HOUSE OF REPRESENTATIVES

H.B. NO.

1707

TWENTY-EIGHTH LEGISLATURE, 2016

H.D. 1

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH INSURANCE.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


SECTION 1. Chapter 431, article 10A, Hawaii Revised Statutes, is amended by adding a new section to part VI to be appropriately designated and to read as follows:

"431:10A-   Rate increases; public disclosures. For sixty days prior to the implementation of any rate increase, the commissioner and any insurer that provides health care coverage shall, at a minimum, make the following information readily available to the public on the commissioner and insurer's respective internet websites, in plain language and in a manner and format specified by the commissioner:

(1) Justifications for the rate increase, including all information and supporting documentation;

(2) The insurer's overall annual medical trend factor assumptions in each rate filing for all benefits;

(3) The insurer's actual costs, by aggregate benefit category to include hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology; and

(4) The amount of the projected trend attributable to the use of services, price inflation, or fees and risk for annual policy trends by aggregate benefit category to include hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology. An insurer that exclusively contracts with no more than two medical groups in the State to provide or arrange for professional medical services for the enrollees of the policy shall instead disclose the amount of its actual trend experience for the prior contract year by aggregate benefit category, using benefit categories that are, to the maximum extent possible, the same or similar to those used by other policies."

SECTION 2. Chapter 432, article 1, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

"432:1-   Rate increases; public disclosures. For sixty days prior to the implementation of any rate increase, the commissioner and the mutual benefit society shall, at a minimum, make the following information readily available to the public on the commissioner and mutual benefit society's respective internet websites, in plain language and in a manner and format specified by the commissioner:

(1) Justifications for the rate increase, including all information and supporting documentation;

(2) The mutual benefit society's overall annual medical trend factor assumptions in each rate filing for all benefits;

(3) The mutual benefit society's actual costs, by aggregate benefit category to include hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology; and

(4) The amount of the projected trend attributable to the use of services, price inflation, or fees and risk for annual plan contract trends by aggregate benefit category, to include hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology. A mutual benefit society that exclusively contracts with no more than two medical groups in the State to provide or arrange for professional medical services for the enrollees of the plan contract shall instead disclose the amount of its actual trend experience for the prior contract year by aggregate benefit category, using benefit categories that are, to the maximum extent possible, the same or similar to those used by other plan contracts."

SECTION 3. Chapter 432D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"432D-   Rate increases; public disclosures. For sixty days prior to the implementation of any rate increase, the commissioner and the health maintenance organization shall, at a minimum, make the following information readily available to the public on the commissioner and health maintenance organization's respective internet websites, in plain language and in a manner and format specified by the commissioner:

(1) Justifications for the rate increase, including all information and supporting documentation;

(2) The health maintenance organization's overall annual medical trend factor assumptions in each rate filing for all benefits;

(3) The health maintenance organization's actual costs, by aggregate benefit category to include hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology; and

(4) The amount of the projected trend attributable to the use of services, price inflation, or fees and risk for annual plan contract trends by aggregate benefit category, to include hospital inpatient, hospital outpatient, physician services, prescription drugs and other ancillary services, laboratory, and radiology. A health maintenance organization that exclusively contracts with no more than two medical groups in the State to provide or arrange for professional medical services for the enrollees of the plan contract shall instead disclose the amount of its actual trend experience for the prior contract year by aggregate benefit category, using benefit categories that are, to the maximum extent possible, the same or similar to those used by other plan contracts."

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2070.


 


 

Report Title:

Rate Filings; Disclosure

 

Description:

Requires the Insurance Commissioner and health insurers, mutual benefit societies, and health maintenance organizations to make public disclosure of rate filings information prior to a rate increase. (HB1707 HD1)

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.