HBA-NRS H.B. 2146 77(R)BILL ANALYSIS


Office of House Bill AnalysisH.B. 2146
By: Chisum
Insurance
4/11/2001
Committee Report (Amended)



BACKGROUND AND PURPOSE 

Small businesses are facing increasingly expensive employee health
insurance premiums. A substantial claim by one employee can increase the
rate of premiums paid by the employer for all employees. Current law does
not require an issuer of group health benefit plans to provide a small
employer with the claims experience of the employees covered by a group
health benefit plan. Consequently, the employer cannot verify the
legitimacy of rate increases. Nondisclosure of claims experience is
intended to protect the privacy of an individual employee who files a large
health insurance claim. However, preventing a small employer's access to
claims information hinders the ability of a small employer to evaluate
alternatives to health insurance providers. House Bill 2146  requires the
issuer of a group health benefit plan to provide a small employer with the
claims experience of the small employer's employees covered by the plan. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

ANALYSIS

House Bill 2146 amends the Insurance Code to require the issuer of group
health benefit plans that are issued to the employees of one or more
employers that sponsor the plan to provide to the employer the claims
experience of the employees covered by the plan during the preceding
calendar year.  The bill requires claims experience to be provided in
aggregate, without information through which a specific individual enrolled
in the group health benefit plan may be identified.  The bill authorizes
the employer to use the information only for purposes relating to obtaining
and maintaining group health benefit plan coverage for the employer's
employees. 

EFFECTIVE DATE

September 1, 2001. The Act applies only to a group health benefit plan that
is delivered, issued for delivery, or renewed on or after January 1, 2002. 

EXPLANATION OF AMENDMENTS

Committee Amendment No. 1 creates the option for an issuer of a group
health benefit plan to provide detailed claims experience of an employee to
an employer.