Bill Summaries: H854 (2019-2020 Session)

  • Summary date: Apr 17 2019 - View summary

    Enacts new GS 58-3-26 to prohibit an insurer offering a health benefit plan in this state from imposing any preexisting condition exclusions with respect to coverage under the plan. Requires the insurer to accept every employer and every individual in the state who is eligible for and applies for coverage. Requires premium rates to be developed based on only whether the health benefit plan covers an individual or family, the geographic rating area, age of the insured individuals, and tobacco use of the insured individuals, with specified limitations. Prohibits adjusting the premium more frequently than annually unless the change is made to reflect one of five specified categories of changes.

    Allows the Department of Insurance to adopt rules to implement and administer the act and to ensure that rating practices used by insurers are consistent with the act.