Here are the Utah health insurance related bills that passed this
year:
Highlighted below are the three bills that will have largest impact
on Utah residents. Click HB 331 to learn more about this bill.
House Bill 165 – Administration
Simplification. This bill…
-Amends the timing of the requirement that a hospital sends an
itemized bill to a patient.
-Creates a system-wide, broad based demonstration project between
health care payers and health care providers for innovating the payment
and delivery of health care in the state.
-Establishes a committee to study and develop a more efficient
coordination of benefits process.
-Requires health benefit plans to issue to enrollees a printed card
containing health plan information.
-Requires an insurer to provide access to information sufficient for a
health care provider to determine the compensation or payment terms for
health care services.
-Requires the Insurance Department to convene a group of providers
and payers to establish standards for the electronic exchange of health
plan information using card swipe technology which is compatible with
national electronic standards.
-Prohibits an insurer from requiring less than one business day’s
notice of an emergency in-patient hospital admission and amends the
period of time in which an insurer can recover an amount paid to a
health care provider when the insurer determines the payment was
incorrect.
-Requires hospitals sending bills to patients to include the
following words in bold “THIS IS THE BALANCE DUE AFTER PAYMENT FROM YOUR
HEALTH INSURER,” or other appropriate language.
House Bill 178 – Health Insurance and Program Amendments. This bill…
-Clarifies that the Children’s Health Insurance Program should have
access to at least two different provider networks.
-Extends the COBRA premium assistance provided under Section 3001 of
the American Recovery and Reinvestment Act of 2009 (Pub. S. 111-5) to
state mini-COBRA benefits; and
-Makes technical amendments to the health benefit plan broker
disclosure
House Bill 188 – Health System Reform – Insurance Market. This bill…
-Prohibits balanced billing by certain health care providers in
certain circumstances.
-Revises the basic benefit plan used for consumer comparison of
health benefit products.
-Requires the Insurance Department to include in its annual market
report a summary of the types of plans sold through the Internet portal,
including market penetration of mandate lite products.
-Allows insurers to offer lower cost health insurance products that
do not include certain state mandates in the individual market, the
small employer group market, and in the conversion market;
-Creates the Utah NetCare Plan, a low cost health benefit plan as an
alternative to current federal COBRA, state mini-COBRA, and conversion
products.
-Requires health insurance brokers and producers to disclose their
commissions and compensation to their customers prior to selling a
health benefit plan.payment reform demonstration projects.
-Modifies the number and type of products an insurer must offer in
the small employer group market and the individual market.
-Establishes a defined contribution arrangement market available on
the Internet portal, which; 1. Beginning January 1, 2010, is available
to small employer groups. 2. Offers a range of health benefit plan
choices to an employer’s eligible employees. 3. Beginning January 1,
2012, is available to eligible large employer groups. 4. Beginning
January 1, 2012, will offer a wider range of choices of health benefit
plans to employees.
-Establishes a board within the Insurance Department that is given
the responsibility to develop a risk adjustment mechanism that will
apportion risk among the insurers participating in the Internet portal
defined contribution market to protect insurers from adverse risk
selection.
-Requires insurers who offer health benefit plans on the Internet
portal to provide greater transparency and disclose information about
the plan benefits, provider networks, wellness programs, claim payment
practices, and solvency ratings.
-Establishes a process for a consumer to compare health plan features
on the Internet portal and to enroll in a health benefit plan from the
Internet portal.
-Requires the Office of Consumer Health Services to convene insurers
and health care providers to monitor and report to the Health Reform
Task Force and to the Business and Labor Interim Committee regarding
progress towards expanding access to the defined contribution market,
greater choice in the market, and
-Establishes limited rule making authority for the Office of Consumer
Health Services to assist employers and insurance carriers with
interacting with the Internet portal and facilitate the receipt and
payment of health plan premium payments from multiple sources.
-Authorizes the Office of Consumer Health Services to establish a fee
to cover the transaction cost associated with the Internet portal
functions such as sending and processing an application or processing
multiple premium payment sources; and
-Re-authorizes the Health Reform Task Force for one year.
