Health insurance-sale of out-of-state policies.

WORKING DRAFT
2012
STATE OF
WYOMING
12LSO-0339.E1

HOUSE BILL
NO.
HB0119

Health insurance-sale of out-of-state policies.

Sponsored by:
Representative(s) Buchanan, Edmonds, Esquibel, K., Hunt, Kasperik, Kroeker, Lubnau, Peasley, Pedersen and Zwonitzer, Dn. and Senator(s) Anderson, Nutting and Ross

A BILL

for

AN ACT relating to
health insurance; authorizing Wyoming insurers to offer individual and small employer health insurance policies in Wyoming that have been approved for issuance in other states; providing minimum standards for
out-
of
-
state policies; prescribing notice requirements; granting rulemaking authority; preempting conflicting laws; providing definitions;
and providing for an effective date.

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

Section 1.

W.S. 26
‑
18
‑
301 through 26
‑
18
‑
307 are created to read:

ARTICLE 3
SALE OF OUT-OF-STATE HEALTH INSURANCE POLICIES

26
‑
18
‑
301.

Definitions.

(a)

As used in this article:

(i)

"Health insurance," "health benefit plan" and "health benefit policy" mean a health benefit plan as defined by W.S. 26
‑
1
‑
102(a)(xxxii);

(ii)

"High deductible health plan" means health insurance plans sold or maintained under the applicable provisions of section 223 of the Internal Revenue Code;

(iii)

"Small employer" means small employer as defined by W.S. 26
‑
1
9
‑
302(a)(xxii);

(iv)

"Small employer health insurance policy" is any
policy defined by W.S. 26
‑
19
‑
303(a).

26
‑
18
‑
302.

Sale of health insurance policies approved in other states.

(a)

The insurance commissioner shall approve for sale in Wyoming any individual or small
employer
health insurance policy or high deductible health plan that is currently approved for issuance in another state where the insurer or the insurer's affiliate or subsidiary is authorized to transact insurance, subject to the following:

(i)

The insurer or the insurer's affiliate or subsidiary filing and issuing the policy in Wyoming is also authorized to transact insurance in this state pursuant to title 26, chapter 3 of the Wyoming statutes;

(ii)

The policy meets the requirements of
this article;

(iii)

Any
authorized
insurer
may offer an individual or small employer insurance policy with benefits equivalent to those in any policy approved for sale in Wyoming under this article, provided that the offered policy meets the requirements of this article.

26
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18
‑
303.

Financial requirements; continuing compliance.

(a)

Any insurer selling a health insurance policy pursuant to this article and any policy approved pursuant to this article shall satisfy actuarial standards of the National Association of Insurance Commissioners, the requirements of this act and any regulations of the department implementing this act.

(b)

The
commissioner
shall determine whether an insurer satisfies the requirements of this article and
shall expeditiously approve policies and plans that comply

with this article. The commissioner shall have the authority to determine whether a health insurance policy or plan
sold pursuant to this article continues to satisfy the requirements of this article in the same manner as for other policies under this code.

The commissioner shall have the authority to require an insurer to participate in the Wyoming health insurance pool and to make other payments required of insurers under this code.

(c)

Any policy sold pursuant to this article shall be protected under the Wyoming Life and Health Guaranty Association Act under Chapter 42 of this title.

26
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18
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304.

Disclaimers required.

(a)

Each written application for a policy sold pursuant to this article shall contain the following language in boldface type at the beginning of the document:

The benefits of this policy may primarily be governed by the laws of a state other than Wyoming. All of the laws applicable to policies filed in this state may not apply to this policy. Any purchase of individual health insurance should be considered carefully since future medical conditions may make it impossible to qualify for another individual health insurance policy.

(b)

Each policy sold pursuant to this article shall contain the following language in boldface
type at the beginning of the document:

The benefits of this policy may be governed primarily by the laws of a state other than Wyoming. The benefits covered may be different
from other policies you can purchase in this state. Consult your insurance agent or insurer to determine which health benefits are covered under this policy.

(c)

If a benefit under the out-of-state policy or a similarly named benefit is defined differently
under
Wyoming
statutes and regulations than it is in the
other state, the policy shall contain a side-by-side chart that compares
Wyoming's and the other state's

respective

definition
s.

26
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18
‑
305.

Rules and regulations.

(a)

The commissioner shall adopt rules and regulations necessary to implement this article
, including the issuance of standard forms for the disclosure of benefits.

(b)

Any dispute resolution mechanism or provision for notice and hearing in this code shall apply to insurers issuing and delivering policies pursuant to this article.

26
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18
‑
306.

Conflict with other code provisions.

If the provisions of this article conflict with any other provision of this code, the provisions of this article shall control.

26
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18
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307.

Authorization date.

No policy shall be issued or delivered for issuance in this state pursuant to this article before July 1, 2012.

Section 2.

This act is effective July 1, 2012.

(END)

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HB0119