Information to be provided by insurers about health care plans offered on the American health benefit exchange

What it would have done

Summary by the Legislative Reference Bureau, the Legislature's nonpartisan drafting office. It's their wording, not ours.

Under the federal Patient Protection and Affordable Care Act (ACA), which was enacted on March 23, 2010, each state must establish an American health benefit exchange (exchange) through which individuals and certain businesses may purchase health insurance. The federal government will establish and operate an exchange in a state that does not establish its own. Health insurance offered through the exchange must meet certain federal requirements, including offering the essential health benefits package that is established by the federal Department of Health and Human Services. Such a health benefit plan is called a qualified health plan (plan) under the ACA.

This bill requires a insurer that offers plans through an exchange that is operating in this state to provide access on the insurer's Internet site to information, in a clear and understandable form, that will enable consumers shopping for health insurance on the exchange to determine all of the following about the insurer's plans offered through the exchange: exclusions from coverage and restrictions on use or quantity of covered services or items; any service or item with a cost-sharing requirement that depends on the cost of the service or item; whether a specific prescription drug is covered and any clinical prerequisites or authorization requirements for coverage of a prescription drug; whether specific types of specialists are included, and whether a specific named specialist is included, in the plan's network; the process for appealing a denial of coverage of a service or item; and how the out-of-pocket costs of medications will or will not be applied towards the deductible under the plan.

Who's behind it

9 lawmakers are its authors⁠. All 9 are Republicans.

3 more lawmakers signed on in support⁠.