums payable on the contract, or a spe cial favor or advantage 14
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in the dividends or other benef its, or paid employment or contr act for services of any 1
kind, or any valuable considera tion or inducement whatever not specified in the 2
contract; or directly or indirectly give, sell, purchase or off er to agree to give, sell, 3
purchase, or allow as inducement to the insurance or annuity or in connection 4
therewith, whether or not to be specified in the policy or contract, an agreement of any 5
form or nature promising returns, profits, stocks, bonds, or ot her securities, or interest 6
present or contingent in the contract or as measured by the con tract, of an insurance 7
company or other corporation, association, or partnership, or d ividends or profits 8
accrued or to accrue under the contract; or offer, promise, or give anything of value 9
that is not specified in the contract. 10
* Sec. 3. AS 21.96 is amended by adding new sections to read: 11
Article 2. Health Care Insurance Policy Incentive Program. 12
Sec. 21.96.210. Access to payment information. A health care insurer that 13
offers a health care insurance policy in the group or individua l market shall provide 14
comprehensive comparison guidance by telephone and make availab le on the Internet 15
website of the insurer a price comparison tool that, to the ext ent practicable, allows an 16
individual enrolled in or covere d under a health care insurance policy to compare the 17
amount of cost sharing that the individual would be responsible for paying under the 18
policy for a specific item or service provided in the same poli cy year and geographic 19
region by each provider participating in the policy. At a minim um, the health care 20
insurer shall comply with 42 U.S.C. 300gg-114. 21
Sec. 21.96.220. Incentive program. (a) A health care insurer that offers a 22
health care insurance policy in the group or individual market shall develop and 23
implement a program that provides a monetary incentive for a covered person enrolled 24
in a health care insurance policy to elect to receive a covered health care service under 25
the health care insurance policy from a health care provider th at charges less than the 26
median contracted rate recognized by the health care insurer fo r that health care 27
service. 28
(b) A health care insurer that offers a health care insurance policy in the group 29
or individual market shall provide an incentive payment to a co vered person as 30
provided in this subsection. An incentive may be calculated as a percentage of the 31
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difference in price as a flat do llar amount or by another reaso nable methodology 1
adopted by the director by regulation. A health care insurer is not required to provide 2
an incentive payment to a covered person if the cost saved by t he health care insurer is 3
$200 or less. 4
(c) If a covered person receives coverage under a group health care insurance 5
policy offered by an employer, a health care insurer shall prov ide the covered person 6
with an incentive of at least 33.4 percent of the costs saved b y the health care insurer 7
resulting from the covered person's election to receive a healt h care service from a 8
health care provider that charges less than the median of the c ontracted rates 9
recognized by the health care insurer for that health care serv ice. The health care 10
insurer shall provide the employe r with at least 33.3 percent o f the costs saved by the 11
health care insurer resulting from the covered person's election. 12
(d) If a covered person receives coverage under a health care insurance policy 13
offered in the individual market, a health care insurer shall provide the covered person 14
with an incentive of at least 50 percent of the costs saved by the health care insurer 15
resulting from the covered person's election. 16
(e) An incentive payment to a covered person under this section is not 17
(1) a violation of AS 21.36.100; or 18
(2) an administrative expense of the health care insurer for r ate 19
development or rate filing purposes. 20
Sec. 21.96.230. Program availability. A health care insurer that offers a 21
health care insurance policy in the group or individual market shall make an incentive 22
program under AS 21.96.220 available as a component of a health c a r e i n s u r a n c e 23
policy offered in this state. Annually, at enrollment or renewa l, a health care insurer 24
shall provide notice about the availability of the program to a person covered under a 25
health care insurance policy eligible for the program. 26
Sec. 21.96.240. Filing requirements. Before offering an incentive program 27
under AS 21.96.220, a health care insurer that offers a health care insurance policy in 28
the group or individual market s hall file a description of the program with the director 29
in the manner determined by the director. The director may revi ew the filing to 30
determine whether the incentive program complies with the requi rements of 31
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AS 21.96.210 - 21.96.300. 1
Sec. 21.96.250. Out-of-network health care providers. If a covered person 2
participates in an incentive program under AS 21.96.220 and ele cts to receive a health 3
care service under AS 21.96.220(a) from an out-of-network healt h care provider that 4
results in a savings for the health care insurer, the health ca re insurer shall apply the 5
amount paid for the health care service toward the cost sharing owed by the covered 6
person as specified in the applicable health care insurance pol icy as if the health care 7
services were provided by an in-network health care provider. 8
Sec. 21.96.260. Reporting requirements. A health care insurer shall, at the 9
request of the director, annuall y provide information to the di rector relating to an 10
incentive program under AS 21.96.220 for the most recent calendar year that includes 11
(1) the total number of incentive payments; 12
(2) information on the use of the incentive program by categor y of 13
service; 14
(3) the total amount of incentive payments; 15
(4) the average amount of each i ncentive payment for each category of 16
service; 17
(5) the total savings achieved below the average price of the health 18
care service in each category of service; and 19
(6) the total number and percentage of covered persons who 20
participated in the incentive program. 21
Sec. 21.96.270. Applicability. (a) Except as provided in (b) of this section, 22
AS 21.96.210 - 21.96.300 apply to a health care insurance polic y or contract but do 23
not apply to excepted benefits. 24
(b) AS 21.96.210 - 21.96.300 apply to excepted benefits provid ed under a 25
dental insurance policy or a vision insurance policy. 26
(c) In this section, "excepted benefits" has the meaning given in AS 21.54.160. 27
Sec. 21.96.300. Definitions. In AS 21.96.210 - 21.96.300, 28
(1) "health care insurance" has the meaning given in AS 21.12.050; 29
(2) "health care insurer" has the meaning given in AS 21.54.500; 30
(3) "health care provider" has the meaning given in AS 18.23.400(n); 31
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(4) "health care service" has the meaning given in AS 18.23.400(n); 1
(5) "policy" has the meaning given in AS 21.97.900. 2
* Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 3
read: 4
TRANSITION: REGULATIONS. The director of the division of insurance may adopt 5
regulations necessary to implement this Act. The regulations ta ke effect under AS 44.62 6
(Administrative Procedure Act), but not before the effective da te of the law implemented by 7
the regulation. 8
* Sec. 5. Section 4 of this Act takes effect immediately under AS 01.10.070(c). 9
* Sec. 6. Except as provided in sec. 5 of this Act, this Act takes effect January 1, 2026. 10