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HB655 • 2026

AN ACT relating to limited health service benefit plans.

AN ACT relating to limited health service benefit plans.

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
D. Lewis
Last action
2026-02-25
Official status
02/25/26: to Banking & Insurance (H)
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

AN ACT relating to limited health service benefit plans.

AN ACT relating to limited health service benefit plans.

What This Bill Does

  • AN ACT relating to limited health service benefit plans.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2026-02-25 Kentucky Legislative Research Commission

    to Banking & Insurance (H)

  2. 2026-02-18 Kentucky Legislative Research Commission

    introduced in House to Committee on Committees (H)

Official Summary Text

AN ACT relating to limited health service benefit plans.

Current Bill Text

Read the full stored bill text 
UNOFFICIAL COPY 26 RS BR 2136
Page 1 of 2
XXXX 2/17/2026 3:15 PM Jacketed
AN ACT relating to limited health service benefit plans. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 304.17C-085 is amended to read as follows: 3
(1) As used in this section: 4
(a) "Contractual discount" means a percentage reduction from a provider's usual 5
and customary rate for covered services [and material ] required under a 6
participating provider agreement; and 7
(b) "Covered services": 8
1. Means services and materials for which: 9
a.[1.] Reimbursement from a plan is provided by the enrollee's plan 10
contract; or 11
b.[2.] Reimbursement would be available but for the application of the 12
enrollee's contractual limitations of deductibles, copayments, 13
coinsurance, or frequency limitations; and 14
2. Does not include services and materials for which reimbursement 15
would be available but for the application of the enrollee's contractual 16
limitation of an annual maximum benefit. 17
(2) A participating provider agreement shall not require a participating provider to 18
provide services to an enrollee at a fee set by or subject to the approval o f the 19
limited health service benefit plan unless the services are covered services under the 20
participating provider agreement. 21
(3) A provider shall not charge more for services and materials that are noncovered 22
services under a limited health service benef it plan than the provider's rate for the 23
services and materials. 24
(4) The amount of a contractual discount shall not result in a fee that is less than the 25
limited health service benefit plan would pay for covered services but for the 26
application an enrollee 's contractual limitations of deductibles, copayments, 27
UNOFFICIAL COPY 26 RS BR 2136
Page 2 of 2
XXXX 2/17/2026 3:15 PM Jacketed
coinsurance, or frequency limitations. 1
(5) Reimbursement paid by the limited health service benefit plan for covered services: 2
(a) Shall be reasonable; and 3
(b) Shall not provide nominal reimbursement i n order to claim that services and 4
materials are covered services. 5
(6) The provisions of this section shall not be waived by contract. Any contractual 6
arrangement in conflict with this section or that purports to waive any 7
requirement of this section shall be void. 8
Section 2. This Act applies to contracts issued or renewed on or after the 9
effective date of this Act. 10