SB 357-2_ Filed 02/24/2010, 07:33 Fry
Adopted 2/24/2010


Text Box


    PREVAILED      Roll Call No. _______
    FAILED        Ayes _______
    WITHDRAWN        Noes _______
    RULED OUT OF ORDER


[

HOUSE MOTION ____

]

MR. SPEAKER:

    I move that Engrossed Senate Bill 357 be amended to read as follows:

SOURCE: Page 63, line 42; (10)MO035706.63. -->     Page 63, after line 42, begin a new paragraph and insert:
SOURCE: IC 27-8-5-1; (10)MO035706.59. -->     "SECTION 59. IC 27-8-5-1, AS AMENDED BY P.L.173-2007, SECTION 21, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 1. (a) The term "policy of accident and sickness insurance", as used in this chapter, includes any policy or contract covering one (1) or more of the kinds of insurance described in Class 1(b) or 2(a) of IC 27-1-5-1. Such policies may be on the individual basis under this section and sections 2 through 9 of this chapter, on the group basis under this section and sections 16 through 19 of this chapter, on the franchise basis under this section and section 11 of this chapter, or on a blanket basis under section 15 of this chapter and (except as otherwise expressly provided in this chapter) shall be exclusively governed by this chapter.
    (b) No policy of accident and sickness insurance may be issued or delivered to any person in this state, nor may any application, rider, or endorsement be used in connection with an accident and sickness insurance policy, until a copy of the form of the policy and of the classification of risks and the premium rates, or, in the case of assessment companies, the estimated cost pertaining thereto, have been filed with and reviewed by the commissioner under section 1.5 of this chapter. This section is applicable also to assessment companies and fraternal benefit associations or societies.
     (c) The premium charged for coverage under a policy of accident and sickness insurance may not be increased by an

amount that is greater than ten percent (10%) of the premium charged for the coverage during the immediately preceding policy year.".

SOURCE: Page 66, line 24; (10)MO035706.66. -->     Page 66, line 24, strike "(m)." and insert " (n).".
    Page 67, between lines 24 and 25, begin a new paragraph and insert:
    " (m) The commissioner shall disapprove a premium rate increase filing that violates section 1(c) of this chapter.".
    Page 67, line 25, strike "(m)" and insert " (n)".
    Page 67, line 28, strike "(n)" and insert " (o)".
    Page 67, line 35, delete "(o)" and insert " (p)".
    Page 78, between lines 25 and 26, begin a new paragraph and insert:
SOURCE: IC 27-13-20-1; (10)MO035706.72. -->     "SECTION 72. IC 27-13-20-1 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 1. (a) The rates to be used by a health maintenance organization, including the actuarial assumptions underlying those rates, must be filed with the commissioner for approval and:
        (1) must be established in accordance with actuarial principles for various categories of enrollees and, in the case of a group contract, shall not be individually determined based on the status of an enrollee's health;
        (2) must be developed by an actuary or other qualified person acceptable to the commissioner; and
        (3) may not be excessive, inadequate, or unfairly discriminatory.
     (b) A premium for coverage under an individual contract or a group contract may not be increased by an amount that is greater than ten percent (10%) of the premium charged for the individual contract or group contract during the immediately preceding contract year.
SOURCE: IC 27-13-20-2; (10)MO035706.73. -->     SECTION 73. IC 27-13-20-2 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 2. (a) Except as provided in subsection (b), a document submitted to the commissioner under this chapter is deemed approved when one (1) of the following conditions is met:
        (1) The health maintenance organization receives a written communication of approval from the commissioner.
        (2) Thirty (30) days pass after the commissioner receives the document.
However, a rate increase is not deemed approved unless the health maintenance organization receives a written communication of approval from the commissioner following a public meeting under section 3 of this chapter.
    (b) A document is not deemed approved under subsection (a)(2) (a) if, within thirty (30) days after the commissioner receives the document, or within any period of extension granted by the commissioner, the commissioner deposits in the United States mail addressed to the health maintenance organization a written

communication to the contrary. Not more than thirty (30) days after receiving the written communication from the commissioner, the health maintenance organization may request a hearing. If, not more than thirty (30) days after receiving the communication from the commissioner, the health maintenance organization requests a hearing, the commissioner shall hold a hearing upon not less than ten (10) days notice to the health maintenance organization.".

SOURCE: Page 78, line 26; (10)MO035706.78. -->     Page 78, line 26, delete "IC 27-13-7-11.5" and insert "IC 27-13-20-3".
    Page 78, line 28, delete "11.5." and insert " 3.".
    Renumber all SECTIONS consecutively.
    (Reference is to ESB 357 as printed February 22, 2010.)

________________________________________

Representative Fry


MO035706/DI 97     2010