Bills › 90th General Assembly
Relating to certain health care plan’s cost-sharing for essential health benefits
Topics:Business & economy
Where it is now
- Done: IntroducedMarch 7, 2024
- Stopped: SubcommitteeDied when the General Assembly ended
- Next: House committee
- Next: Passes the House
- Next: Senate committee
- Next: Passes the Senate
- Next: To the Governor
- Next: Signed into law
Died when the session ended The 2024 session adjourned on April 19, 2024, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?
What’s in it
AI summary Health insurance companies must count all essential health benefits toward a person's yearly limit on out-of-pocket costs. This rule applies to people with individual, small group, or group health insurance plans. Even if a company doesn't label a specific service as an essential benefit, they must still include those costs when calculating how much a person has paid toward their annual limit.1
Read the official explanation
This bill relates to certain health care plan’s cost-sharing for essential health benefits. Under the bill, when calculating an enrollee’s contribution to the annual limitation on cost-sharing under federal law, a health care plan, or its subcontractors, that provides small group health coverage, individual health coverage, or group health insurance coverage shall include expenditures for any item or service covered under the health care plan if the item or service is included within a category of essential health benefits regardless of whether the health care plan, or its subcontractors, classifies the item or service as an essential health benefit. “Cost-sharing” is defined in the bill as any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket cost obligation imposed by a health care plan, or the health care plan’s subcontractors, on an enrollee.