Commonwealth Care Health Benefits Program; association health plans for individual market. (SB364)

Introduced By

Sen. Siobhan Dunnavant (R-Henrico)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Joint Commission on Health Care; association health plans for the individual market; review. Directs the Joint Commission on Health Care (JCHC) to examine and review the implications of the establishment, implementation, and administration of a program, to be known as the Commonwealth Care Health Benefits Program (the Program), under which a division of the State Corporation Commission (the Commission), or nonprofit corporation established by the Commission, will be the sponsor of association health plans through which it will sell individual health insurance coverage in the Commonwealth. The bill provides that JCHC shall request and consider information and input from the Commission's Bureau of Insurance and the Secretary of Health and Human Resources. The bill provides that elements of the Program to be reviewed and examined by JCHC shall include the following: (i) implementation of the Program would be contingent on the approval of the U.S. Secretary of Health and Human Services of a state innovation waiver under § 1332 of the Patient Protection and Affordable Care Act (ACA); (ii) the Commission will retain staff sufficient to establish and implement the Program; (iii) the Program will arrange for a number of third-party administrators, sufficient to ensure competition but in no event fewer than two; (iv) the Program will design and implement health plans that are comparable those currently sold through the federal exchange; (v) the covered benefits provided under a plan offered through the Program would provide coverage that a large group plan or association health plan subject to the federal Employee Retirement Income Security Act of 1974 (ERISA) is required to provide so long as one or more health plans provide additional benefits as may be required to provide coverage that is at least as comprehensive and affordable as plans currently offered on the exchange pursuant to the ACA or otherwise to comply with the Guardrail requirements of the ACA; (vi) the Program will address the establishment of a reinsurance program; (vii) health plan premiums for individuals with a household income between 100 percent and 400 percent of the federal poverty level would be subsidized; (viii) the Program will offer a cost-sharing reduction feature that removes disincentives to Program participation by low-income individuals who are enrolled in the Medicaid program; (ix) individuals will still be able to purchase individual health insurance coverage outside of the Program; (x) premiums for the plans offered through the Program will be set by the third-party administrators, subject to approval by the Commission with assistance of qualified actuaries; (xi) the Program would be designed and operated in order to ensure that any shortfall in revenues is addressed by the reinsurance program and by self-funding a reserve that is determined by the corporation's actuary to be adequate, and (xii) the Program will include premium incentives for compliance with wellness or chronic disease management benefit programs. The bill requires JCHC to report its findings and conclusions to the Joint Committee for Health and Human Resources Oversight. Read the Bill »


Bill Has Failed


01/06/2020Prefiled and ordered printed; offered 01/08/20 20101921D
01/06/2020Referred to Committee on Commerce and Labor
01/12/2020Impact statement from DPB (SB364)
01/13/2020Rereferred from Commerce and Labor (15-Y 0-N) (see vote tally)
01/13/2020Rereferred to Rules
01/31/2020Reported from Rules with substitute (15-Y 0-N) (see vote tally)
01/31/2020Committee substitute printed 20107384D-S1
02/03/2020Constitutional reading dispensed (40-Y 0-N) (see vote tally)
02/04/2020Read second time
02/04/2020Reading of substitute waived
02/04/2020Committee substitute agreed to 20107384D-S1
02/04/2020Engrossed by Senate - committee substitute SB364S1
02/05/2020Read third time and passed Senate (40-Y 0-N) (see vote tally)
02/12/2020Impact statement from DPB (SB364S1)
02/13/2020Placed on Calendar
02/13/2020Read first time
02/13/2020Referred to Committee on Rules
02/27/2020Tabled in Rules (13-Y 5-N) (see vote tally)