HB1879 Makes various changes in health insurance laws to comply with changes in the federal law.
Sponsor: Patek, Jewell (7) Effective Date:00/00/0000
CoSponsor: Secrest, Patricia K. (93) LR Number: 3870L.01I
Last Action: 02/10/2000 - Referred: Critical Issues (H)
HB1879
Next Hearing:Hearing not scheduled
Calendar:Bill currently not on calendar
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* Introduced

Available Bill Text for HB1879
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BILL SUMMARIES

INTRODUCED

HB 1879 -- Health Insurance

Co-Sponsors:  Patek, Secrest, Luetkemeyer, Scott, Myers,
Shields, Pryor

This bill modifies the law relating to health insurance.  In its
major provisions, the bill:

(1)  Allows small employers a tax credit for costs associated
with health insurance premiums paid on behalf of employees.
Under the bill's provisions, small employers include those with
2 to 50 employees who work at least 30 hours per week.  The bill
also specifies that a farmer's spouse may be considered a second
eligible employee if the spouse is hired by the farmer.  All
eligible small employers receive a tax credit of $25 per month
for each employee for whom health insurance premiums are paid.
A small employer receives higher credits for up to 4 years if
the employer does not pay its employees' health insurance
premiums on January 1, 2001, and begins to pay for its
employees' premiums after that date.  Small employers that are
eligible for these tax credits may claim an additional credit of
$10 per month per employee if the small employer is a member of
a private health insurance purchasing cooperative.  The tax
credit is conditioned upon receiving appropriations from the
tobacco settlement to offset the costs to the state of the tax
credit;

(2)  Specifies that $10 million of the tobacco settlement,
subject to appropriation, must be used to facilitate access to
health care for members of the Missouri Health Insurance Pool
(also referred to as the "high-risk" pool);

(3)  Requires the Department of Insurance to administer a grant
program to assist in the establishment of health insurance
purchasing cooperatives.  Each grant is limited to $25,000.
Funds for the grants must be appropriated from the General
Revenue Fund and the total amount of grants may not exceed
$400,000;

(4)  Allows a health insurer offering group coverage to impose a
preexisting condition exclusion if medical care was recommended
or received within 6 months before the covered person's
enrollment date and the exclusion is applied only for the first
12 months of coverage or 18 months if the person is a late
enrollee.  The period of applying a preexisting condition
exclusion may be reduced based on previous coverage.  No
preexisting condition exclusion relating to pregnancy may be
imposed under these provisions;

(5)  Requires a health insurer offering group coverage to permit
an eligible employee or dependent to enroll after coverage was
previously offered if the eligible person had health insurance
coverage at that time and certain conditions are met.  Group
plans must offer to eligible individuals a special enrollment
period for 30 days after a marriage, birth, or adoption;

(6)  Allows a health insurer offering group coverage through a
health maintenance organization (HMO) to impose an affiliation
period of 2 months following enrollment.  During this period,
the HMO does not charge premiums and does not provide health
care services or benefits;

(7)  Prohibits a health insurer offering group coverage from
establishing rules for continued eligibility of an enrollee
based on health status, medical condition, claims experience,
receipt of health care, medical history, genetic information,
evidence of insurability, and disability;

(8)  Requires a health insurer offering group coverage in the
market for employers with at least 51 employees to continue the
coverage at the option of the plan's sponsor unless the sponsor
failed to pay premiums, the sponsor intentionally misrepresented
a fact related to the terms of the coverage, the sponsor failed
to comply with the insurer's minimum participation requirements
or contribution requirements, the insurer is ceasing to offer
coverage in the group market for large employers, no enrollee
resides in the plan's service area, or the employer has
discontinued membership in the association through which the
coverage was obtained;

(9)  After adjusting for benefit design and all rating
characteristics, prohibits a health insurer offering coverage in
the individual market from filing a rate for one block of
business that exceeds the rate for another block by more than
150% by July 1, 2001, 125% by July 1, 2002, and 100% by July 1,
2003;

(10)  Prohibits an insurer that renews an individual health
benefit plan from basing the premium for any individual on that
individual's health status or claims experience;

(11)  Requires a health insurer offering coverage in the
individual market to continue an individual's coverage at the
individual's option unless the individual failed to pay
premiums, the individual intentionally misrepresented a fact
relating to the terms of the coverage, the insurer is ceasing to
offer coverage in the individual market, no enrollee resides in
the plan's service area, or the individual has discontinued
membership in the association through which the coverage was
obtained.  The insurer, however, may modify the individual's
coverage at the time of renewal;

(12)  Requires insurers to provide certification of creditable
coverage in accordance with the federal Health Insurance
Portability and Accountability Act (P.L. 104-191);

(13)  Allows a Missouri resident to be eligible for coverage in
the Missouri Health Insurance Pool if the person has 18 months
of eligible coverage, is not eligible for coverage under a group
health plan, does not have other health coverage, had coverage
terminated for reasons other than nonpayment of premiums or
fraud, and has exhausted any available COBRA coverage.  Rates
for those eligible individuals may not exceed 125% of rates
applicable to individual standard risks.  A Missouri resident is
also eligible for coverage through the pool if the person has
been refused coverage or refused coverage except at a rate
exceeding 135% of the standard risk rate.  Rates for that group
of individuals may not exceed 135% of rates applicable to
individual standard risks;

(14)  Requires that any new mandated health insurance coverage
must apply only to the Missouri Consolidated Health Care Plan
(MCHCP) for one year.  Following the one-year period, the board
of the MCHCP must submit to the General Assembly a report
describing the effect of the mandated coverage on the MCHCP.
The board must also recommend whether the mandated coverage
should continue; and

(15)  Modifies Missouri's Small Employer Health Insurance
Availability Act to apply to employers that employ 2 to 50
employees and to comply with other requirements of the federal
Health Insurance Portability and Accountability Act (P.L. 104--
191).


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