Health insurance reform.

WORKING DRAFT
2010
STATE OF
WYOMING
10LSO-0162.E1

HOUSE BILL
NO.
HB0108

Health insurance reform.

Sponsored by:
Representative(s) Simpson, Lubnau and Madden and Senator(s) Scott

A BILL

for

AN ACT relating to insurance; creating the Wyoming Affordable HSA Eligible High Deductible Health Plan Act; prescribing duties of the insurance commissioner; providing exceptions to the Unfair Trade Practices Act; limiting provisions for reimbursement of preferred and nonpreferred providers as specified; and providing for an effective date.

Be It Enacted by the Legislature of the State of
Wyoming
:

Section 1.

W.S. 26
‑
51
‑
101 through 26
‑
51
‑
107 are created to read:

CHAPTER 51
AFFORDABLE HEALTH PLANS

26
‑
51
‑
1
01
.

Short title.

This chapter shall be known and may be cited as the
"Wyoming
Affordable HSA Eligible High Deductible Health Plan
Act
"
.

26
‑
51
‑
10
2.

Legislative intent.

(a)

It is the intent of the
legislature
:

(
i
)

To authorize the
commissioner
to establish flexible guidelines for health savings account eligible high deductible plan designs which will be affordable and to increase the availability of these types of plans by
an authorized
insurer

in this state;

(
ii
)

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
Wyoming residents
and the general intent of creating affordable comprehensive health insurance for all
Wyoming residents
; and

(
iii
)

To enhance the affordability of insurance with the flexible health savings account eligible high deductible plans
authorized
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.

26
‑
51
‑
10
3.

Health savings account eligible high deductible plans; guidelines; commissioner's duties.

(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
and
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 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
residents of this state
.

(
c
)

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.

(
d
)

The
commissioner
shall be authorized to promulgate rules and regulations as 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
.

26
‑
51
‑
10
4.

Wellness programs not considered unfair trade practices.

I
nsurers 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
the Unfair Trade Practices Act
with respect to references to the practices of illegal ind
ucements, unfair discrimination
and rebating.

26
‑
51
‑
10
5.

Preferred and nonpreferred providers; prohibited provisions.

(a)

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:

(
i
)

Unfairly deny health benefits for medically necessary covered services;

(
ii
)

Have differences in benefit levels payable to preferred providers compared to other providers that unfairly deny benefits for covered services;

(
iii
)

Have a plan coinsurance percentage applicable to benefit levels for services provided by nonpreferred providers that is less than
sixty
percent
(60%)
of the benefit levels under the policy for
those
services; or

(
iv
)

Have an adverse effect on the availability or the quality of services.

26
‑
51
‑
10
6.

Health cost reimbursement arrangements.

(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.

(c)

Individual insurance policies offered or funded through health reimbursement arrangements shall not be considered employer sponsored or group coverage for purposes of this title, and nothing in this section shall be interpreted to require an insurer to offer an individual health insurance policy for sale in connection with or packaged with a health reimbursement arrangement or to accept premiums from health reimbursement arrangement plans for individual health insurance policies.

26
‑
51
‑
10
7.

Pharmaceutical and dental provider parity.

H
ealth benefit plans providing incentives for covered persons to use pharmaceutical or dental services of preferred providers shall provide, and clearly indicate, 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 servic
es.

Section
2
.

This act is effective July 1, 2010.

(END)

1
HB0108