HOUSE OF REPRESENTATIVES

H.B. NO.

726

TWENTY-EIGHTH LEGISLATURE, 2015

H.D. 1

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO THE HAWAII HEALTH CONNECTOR.

 

 

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

 


SECTION 1. Section 435H-6, Hawaii Revised Statutes, is amended to read as follows:

"[[]435H-6[]] Eligibility of insurers and plans. (a) The commissioner shall determine eligibility for the inclusion of insurers and plans; provided that all qualified plans and qualified dental plans that apply for inclusion shall be included in the connector[.]; provided further that, as a condition of its license or certificate of authority, any insurer who controls, in any fiscal year and as determined by the commissioner, greater than twenty per cent share of the State's small group market for all policies of accident and health or sickness insurance subject to article 10A of chapter 431 or chapter 432 or 432D, shall offer through the connector, in the following fiscal year:

(1) At least one silver level qualified health plan; and

(2) At least one gold level qualified health plan,

as a condition of participation in the individual market of the connector.

(b) The commissioner shall require that each qualified plan, as a condition of certification, shall:

(1) Offer to any willing federally-qualified health center providing services in geographic areas served by the qualified plan, the opportunity to contract with the qualified plan to provide to the qualified plan's enrollees all ambulatory services that are covered by the qualified plan that the federally-qualified health center offers to provide; and

(2) Reimburse each federally-qualified health center for services as provided in 42 United States Code section 1396a(bb).

(c) As used in this section:

"Federally-qualified health center" has the same meaning as provided in 42 United States Code section 1396d(l)(2)(B).

"Silver level" and "gold level" have the same meaning as provided in 42 United States Code section 18022(d)."

SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 3. This Act shall take effect on July 1, 2050.



 

Report Title:

Hawaii Health Connector; Insurers; Mandatory Inclusion; Federally-Qualified Health Centers.

 

Description:

Requires health insurers with greater than 20 percent share of the State's small group health insurance market to offer gold and silver level qualified health plans as a condition of participation in the individual market of the Hawaii Health Connector. Requires the issuer of each qualified plan to offer to contract with federally qualified health centers.

(HB726 HD1)

 

 

 

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