HB 790-FN – VERSION ADOPTED BY BOTH BODIES
27Mar2007… 0800h
05/10/07 1423s
2007 SESSION
HOUSE BILL 790-FN
AN ACT relative to dependent coverage for health insurance and establishing the joint legislative oversight committee on insurance expansion initiatives.
SPONSORS: Rep. McLeod, Graf 2; Rep. Nordgren, Graf 9; Rep. Rosenwald, Hills 22; Rep. Moran, Hills 18; Sen. Fuller Clark, Dist 24; Sen. Hassan, Dist 23
This bill expands the definition of dependent young adults to those who are less than 26 years of age for purposes of insurance coverage.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
27Mar2007… 0800h
05/10/07 1423s
07-0886
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Seven
AN ACT relative to dependent coverage for health insurance and establishing the joint legislative oversight committee on insurance expansion initiatives.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Insurance; Young Adults Added. Amend RSA 415:5, I(3) to read as follows:
(3)(a) It purports to
insure only one person, except that a policy may insure, originally or
by subsequent amendment, upon the application of an adult member of a
family who shall be deemed the policyholder, any 2 or more eligible
members of that family, including husband, wife, dependent children or
any [children under a specified age which shall not exceed 18 years and any other person dependent upon the policyholder] dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(1) Is less than 26 years of age;
(2) Is unmarried;
(3) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(4) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.
(b) Nothing in this subparagraph shall be construed to require:
(1) Coverage for services provided to a dependent before the effective date of this section; or
(2) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this subparagraph.
(c) A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this subparagraph.
(d) Coverage for a dependent provided pursuant to this subparagraph shall be provided until the earlier of the following:
(1) The dependent is disqualified for dependent status as set forth in subparagraph I(3)(a); or
(2) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.
(e) Nothing in this subparagraph shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to subparagraph (c), based upon the dependent’s prior disqualification pursuant to subparagraph (d)(1).
(f) Notice regarding coverage for a dependent as provided pursuant to this subparagraph shall be provided to a subscriber:
(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and
(2) Within 30 days following the effective date of this subparagraph. Such notice shall include information regarding the required special open enrollment period.
2 New Section; Health Service Corporations; Dependent Coverage Added. Amend RSA 420-A by inserting after section 10 the following new section:
420-A:10-a Dependent Coverage.
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.
II. Nothing in this section shall be construed to require:
(a) Coverage for services provided to a dependent before the effective date of this section; or
(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.
III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.
IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:
(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or
(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.
V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent’s prior disqualification pursuant to subparagraph IV(a).
VI.(a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:
(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and
(2) Within 30 days following the effective date of this section.
(b) Such notice shall include information regarding the required special open enrollment period.
3 New Section; Health Maintenance Organizations; Dependent Coverage Added. Amend RSA 420-B by inserting after section 8-a the following new section:
420-B:8-aa Dependent Coverage.
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.
II. Nothing in this section shall be construed to require:
(a) Coverage for services provided to a dependent before the effective date of this section; or
(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.
III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent child eligible pursuant to this section.
IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:
(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or
(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.
V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent’s prior disqualification pursuant to subparagraph IV(a).
VI.(a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:
(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and
(2) Within 30 days following the effective date of this section.
(b) Such notice shall include information regarding the required special open enrollment period.
4 New Section; Preferred Provider Agreements; Dependent Coverage Added. Amend RSA 420-C by inserting after section 4 the following new section:
420-C:4-a Dependent Coverage.
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a name subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.
II. Nothing in this section shall be construed to require:
(a) Coverage for services provided to a dependent before the effective date of this section; or
(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.
III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.
IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:
(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or
(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.
V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent’s prior disqualification pursuant to subparagraph IV(a).
VI.(a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:
(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and
(2) Within 30 days following the effective date of the passage of this law.
(b) Such notice shall also include information regarding the required special open enrollment period.
5 New Section; Delta Dental; Dependent Coverage Added. Amend RSA 420-F by inserting after section 5 the following new section:
420-F:5-a Dependent Coverage.
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a name subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.
II. Nothing in this section shall be construed to require:
(a) Coverage for services provided to a dependent before the effective date of this section; or
(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.
III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.
IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:
(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or
(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.
V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent’s prior disqualification pursuant to subparagraph IV(a).
VI.(a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber if:
(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and
(2) Within 30 days following the effective date of this section.
(b) Such notice shall include information regarding the required special open enrollment period.
6 New Section; Managed Care; Dependent Coverage Added. Amend RSA 420-J by inserting after section 8-b the following new section:
420-J:8-c Dependent Coverage.
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.
II. Nothing in this section shall be construed to require:
(a) Coverage for services provided to a dependent before the effective date of this section; or
(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.
III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.
IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:
(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section;
(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.
V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent’s prior disqualification pursuant to subparagraph IV(a).
VI.(a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:
(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and
(2) Within 30 days of the effective date of this section.
(b) Such notice shall include information regarding the required special open enrollment period.
7 Special Enrollment Period. With respect to a subscriber’s child that previously ceased to be eligible for coverage and who newly qualifies as a dependent under RSA 415:5, I(3), RSA 420-A:10-a, II(b), RSA 420-B:8-aa, II(b), RSA 420-C:4-b, II(b), RSA 420-F:5-a, II(b), and RSA 420-J:8-c, II(b), there shall be a special open enrollment period during which a subscriber with family coverage can elect to reinstate coverage for the dependent child. The special enrollment period shall begin August 1, 2007 and end September 30, 2007.
8 Department of Insurance; Report Required.
I. The department of insurance shall compile available data and prepare a report concerning the implementation and effectiveness of the dependant coverage for health insurance under sections 1-6 of this act. The report shall include review of the impact of the dependent coverage health insurance initiative on coverage as well as cost.
II. The commissioner shall make the report, together with any recommendations for legislation, to the president of the senate, the speaker of the house of representatives, the governor, and the chairs of the house and senate commerce committees on or before December 15, 2008.
9 Effective Date. This act shall take effect 60 days after its passage.
LBAO
07-0886
Amended 04/11/07
HB 790 FISCAL NOTE
AN ACT relative to dependent coverage for health insurance and establishing the joint legislative oversight committee on insurance expansion initiatives.
FISCAL IMPACT
The Department of Insurance, and Department of Health and Human Services state this bill, as amended by the House, (Amendment # 2007-0800h), may have an indeterminable fiscal impact on state expenditures, increase state revenue by an indeterminable amount, and increase county and local expenditures by an indeterminable amount in FY 2008 and each year thereafter. This bill will have no fiscal impact on county and local revenue.
METHODOLOGY
The Department of Insurance states this bill would require health insurance plans to cover commercially insured dependent children under age 26 whether or not they are students. The bill would affect both individual insurance policies and group insurance policies. The dependent age increase will allow additional family members to obtain insurance coverage under a family plan or some variant thereof. This change will most likely result in additional people receiving insurance coverage. The cost of the additional insurance coverage will most likely be reflected in additional premiums paid as employees switch from individual or couple coverage to a family plan or some variant of a family plan. The increase in total premiums received (in aggregate) by insurance carriers to cover the additional insured members is expected to be less than 1% of the current premium base for each year over the first three years this change is in place. The Department derived the increase in premiums received from a claims database based on the average per member per month claims cost for insuring the population within this age group, combined with assumptions about the number of new enrollees provided by the New Hampshire Center for Public Policy Studies. The Department states that the State collects premium taxes on premium revenues, and if the premium tax base is increased, state revenues will also increase. The Department expects the impact on premium tax revenue to be negligible but is unable to determine the exact fiscal impact at this time. The Department states the State of New Hampshire is self-funded, and would have no obligation to comply with the provisions of this bill.
The Department of Health and Human Services (DHHS) states the only section of this bill that would directly affect DHHS is the requirement that the oversight committee established by the bill review reports filed by the commissioner to monitor the effectiveness and cost of the insurance expansion program. The Department states this portion of the bill would have no fiscal impact on the Department. The Department states the bill may have a positive but indeterminable impact if many citizens/dependents ages 18 to 26 would no longer need to rely on family assistance medical benefits to reimburse medical providers for necessary medical care.