Measure to Prohibit Cherry Picking by Insurance Venders Involuntarily Deferred

HB 237, a measure put forth by Rep. Chad Brown and supported by the Governor, to prohibit
discrimination by health insurance issuers in the individual market and small and large group
market based on health status, and from imposing any preexisting condition exclusion with respect to the plan or coverage, was involuntarily deferred in Committee on Insurance. The measure also took on six amendments.

The proposed law, if it would have passed, requires a health insurance issuer to include mental health and substance use disorder services, including behavioral health treatment, and preventive and wellness services and chronic disease management.

“Proposed law requires a health insurance issuer offering health insurance coverage in the
individual or group market to renew or continue in force the coverage at the option of the plan sponsor or the individual, as applicable, except that the issuer may nonrenew or discontinue health insurance coverage based only on a failure to pay premiums or contributions, an act or practice that constitutes fraud or an intentional misrepresentation of material fact under the terms of the coverage, or the issuer is ceasing to offer coverage in the market.”

The new law prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage from establishing rules for eligibility, including continued
eligibility, of any individual to enroll under the terms of the plan based on any of the following
health status-related factors in relation to the individual or a dependent of the individual:
(1) Health status.
(2) Medical condition, including both physical and mental illnesses.
(3) Claims experience.
(4) Receipt of health care.
(5) Medical history.
(6) Genetic information.
(7) Evidence of insurability, including conditions arising out of acts of domestic violence.
(8) Disability.
(9) Any other health status-related factor determined appropriate by the commissioner of insurance.

The proposed law prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage in La. from establishing lifetime limits on the dollar value of benefits for any participant or beneficiary.

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