Connecticut Seal

General Assembly

Amendment

 

February Session, 2018

LCO No. 4278

   
 

*HB0521004278HRO*

Offered by:

 

REP. SAMPSON, 80th Dist.

 

To: Subst. House Bill No. 5210

File No. 146

Cal. No. 117

(As Amended)

"AN ACT MANDATING INSURANCE COVERAGE OF ESSENTIAL HEALTH BENEFITS AND EXPANDING MANDATED HEALTH BENEFITS FOR WOMEN, CHILDREN AND ADOLESCENTS."

After the last section, add the following and renumber sections and internal references accordingly:

"Sec. 501. (NEW) (Effective October 1, 2018) (a) For the purposes of this section, "basic benefit design plan" means any individual or group health insurance policy or plan that (1) covers the state's essential health benefits as required under the Patient Protection and Affordable Care Act, P.L. 111-148, as amended from time to time, (2) covers all health benefits mandated by chapter 700c of the general statutes, and (3) is in compliance with all state and federal laws, regulations and other administrative guidance, including, but not limited to, laws, regulations and administrative guidance concerning network adequacy, as described in section 38a-472f of the general statutes.

(b) A basic benefit design plan may offer alternative levels of cost-sharing, including deductibles, coinsurance and copayments, within allowable ranges pursuant to the AV Calculator described in 45 CFR 156.135.

(c) Notwithstanding any provision of the general statutes, a health carrier, as defined in section 38a-591a of the general statutes, may offer or sell a basic benefit design plan either through the Connecticut Health Insurance Exchange, established pursuant to section 38a-1081 of the general statutes, as amended by this act, or independent of the exchange.

Sec. 502. (NEW) (Effective October 1, 2018) Notwithstanding any provision of the general statutes, the Connecticut Health Insurance Exchange, established pursuant to section 38a-1081 of the general statutes, as amended by this act, shall not establish any requirements concerning basic benefit design plans, as defined in section 501 of this act."

This act shall take effect as follows and shall amend the following sections:

Sec. 501

October 1, 2018

New section

Sec. 502

October 1, 2018

New section