SB 805 - This act attempts to curtail health insurance premium increases by creating a "bare-bones" health insurance policy. The "bare-bones" or "stripped-down" health insurance policy created by this act does not have to include coverage for all the state required mandated health benefits. The act will allow individuals and small employers to purchase more affordable health insurance by providing that such policies need not include coverage for certain maternity benefits, newborn children, continuation of health insurance after termination of employment (state COBRA), mammographies, adopted children, certain childhood immunizations, and PKU formulas. Under current law, individuals and small employers cannot purchase limited mandate health insurance policies without these mandated health insurance benefits. Nothing in this act requires individuals or small employers to buy these types of policies. This act also eliminates a marketing restriction on insurance companies. Under the current law, health insurance companies may market limited mandate health insurance policies, which must include the above aforementioned mandated health care benefits, only to those who currently do not have health insurance coverage or to persons or employers which certify in writing to the insurer that they will terminate the coverage they currently have at the time they would otherwise renew coverage because of cost.

This act establishes the Mandated Benefit Review Commission within the Department of Insurance. The Commission will be comprised of the Director of the Department of Insurance, the Director of the Department of Health, four members of the General Assembly (2 Senate/2 House - nonvoting advisory capacity), and six individuals appointed by the governor with the advice and consent of the Senate (2 health insurance purchasers, two employers (small and large), and two employees who pay a percentage of their employer sponsored health insurance. The Commission must be established by October 1, 2004.

Once the Commission has been established, it must review all existing state mandated benefits and issue a report to the General Assembly by the tenth legislative day in January 2006. The report shall discuss the projected costs of all state and federal mandates and the Commission shall recommend to the General Assembly which mandated benefits should be repealed from state law.

The Commission shall also review all mandated benefits proposed by member of the General Assembly. Whenever a bill containing a mandated benefit is proposed, the committee having jurisdiction over the proposal shall determine whether the committee favors the proposed mandate or not. If the Committee is in favor of the mandate, the Committee may refer the matter to the Commission for its review. The Committee must review the proposed mandate and issue a report to the committee. The report must contain the social impact of mandating the benefit, the financial impact of mandating the benefit, the medical efficacy of mandating the benefit, and the effects of balancing the social, economic and medical efficacy considerations. Once a review and evaluation of the mandated benefit has been made by the commission, the committee shall review the commission's findings.

Under this act, no mandated health benefit shall be enacted into law prior to January 1, 2006. After that date, no proposed mandate may be enacted into law unless the commission has reviewed and evaluated the mandate.

This act is identical to SB 460 and HB 193 (2003) and is similar to provisions contained in SB 1063 (2002).
STEPHEN WITTE