Interstate sales of health insurance.

WORKING DRAFT

ORIGINAL HOUSE
BILL

NO.
0082

ENROLLED ACT NO. 30, HOUSE OF REPRESENTATIVES

SIXTY-SECOND LEGISLATURE OF THE STATE OF WYOMING
2013 GENERAL SESSION

AN ACT relating to health insurance; authorizing Wyoming insurers to offer individual and small employer health insurance policies
or high deductible health plans
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
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18
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301 through 26
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18
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307 are created to read:

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

26
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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
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1
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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
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19
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302(a)(xxii);

(iv)

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

26
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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)

Approval shall include approval of any relevant policy forms, provided the forms have been approved by the appropriate regulatory body in the other state;

(i
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;

(i
ii
)

The policy meets the requirements of this article;

(iv)

The insurer shall agree that the Wyoming insurance commissioner may enforce the provisions of the insurance policy and resolve disputes between the insurer and the policyholder in the same manner as the regulatory authorities in the other state, provided that if a contested case arises it shall be subject to the provisions of the Wyoming Administrative Procedure Act and any appeals shall be resolved in Wyoming courts;

(v)

The insurer shall inform the commissioner whether the policy will be priced as it is in the other state or at a Wyoming specific price;

(vi)

For small
employer health insurance
policies, all policies shall be subject to the provisions of W.S. 26
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19
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306(a) and (c)(vi)
;

(vii)

The commissioner shall review any provider network requirements in the policy and may require modification of those requirements if the insurer lacks sufficient within network providers in Wyoming
;

(viii)

Any authorized insurer may offer an individual or small employer an 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
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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
article
and any regulations of the department implementing this
article
.

(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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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:

Warning
!

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:

Warning
!

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.

26
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305.

Rules and regulations.

(a)

The commissioner shall adopt rules and regulations necessary to implement this article
.

(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
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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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307.

Authorization date.

No policy shall be issued or delivered for issuance in this state pursuant to this article before July 1, 2013.

Section 2.
The insurance commissioner shall report to the joint labor, health and social services interim committee by October 31, 2014 regarding the number of policies sold under this act and a summary of the information provided to the commissioner under W.S. 26
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18
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302(a)(v).

Section
3
.

This act is effective July 1, 2013.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the House.

Chief Clerk

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