Senate committee substitute makes the following changes to 1st edition. Amends proposed GS 58-50-300 to include insurer as a defined term. Amends proposed GS 58-50-305 by clarifying the report of claim information must include certain information for the 36 months prior to the employer’s request, if the request is made to the employer’s current insurer or for the 12 months prior to the employer’s request if the request is made to the employer’s prior insurer. Removes the requirement that such report contain the following information: (1) the total dollar amount of claims pending as of the date of the report and (2) for certain claims, a statement describing precertification requests for hospital stays of five days or longer that were made during the 30-day period preceding the date of the report. Makes other clarifying changes to the information required in the report.
Amends proposed GS 58-50-310, GS 58-50-315, GS 58-50-320, and GS 58-50-325 by removing the term health care benefits provider issuer and replacing it with the term insurer throughout. Clarifies that an insurer is not required to provide a report to an employer more than once (was, twice) in a 12-month period. Makes other conforming and clarifying changes. Deletes provision concerning requests for additional information after receipt of report.