Group health benefit plans; sponsoring associations, formation of benefits consortium, definitions. (SB195)

Introduced By

Sen. Monty Mason (D-Williamsburg) with support from co-patron Sen. Siobhan Dunnavant (R-Henrico)

Progress

Introduced
Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law

Description

Group health benefit plans; bona fide associations; formation of benefits consortium. Provides that certain trusts constitute a benefits consortium and are authorized to sell health benefit plans to members of a sponsoring association that (i) has been formed and maintained in good faith for purposes other than obtaining or providing health benefits; (ii) does not condition membership in the sponsoring association on any factor relating to the health status of an individual, including an employee of a member of the sponsoring association or a dependent of such an employee; (iii) makes any health benefit plan available to all members regardless of any factor relating to the health status of such members or individuals eligible for coverage through a member; (iv) does not make any health benefit plan available to any person who is not a member of the association; (v) makes available health plans or health benefit plans that meet requirements provided for in the bill; (vi) operates as a nonprofit entity under § 501(c)(5) or 501(c)(6) of the Internal Revenue Code; and (vii) has been in active existence for at least five years. The bill replaces references to "bona fide association," as used in provisions applicable to health care plans in the small employer market, with the term "sponsoring association." The bill requires any health benefit plan issued by a self-funded multiple employer welfare arrangement (MEWA) that covers one or more employees of one or more small employers to (a) provide essential health benefits and cost-sharing requirements; (b) offer a minimum level of coverage designed to provide benefits that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided under the plan; (c) not limit or exclude coverage for an individual by imposing a preexisting condition exclusion on that individual; (d) be prohibited from establishing discriminatory rules based on health status related to eligibility or premium or contribution requirements as imposed on health carriers; (e) meet the renewability standards set forth for health insurance issuers; (f) establish base rates formed on an actuarially sound, modified community rating methodology that considers the pooling of all participant claims; and (g) utilize each employer member's specific risk profile to determine premiums by actuarially adjusting above or below established base rates, and utilize either pooling or reinsurance of individual large claimants to reduce the adverse impact on any specific employer member's premiums. The bill prohibits a self-funded MEWA from issuing health benefit plans in the Commonwealth until it has obtained a license pursuant to regulations promulgated by the State Corporation Commission. The bill authorizes the Commission to adopt regulations applicable to self-funded MEWAs, including regulations addressing financial condition, solvency requirements, and the exclusion of self-funded MEWAs from the Virginia Life, Accident and Sickness Insurance Guaranty Association. This bill is identical to HB 884. Read the Bill »

Outcome

Bill Has Passed

History

DateAction
01/10/2022Prefiled and ordered printed; offered 01/12/22 22100845D
01/10/2022Referred to Committee on Commerce and Labor
01/23/2022Impact statement from SCC (SB195)
01/24/2022Reported from Commerce and Labor with substitute (15-Y 0-N) (see vote tally)
01/24/2022Committee substitute printed 22105172D-S1
01/24/2022Incorporates SB549 (Dunnavant)
01/24/2022Rereferred to Finance and Appropriations
01/31/2022Impact statement from SCC (SB195S1)
02/02/2022Senate committee, floor amendments and substitutes offered
02/02/2022Reported from Finance and Appropriations with substitute (15-Y 0-N) (see vote tally)
02/02/2022Committee substitute printed 22105706D-S2
02/03/2022Constitutional reading dispensed (40-Y 0-N) (see vote tally)
02/04/2022Read second time
02/04/2022Committee substitute rejected 22105172D-S1
02/04/2022Reading of substitute waived
02/04/2022Committee substitute agreed to 22105706D-S2
02/04/2022Engrossed by Senate - committee substitute SB195S2
02/07/2022Read third time and passed Senate (40-Y 0-N) (see vote tally)
02/10/2022Impact statement from SCC (SB195S2)
02/21/2022Placed on Calendar
02/21/2022Read first time
02/21/2022Referred to Committee on Commerce and Energy
02/22/2022House committee, floor amendments and substitutes offered
02/22/2022Reported from Commerce and Energy with substitute (14-Y 8-N) (see vote tally)
02/22/2022Committee substitute printed 22106828D-H1
02/24/2022Read second time
02/25/2022Read third time
02/25/2022Committee substitute agreed to 22106828D-H1
02/25/2022Engrossed by House - committee substitute SB195H1
02/25/2022Passed House with substitute (63-Y 35-N)
02/25/2022VOTE: Passage (63-Y 35-N) (see vote tally)
02/28/2022Impact statement from SCC (SB195H1)
03/01/2022House substitute agreed to by Senate (40-Y 0-N) (see vote tally)
03/01/2022Title replaced 22106828D-S1
03/03/2022Enrolled
03/03/2022Bill text as passed Senate and House (SB195ER)
03/03/2022Impact statement from SCC (SB195ER)
03/03/2022Signed by Speaker
03/04/2022Signed by President
03/11/2022Enrolled Bill Communicated to Governor on March 11, 2022
03/11/2022G Governor's Action Deadline 11:59 p.m., April 11, 2022
04/11/2022G Approved by Governor-Chapter 405 (effective 7/1/22)
04/11/2022G Acts of Assembly Chapter text (CHAP0405)

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