SB774: Essential health benefits benchmark plan review; members of stakeholder work group.

Legislative Summary

Essential health benefits benchmark plan review; stakeholder work group. Requires that the stakeholder work group convened by the Bureau of Insurance of the State Corporation Commission for the essential health benefits benchmark plan review consist of members who possess demonstrated and acknowledged expertise in health benefit plan design, actuarial science, population health, patient advocacy, or advocating for or assisting enrollees in individual or small group health coverage. The bill requires the work group to consider factors including (i) coverage denial rates of benefits that are not covered under the current benchmark plan; (ii) the utilization of mandated benefits; (iii) the projected impact of a proposed mandate on the prevalence of medical need, the urgency of such medical need, and any disproportionate disease burden borne by different subpopulations; (iv) the projected cost of each proposed mandate; and (v) other data as determined by the work group. This bill is a recommendation of the Health Insurance Reform Commission.