Louisiana SB 83: INSURANCE DEPARTMENT: Provides relative to the Health Reinsurance Association of Louisiana. (8/1/21)

Bill Text

SLS 21RS-46 ORIGINAL
2021 Regular Session
SENATE BILL NO. 83
BY SENATOR TALBOT
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
INSURANCE DEPARTMENT. Provides relative to the Health Reinsurance Association
of Louisiana. (8/1/21)
1 AN ACT
2 To enact Part II of Chapter 20 of Title 22 of the Louisiana Revised Statutes of 1950, to be
3 comprised of R.S. 22:2481 through 2491, and to repeal R.S. 22:1641(1)(j), relative
4 to the Health Reinsurance Association of Louisiana; to provide for legislative
5 findings, purpose, definitions, and the board of directors; to provide for the powers
6 and duties of the association, fee assessments, and the powers of the commissioner;
7 and to provide for related matters.
8 Be it enacted by the Legislature of Louisiana:
9 Section 1. Part II of Chapter 20 of Title 22 of the Louisiana Revised Statutes of
10 1950, to be comprised of R.S. 22:2481 through 2491, is hereby enacted to read as follows:
11 PART II. LOUISIANA HEALTH REINSURANCE ASSOCIATION
12 §2481. Legislative Findings; purpose
13 A.(1) The legislature finds there is a need to provide for a stable and
14 economically viable individual health insurance market in the state of
15 Louisiana. The individual health insurance market serves a vital need for the
16 state's residents who do not have access to employer-sponsored health insurance
17 or other forms of health care coverage. Health insurance in the individual
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.

SB NO. 83
SLS 21RS-46 ORIGINAL
1 market can be the last line of defense against the risk of bankruptcy for sick
2 individuals. Since 2012, premium rates in the individual market have risen
3 significantly, which has forced some Louisiana consumers to exit the market
4 and risk having no health insurance coverage. Additionally, the number of
5 health insurers doing business in the individual market has declined
6 dramatically.
7 (2) The purpose of this Part is to authorize a means of stabilizing the
8 individual health insurance market through state-based reinsurance in order
9 to lower premiums, increase enrollment of consumers in the individual market,
10 increase the number of health insurers doing business in the individual market,
11 and to prevent a health insurance premium rate death spiral.
12 B. This Chapter is to provide for stabilization of the individual
13 insurance market by creation of an association of health insurance issuers,
14 health maintenance organizations, group self-insurers, and third-party
15 administrators. Members of the association are subject to a fee assessment
16 promulgated by the commissioner of insurance to provide for a state-based
17 reinsurance fund to stabilize the individual health insurance market and to
18 carry out the purposes of this Part.
19 §2482. Definitions
20 As used in this Part:
21 (1) "Association member" means all of the following:
22 (a) Every health insurance issuer that has a certificate of authority to
23 transact the business of health and accident insurance in this state.
24 (b) Every health maintenance organization as defined in R.S. 22:242.
25 (c) Every third-party administrator as defined in R.S. 22:1641.
26 (d) Every self-insurer as defined in R.S. 22:452.
27 (2) "Commissioner" means the commissioner of insurance for the state
28 of Louisiana.
29 (3) "Group market" means the large group market as defined in R.S.
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.

SB NO. 83
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1 22:1091 and the small group market which offers coverage for a small group as
2 defined in R.S. 22:1091, when the applicable coverage constitutes major medical
3 insurance.
4 (4) "Individual market" as defined in R.S. 22:1091, when the applicable
5 coverage constitutes major medical insurance.
6 (5)(a) "Major medical insurance" means all of the following items:
7 (i) Services consisting of medical care provided directly through
8 insurance or reimbursement including items and services paid for as medical
9 care under a hospital or medical service policy or certificate, hospital or medical
10 service plan contract, preferred provider organization, health maintenance
11 organization contract, or any contract or policy issued by a health insurance
12 issuer. Although not exclusive, if any particular form of health plan coverage
13 is subject to the requirements of Title XXVII of the federal Public Health
14 Service Act 42 U.S.C.A. 201 et seq., relating to guaranteed availability and
15 guaranteed renewability, or if a particular form of health plan coverage is
16 subject to the requirement of Title I of the Affordable Care Act P.L. 111-148,
17 or is considered minimum essential coverage as defined in 26 U.S.C.A. 5000 A,
18 then the health plan constitutes major medical insurance.
19 (ii) The same or