A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Plain English Breakdown

The official source material does not specify which actions insurers are prohibited from taking when collecting cost sharing, nor does it mention enforcement mechanisms or consequences for non-compliance.

Health Insurance Cost Sharing Rules

This bill changes how health insurers handle cost sharing for healthcare services.

What This Bill Does

• Requires insurance companies to pay healthcare providers in full, including any costs the patient must cover.
• Makes insurance companies responsible for collecting money from patients that they owe for their care.
• Allows patients to ask insurance companies to collect their share of costs throughout the year in smaller amounts.
• Forbids insurance companies from taking certain actions when collecting cost sharing from patients.
• Requires insurance companies to tell the state each year if they followed these rules.

Who It Names or Affects

• Insurance companies
• Healthcare providers
• Patients with health insurance

Terms To Know

Cost sharing

The part of healthcare costs that patients pay, like copayments or deductibles.

Insurance commissioner

A government official who oversees insurance companies and makes sure they follow the law.

Limits and Unknowns

• Does not specify what actions insurers are prohibited from taking when collecting cost sharing.
• The bill does not mention how it will be enforced or what happens if an insurer breaks the rules.
• It is unclear who will benefit most from this change in insurance practices.

Official Summary Text

A BILL FOR AN ACT to amend the Indiana Code concerning insurance.
Collection of cost sharing.

Current Bill Text

A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Collection of cost sharing.

Provides that an insurer: (1) must pay a health care provider the full amount due for health care services under the health care provider's agreement with the insurer, including any cost sharing; (2) has the sole responsibility for collecting cost sharing from a covered individual; and (3) upon request of the covered individual, must collect cost sharing throughout the policy year in increments defined by the insurer. Prohibits an insurer from taking certain actions regarding the collection of cost sharing. Requires each insurer to certify to the insurance commissioner, before December 31 of each year, that the insurer has fully and completely complied with the requirements during the previous calendar year.