Bill Text: HI SB2340 | 2018 | Regular Session | Amended
Bill Title: Relating To Health Insurance.
Spectrum: Partisan Bill (Democrat 12-0)
Status: (Passed) 2018-07-06 - Act 111, 07/05/2018 (Gov. Msg. No. 1212). [SB2340 Detail]
Download: Hawaii-2018-SB2340-Amended.html
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THE SENATE |
S.B. NO. |
2340 |
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TWENTY-NINTH LEGISLATURE, 2018 |
S.D. 2 |
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STATE OF HAWAII |
H.D. 1 |
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A BILL FOR AN ACT
RELATING TO HEALTH INSURANCE.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1.
The legislature finds that the Patient Protection and Affordable Care
Act of 2010 ("Affordable Care Act"), P.L. 111-148, has resulted in an
estimated 20,000,000 Americans gaining health insurance coverage. The provisions under the Affordable Care Act made
changes to private insurance that expanded coverage options, including permitting
young adults to remain on their parents' health insurance plans, requiring
health insurance plans to cover people with preexisting health conditions, and
prohibiting discrimination based on gender. According to a report from the United States
Department of Health and Human Services, more than 6,000,000 uninsured young
adults ages nineteen to twenty-five have gained health insurance coverage due
to the Affordable Care Act. This is
especially important because young adults were particularly likely to be
uninsured before the law went into effect.
The legislature further finds that the
future of the Affordable Care Act remains uncertain. The current Presidential administration
campaigned on a promise to repeal the Affordable Care Act, and certain members
of Congress have supported that approach, which could have widespread and
devastating ramifications. The Urban
Institute has estimated that repealing the Affordable Care Act without an
adequate replacement plan that ensures affordable coverage would take health
insurance coverage away from 29,800,000 people nationwide by 2019, more than
doubling the total number of uninsured to 58,700,000.
The legislature concludes that, due to the
uncertainty over the future of the Affordable Care Act, it is vital to preserve
certain important aspects of the Act for residents of Hawaii.
Accordingly, the purpose of this Act is to
ensure that the following benefits made available under
the Affordable Care Act, which may not otherwise be available under the State's
Prepaid Health Care Act, remain available under Hawaii law:
(1) Extending dependent coverage for adult children until the children turn twenty-six years of age;
(2) Prohibiting health insurance entities from imposing a preexisting condition exclusion; and
(3) Prohibiting health insurance entities from using an individual's gender to determine premiums or contributions.
SECTION 2.
Chapter 431, Hawaii Revised Statutes, is amended by adding three new
sections to part I of article 10A to be appropriately designated and to read as
follows:
"§431:10A- Extension
of dependent coverage. An
individual policy of accident and health or sickness insurance and a health
insurer offering individual accident and health or sickness insurance coverage
that provides dependent coverage of children shall continue to make that
coverage available for an adult child until the child turns twenty-six years of
age. Nothing in this section shall
require a policy or health insurer to make coverage available for a child of a
child receiving dependent coverage. This
section shall not apply to limited benefit health insurance as provided
pursuant to section 431:10A-102.5.
§431:10A- Prohibition
of preexisting condition exclusions.
(a) No individual policy of accident
and health or sickness insurance issued or renewed in this State shall impose
any preexisting condition exclusion.
(b)
For purposes of this section, a "preexisting condition
exclusion" means a limitation or exclusion of benefits, including a denial
of coverage, based on the fact that the condition was present before the
effective date of coverage (or if coverage is denied, the date of the denial)
under an individual policy of accident and health or sickness insurance, whether
or not any medical advice, diagnosis, care, or treatment was recommended or
received before that day, and includes any condition.
The term "preexisting condition
exclusion" includes any limitation or exclusion of benefits, including a
denial of coverage, applicable to an individual as a result of information
relating to an individual's health status before the individual's effective
date of coverage (or if coverage is denied, the date of the denial) under an
individual policy of accident and health or sickness insurance, such as a
condition identified as a result of a pre-enrollment questionnaire or physical
examination given to the individual or a review of medical records relating to
the pre-enrollment period.
(c)
This section shall not apply to limited benefit health insurance as
provided pursuant to section 431:10A-102.5.
§431:10A- Prohibited
discrimination in premiums or contributions. (a)
No individual policy of accident and health or sickness insurance and no
health insurer offering individual accident and health or sickness insurance
coverage issued or renewed in this State shall require an individual, as a
condition of enrollment or continued enrollment under the policy, to pay a
premium or contribution based on the individual's gender that is greater than
the premium or contribution for a similarly situated individual of the opposite
gender who is covered under the same policy or a substantially similar policy
offered by the same insurer.
(b)
This section shall not apply to limited benefit health insurance as
provided pursuant to section 431:10A-102.5."
SECTION 3. Chapter 431, Hawaii Revised Statutes, is amended by adding three new sections to part II of article 10A to be appropriately designated and to read as follows:
"§431:10A- Extension
of dependent coverage. A
group policy of accident and health or sickness insurance and a health insurer
offering group accident and health or sickness insurance coverage that provides
dependent coverage of children shall continue to make that coverage available
for an adult child until the child turns twenty-six years of age. Nothing in this section shall require a
policy or health insurer to make coverage available for a child of a child
receiving dependent coverage. This
section shall not apply to limited benefit health insurance as provided
pursuant to section 431:10A-102.5.
§431:10A- Prohibition of preexisting condition
exclusions. (a) No group policy of accident and health or
sickness insurance issued or renewed in this State shall impose any preexisting
condition exclusion.
(b) For purposes of this section, a
"preexisting condition exclusion" means a limitation or exclusion of
benefits, including a denial of coverage, based on the fact that the condition
was present before the effective date of coverage (or if coverage is denied,
the date of the denial) under a group policy of accident and health or sickness
insurance, whether or not any medical advice, diagnosis, care, or treatment was
recommended or received before that day and includes any condition.
The term "preexisting
condition exclusion" includes any limitation or exclusion of benefits,
including a denial of coverage, applicable to an individual as a result of
information relating to an individual's health status before the individual's
effective date of coverage (or if coverage is denied, the date of the denial)
under a group policy of accident and health or sickness insurance, such as a
condition identified as a result of a pre-enrollment questionnaire or physical
examination given to the individual, or review of medical records relating to
the pre-enrollment period.
(c) This section shall not apply to limited
benefit health insurance as provided pursuant to section 431:10A-102.5.
§431:10A- Prohibited discrimination in premiums or
contributions. (a) No group policy of accident and health or
sickness insurance and no health insurer offering group accident and health or
sickness insurance coverage issued or renewed in this State shall require an
individual, as a condition of enrollment or continued enrollment under the
policy, to pay a premium or contribution based on the individual's gender that
is greater than the premium or contribution for a similarly situated individual
of the opposite gender who is covered under the same policy or a substantially
similar policy offered by the same insurer.
(b) This section shall not apply to limited benefit health insurance as provided pursuant to section 431:10A-102.5."
SECTION 4. Chapter 432, Hawaii Revised Statutes, is amended by adding three new sections to article 1 to be appropriately designated and to read as follows:
"§432:1- Extension
of dependent coverage. Each
individual or group hospital or medical service plan contract and each mutual
benefit society offering individual or group hospital or medical service plan
contracts that provide dependent coverage of children shall continue to make
that coverage available for an adult child until the child turns twenty-six
years of age. Nothing in this section
shall require a plan contract to make coverage available for a child of a child
receiving dependent coverage.
§432:1- Prohibition of preexisting condition
exclusions. (a) No individual or group hospital or medical
service plan contract issued or renewed in this State shall impose any
preexisting condition exclusion.
(b) For purposes of this section, a
"preexisting condition exclusion" means a limitation or exclusion of
benefits, including a denial of coverage, based on the fact that the condition
was present before the effective date of coverage (or if coverage is denied,
the date of the denial) under an individual or group hospital or medical
service plan contract, whether or not any medical advice, diagnosis, care, or
treatment was recommended or received before that day and includes any
condition.
The term "preexisting condition exclusion" includes any limitation or exclusion of benefits, including a denial of coverage, applicable to an individual as a result of information relating to an individual's health status before the individual's effective date of coverage (or if coverage is denied, the date of the denial) under an individual or group hospital or medical service plan contract, such as a condition identified as a result of a pre-enrollment questionnaire or physical examination given to the individual, or review of medical records relating to the pre-enrollment period.
§432:1- Prohibited discrimination in premiums or contributions. No individual or group hospital or medical service plan contract and no mutual benefit society offering individual or group hospital or medical service plan contracts issued or renewed in this State shall require an individual, as a condition of enrollment or continued enrollment under the plan contract, to pay a premium or contribution based on the individual's gender that is greater than the premium or contribution for a similarly situated individual of the opposite gender who is covered under the same plan contract or a substantially similar plan contract offered by the same mutual benefit society."
SECTION 5. Chapter 432D, Hawaii Revised Statutes, is amended by adding three new sections to be appropriately designated and to read as follows:
"§432D- Extension
of dependent coverage. Each
individual or group policy, contract, plan, or agreement and each health
maintenance organization offering individual or group policies, contracts,
plans, or agreements that provides dependent coverage of children shall
continue to make that coverage available for an adult child until the child
turns twenty-six years of age. Nothing
in this section shall require a policy, contract, plan, or agreement to make
coverage available for a child of a child receiving dependent coverage.
§432D- Prohibition of preexisting condition
exclusions. (a) No individual or group health maintenance
organization policy, contract, plan, or agreement issued or renewed in this
State shall impose any preexisting condition exclusion.
(b) For purposes of this section, a
"preexisting condition exclusion" means a limitation or exclusion of
benefits, including a denial of coverage, based on the fact that the condition
was present before the effective date of coverage (or if coverage is denied,
the date of the denial) under an individual or group health maintenance
organization policy, contract, plan, or agreement, whether or not any medical
advice, diagnosis, care, or treatment was recommended or received before that
day and includes any condition.
The term "preexisting condition exclusion" includes any limitation or exclusion of benefits, including a denial of coverage, applicable to an individual as a result of information relating to an individual's health status before the individual's effective date of coverage (or if coverage is denied, the date of the denial) under an individual or group health maintenance organization policy, contract, plan, or agreement, such as a condition identified as a result of a pre-enrollment questionnaire or physical examination given to the individual, or review of medical records relating to the pre-enrollment period.
§432D- Prohibited discrimination in premiums or contributions. No individual or group policy, contract, plan, or agreement and no health maintenance organization offering group or individual policies, contracts, plans, or agreements issued or renewed in this State shall require an individual, as a condition of enrollment or continued enrollment under a policy, contract, plan, or agreement, to pay a premium or contribution based on the individual's gender that is greater than the premium or contribution for a similarly situated individual of the opposite gender who is covered under the same policy, contract, plan, or agreement or a substantially similar policy, contract, plan, or agreement offered by the same health maintenance organization."
SECTION 6. New statutory material is underscored.
SECTION 7. This Act shall take effect on July 1, 2050.
Report Title:
Health Insurance; Extended Coverage; Preexisting Conditions; Nondiscrimination
Description:
Ensures certain benefits under the federal Affordable Care Act are preserved under Hawaii law, including: extending dependent coverage for adult children up to 26 years of age; prohibiting health insurance entities from imposing a preexisting condition exclusion; and prohibiting health insurance entities from using an individual's gender to determine premiums or contributions. Clarifies that benefits extended by this measure do not apply to limited benefit health insurance. Effective 7/1/2050. (SB2340 HD1)
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
