Insurance - Digest of Bills

Digest of Bills - 1998

INSURANCE

S.B. 98-12 Motor vehicle insurance - prohibition against adverse action by insurer based on prior insurance coverage - exception when actuarial justification is filed. Unless an insurer files actuarial justification showing an increase in risk, prohibits the insurer from refusing to write a motor vehicle insurance policy for a new applicant, surcharging the premium of a new applicant, or placing a new applicant in a higher priced program or plan based solely upon:

The fact that the applicant had no prior insurance;
The identity of the applicant's prior insurer; or
The applicant's prior type of coverage.

Prohibits any insurer from refusing to write a motor vehicle insurance policy for a new applicant, surcharging the premium of a new applicant, or placing a new applicant in a higher priced program or plan based solely upon the fact that the applicant had no prior insurance if the applicant was not required to have insurance under Colorado law or a similar law in another state.

APPROVED by Governor April 17, 1998
EFFECTIVE August 5, 1998
NOTE: This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

S.B. 98-13 Motor vehicle insurance - managed care arrangements - disclosure requirements. When a person makes an initial application for motor vehicle insurance coverage, requires the insurer to disclose:

That motor vehicle insurance policies may include managed care arrangements;
What managed care is and how it affects the consumer; and
Whether the insurer offers a managed care option and, if so, that cost savings may be obtained by choosing such an option.

Requires the disclosure form that is currently required for motor vehicle insurance policies containing managed care options to disclose the following:

That the insured may accept or reject managed care options at any time;
That obtaining or renewing an insurance policy is not dependent on accepting a managed care option; and
What the approximate cost savings would be if the insured accepted a managed care option.

APPROVED by Governor May 27, 1998
EFFECTIVE January 1, 1999

S.B. 98-14 Motor vehicle insurance - wage loss replacement coverage - waiver of coverage - notice to insured persons. Allows a person having a motor vehicle insurance policy to decline coverage for loss of gross income without representing that the insured and the insured's spouse have not received any income from wages and do not anticipate any such income for specified time periods. Provides that such option to decline coverage applies to any resident relative of the named insured, in addition to the named insured and the insured's resident spouse.

Upon the first policy renewal for an existing motor vehicle insurance policy, requires an insurer to provide a notice to the named insured regarding the opportunity to waive loss of gross income coverage. Requires that such notice include a description of the coverage that may be waived, the estimated cost of such coverage, and a statement indicating that the insured may waive such coverage.

Requires an insured to sign a written waiver in order to waive loss of gross income coverage for an application for a new motor vehicle insurance policy and upon the first renewal of an existing policy. Requires that such written waiver describe the coverage being waived, provide the estimated cost of such coverage, and indicate that the coverage is being voluntarily waived. Allows a named insured to obtain or waive loss of gross income coverage at any time upon request to the insurer.

APPROVED by Governor May 27, 1998
EFFECTIVE January 1, 1999

S.B. 98-104 Health care - managed care plans - required access to certified nurse midwives. Requires managed care plans that cover reproductive health care to provide their patients with access to an advanced practice nurse who is a certified nurse midwife participating and available under the plan.

APPROVED by Governor March 24, 1998
EFFECTIVE January 1, 1999

S.B. 98-107 Health insurance - pharmacy benefit management firms - open networks - participation by each pharmacy in contract service area. Requires any pharmacy benefit management firm, whose contract with an health care insurance entity includes an open network, to allow participation by each pharmacy provider in the contract service area. Allows such pharmacy benefit management firm to offer an open network on a regional or local basis. Defines "open network".

Allows a pharmacy benefit management firm to contract with exclusive pharmacy networks if, 60 days before the termination or effective date of such contract, the pharmacy benefit management firm publishes notice of such termination or effective date in one or more newspapers of general circulation in the affected contract area.

APPROVED by Governor June 1, 1998
EFFECTIVE August 5, 1998
NOTE: This act shall take effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution; except that, if a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, if approved by the people, shall take effect on the date of the official declaration of the vote thereon by proclamation of the governor.

S.B. 98-118 Scope of regulation - exemptions - motor vehicle rental companies. Provides an exemption from the insurer licensing statutes for motor vehicle rental companies and their agents who offer liability coverage and other types of coverage typically included in automobile insurance policies in connection with, and incidentally to, the short-term rental of a motor vehicle for transportation purposes.

APPROVED by Governor April 10, 1998
EFFECTIVE April 10, 1998

H.B. 98-1019 Health care - mandatory insurance coverage - minimum hospital stays for childbirth. Specifies that mandatory coverage for newborn children and maternity under health care coverage policies shall, at a minimum, provide coverage for a 48-hour hospital stay following a normal childbirth delivery and 96 hours following a cesarean section. Specifies that, if the 48-hour or 96-hour period ends after 8 p.m., coverage shall continue until 8 a.m. the following morning.

States that nothing in the act shall be construed to require a health plan participant to give birth in a hospital or to stay in the hospital for a fixed period of time nor to prevent a carrier from imposing its usual deductibles, coinsurance, or other cost sharing in relation to hospital coverage.

Deletes obsolete language in the law relating to maternity coverage that is inconsistent with current federal and Colorado health care coverage laws dealing with preexisting condition limitations.

APPROVED by Governor March 23, 1998
EFFECTIVE March 23, 1998

H.B. 98-1025 Motor vehicle insurance - PIP coverage - option and disclosure requirements. Requires insurers offering PIP coverage to make deductibles and coinsurance arrangements available in their coverage options and in any managed care arrangement. Provides that such deductibles and coinsurance arrangements shall apply only to the named insured, a resident spouse, resident relative, and permissive operators, but that any policy of a permissive operator shall be primary.

Requires disclosure forms for managed care arrangements to include specific information that includes an insured's right to change his or her option. Also requires the following information to be disclosed to applicants:

That motor vehicle insurance policies in Colorado may include optional managed care arrangements;
What managed care is and how it affects the consumer; and
Whether the insurer offers a managed care option and, if so, the potential cost savings to the consumer if such option is chosen.

APPROVED by Governor April 21, 1998
EFFECTIVE January 1, 1999

H.B. 98-1053 Health insurance - short-term limited duration health policies - exemption from creditable coverage provisions. Exempts short-term limited duration health insurance policies from the provisions concerning creditable coverage for individual policies.

Defines "short-term limited duration health insurance" as a nonrenewable individual health benefit plan of less than 6 months duration that is issued only to persons who have not had more than one such policy within the previous 12 months and that contains a disclosure that the policy does not provide portability of prior coverage.

APPROVED by Governor April 21, 1998
EFFECTIVE April 21, 1998

H.B. 98-1213 Motor vehicle insurance - proof of compliance with compulsory insurance requirements prior to motor vehicle registration - penalty for providing fraudulent information - appropriation. Authorizes the department of revenue to issue or renew the registration of a class C motor vehicle only if the applicant has a complying policy of motor vehicle insurance or a certificate of self-insurance in effect. Requires an applicant for registration of a vehicle to provide the department a certificate of insurance or insurance identification card provided by the applicant's insurer or provide proof in such other media as is authorized by the department. Provides that any person who knowingly provides fraudulent information or documents regarding compliance with the insurance requirements in order to register a motor vehicle is guilty of a misdemeanor and is subject to a $500 criminal penalty and a $500 civil penalty.

Whenever an insurer issues or renews a policy of motor vehicle insurance, requires the insurer to provide a certificate of insurance or insurance identification card to the insured or provide proof of insurance in such other media as is authorized by the department of revenue.

Requires the commissioner of insurance to inform the public regarding the requirement for providing proof of insurance prior to registering a motor vehicle.

Appropriates $75,000 to the department of regulatory agencies for the implementation of the act.

APPROVED by Governor May 22, 1998
PORTIONS EFFECTIVE January 1, 1999, July 1, 1999
NOTE: Sections 1, 2, 3, 4, and 6 of this act shall take effect July 1, 1999, and the remainder of this act shall take effect January 1, 1999, unless a referendum petition is filed during the ninety-day period after final adjournment of the general assembly that is allowed for submitting a referendum petition pursuant to article V, section 1 (3) of the state constitution. If such a referendum petition is filed against this act or an item, section, or part of this act within such period, then the act, item, section, or part, shall take effect on the specified date only if approved by the people.

H.B. 98-1243 Health insurance - mandatory coverage - general anesthesia for dental procedures performed on certain children. Requires all individual and all group sickness and accident insurance policies, all individual and group health care service or indemnity contracts, and other group health care coverage, except supplemental policies that cover a specific disease or other limited benefit, offered to residents of this state by covered entities to provide coverage for the administration of general anesthesia and hospital or facility charges for dental procedures performed on dependent children who satisfy one of the necessary criteria. Excepts treatment rendered for temporal mandibular joint (TMJ) disorders from coverage.

When general anesthesia is used for dental procedures on dependent children, requires that those procedures be performed in a hospital or other facility licensed by the department of public health and environment. Also requires that, if coverage is provided by a managed care plan, coverage will only be provided if the provider of those services is affiliated with the insurance carrier.

Allows a health insurance carrier to require prior authorization for anesthesia and dental care treatment in the same manner as other covered diseases or procedures or to require that only specifically qualified dentists perform the dental procedure.

APPROVED by Governor April 22, 1998
EFFECTIVE April 22, 1998

H.B. 98-1297 Lloyd's insurers - trust requirements - service of process. Changes the required amount of the trust an unincorporated group of individual insurers, commonly known as a Lloyd's plan, or similar group must maintain to do business in Colorado from an amount equal to the group's liabilities in this country to an amount satisfactory to the commissioner of insurance that is not less than the amount required in the state where the trust is located.

Allows the commissioner to adopt a rule under which a nonadmitted insurer designates a person on whom process may be sent after the commissioner has been served.

APPROVED by Governor April 10, 1998
EFFECTIVE April 10, 1998

H.B. 98-1309 Health insurance - mandatory coverage - diabetes. Requires every health benefit plan, except supplemental policies covering a specified disease or other limited benefit, to provide coverage for equipment, supplies, and outpatient self-management training and education, including medical nutrition therapy, for the treatment of diabetes if prescribed by a health care provider licensed to prescribe such items pursuant to Colorado law. Makes such coverage subject to the same annual deductibles or copayments as other covered benefits within a given policy. Prohibits third-party payors from reducing or eliminating health care coverage because of the diabetes coverage requirement.

APPROVED by Governor April 13, 1998
EFFECTIVE July 1, 1998

H.B. 98-1391 Health care - coverage - benefit plans - modification. Permits the reasonable modification of benefits under small group and individual health benefit plans if:

The modification is effective only at the time of coverage renewal;
The health benefit plan is uniformly modified for all groups and individuals covered by the same health benefit plan;
Coverage for basic health care services continues to be provided by the carrier;
A description of the modification is provided to policyholders and the commissioner at least 90 days prior to the effective date of the modification; and
The carrier provides to each affected policyholder the opportunity to purchase any other health benefit plan offered by the carrier in such market.

Authorizes the commissioner of insurance to adopt such rules as are necessary to carry out the provisions of the act.

APPROVED by Governor May 18, 1998
EFFECTIVE May 18, 1998