SB 0545 - Fiscal Note

Fiscal Note - SB 0545 - Insurance Policies Shall Cover Immunizations

L.R. NO.  2072-03
BILL NO.  SB 545
SUBJECT:  Child, Health
TYPE:     #Corrected
DATE:     January 22, 1996
#To correctly state response from Department of Insurance


                              FISCAL SUMMARY
                    ESTIMATED NET EFFECT ON STATE FUNDS


FUND AFFECTED              FY 1997             FY 1998     FY 1999
General Revenue           $357,739            $429,304    $429,304
#Insurance
Dedicated                 #$40,500

Total Estimated
Net Effect on All
State Funds              #$398,239            $429,304    $429,304


                   ESTIMATED NET EFFECT ON FEDERAL FUNDS


FUND AFFECTED              FY 1997             FY 1998     FY 1999
Federal                   $273,566            $328,292    $328,292

Total Estimated
Net Effect on All
Federal Funds             $273,566            $328,292    $328,292


                    ESTIMATED NET EFFECT ON LOCAL FUNDS


FUND AFFECTED              FY 1997             FY 1998     FY 1999
Local Government                $0                  $0          $0


                              FISCAL ANALYSIS

ASSUMPTION

The Department of Health (DOH) stated this legislation should improve
immunization rates among pre-school population and should ease the burden on
the public health structure by covering more children.  The current average
number of annual births is 75,000.  DOH serves half of this number or 37,500.
Of the  births, 48.1%  or 18,038  are insured. It cost $140 in vaccine for
each child. Therefore, 75,000 x 50%=37,500 x 48.1% = 18,038 x $140 =
$2,525,320. Savings were apportioned across five funding sources:

The MCH/PHS Block Grants are 13% of vaccine funding, resulting in $328,292 in
federal savings.  General Revenue funds are 17% of vaccine funding, resulting
in $429,304 in General  Revenue savings. There will be savings in two other
vaccine funding sources that are direct assistance to the department but are
not reflected in the budget. Vaccines for Children(VFC)Program is 53% of
vaccine funding, resulting in $1,338,420 in federal savings. Title 317
Immunization Grants are 17% of vaccine funding, resulting in $429,304 in
federal savings.

#The Department of Insurance(INS) states it will need .5 FTE, an Insurance
Product Analyst II, and related expense to review all new life and health
form filings caused by changes to insurance policies and plans generated by
this and all other legislation enacted during this session.  This FTE would
work full-time for six months a year.  INS states that approximately 245
insurers and 25 HMOs are currently writing medical plans.  On average each
company offers three plans. The result would be 810 new policy filings needed
to comply with this legislation.  A policy filing fee of $50 is required and
based on  810 filings, $40,500 in revenue to the Insurance Dedicated Fund
would be generated in the first fiscal year only.

#Oversight assumes the passage of this proposal would not increase cost to
INS; however,  revenue of $40,500 in the first fiscal year only would be
realized. In addition, passage of  more than one similar proposal could
require the INS to request increased appropriations to cover cumulative
administrative costs.

The Department of Conservation, Department of Public Safety-Missouri State
Highway Patrol, the Department of Social Services-Division of Medical
Services, Missouri Consolidated Health Care Plan, Office of Administration,
Department of Highway and Transportation, and Department of Corrections
stated that the proposed legislation will have no fiscal impact.

FISCAL IMPACT-State Government         FY 1997      FY 1998     FY 1999
                                   (10 Months)

GENERAL REVENUE FUND

Savings-Department of Health

Reduced Immunization Payments         $357,739     $429,304    $429,304

Estimated Net Effect on General
Revenue Fund                          $357,739     $429,304    $429,304

INSURANCE DEDICATED FUND

#Income - Department of Insurance

#Policy Filing Fees                    $40,500           $0          $0

#Estimated Net Effect on Insurance     $40,500           $0          $0
Dedicated Fund

FEDERAL FUNDS

Savings-Department of Health

Reduced Immunization Payments         $273,566     $328,292     $328292

Estimated Net Effect on Federal Funds $273,566     $328,292    $328,292


FISCAL IMPACT - Local Government       FY 1997      FY 1998     FY 1999
                                      (10 Mo.)

                                            $0           $0          $0

DESCRIPTION

This bill permits persons other than parents to consent to immunization of
certain children and requires insurance coverage for immunization.

This legislation is not federally mandated, would not duplicate any other
program and would not require additional capital improvements or rental
space.


SOURCES OF INFORMATION

Department of Highway and Transportation
Office of Administration
Department of Corrections
Department of Conservation
Department of Public Safety
Department of Insurance
Missouri Consolidated Health Care Plan
Department of Health
Department of Social Services