Actuarial Reviews Health Insurance Mandate Legislation

The act requires the division of insurance (division), on or before November 1, 2022, to retain by contract one or more entities that have experience in actuarial reviews, health-care policy, and health equity (contractors) for the purpose of performing actuarial reviews of legislative proposals that may impose a new health benefit coverage mandate on health benefit plans or reduce or eliminate coverage mandated under health benefit plans. The contractors, under the direction of the division, shall conduct an actuarial review of up to 6 such legislative proposals for each regular legislative session as follows:

• Up to 2 members of the majority party of the house of representatives may submit a request for an actuarial review;
• One member of the minority party of the house of representatives may submit up to one request for an actuarial review;
• Up to two members of the majority party of the senate may submit a request for an actuarial review; and
• One member of the minority party of the senate may submit up to one request for an actuarial review.

Each actuarial review performed by the contractors must consider the predicted effects of the legislative proposal during the 5 and 10 years immediately following the effective date of the proposed legislation, or during another time period following the effective date if such consideration is more actuarially feasible, including specifically described considerations.

A request for an actuarial review and the final report resulting from such a request must be treated as confidential except by the member of the general assembly who made the request until the legislative proposal that is the subject of the actuarial review is introduced in the regular legislative session following the submission of the request for the actuarial review or, if no such legislative proposal is introduced, until after the end of the legislative session following the submission of the request.

The division may not engage any contractor to perform an actuarial review unless the division determines that there are adequate resources available within existing appropriations to compensate the contractor for the actuarial review.

In preparing a fiscal note for any legislative proposal that may impose a new health benefit mandate on health benefit plans, the legislative service agency charged with preparing the fiscal note shall include a statement that a report has been prepared by the contractors for the legislative proposal and an indication of how the report may be obtained in its entirety.

The act is repealed, effective November 1, 2027.

For the 2022-23 state fiscal year, the act appropriates $100,000 from the division of insurance cash fund to the department of regulatory agencies for use by the division of insurance as follows:

• $50,000 for personal services; and
• $50,000 for operating expenses.
  (Note: This summary applies to this bill as enacted.)