SB 453 - This act is a compliance bill for the federal Health Insurance Portability and Accountability Act of 1996. It requires availability and renewability of health insurance policies for all groups and specified individuals in the state.

GROUPS - The general group insurance statutes of Chapter 376, RSMo, are revised to assure minimum compliance with the federal law.

SMALL GROUPS - The small group statutes of Chapter 379, RSMo, are rewritten in particular to comply with the federal law. Small employers must have between 2 and 50 employees. No health status-related factors may be used in establishing classes or issuing or renewing coverage.

Policies need not be renewed if the insurer decides to discontinue a particular type of plan and follows the notification procedures. Currently law generally requires these policies to be renewed with several exceptions. An insurer that elects not to offer any small group plans shall be prevented from reentering that market for 5 years.

All health benefit plans actively marketed by the insurer shall be made available to small employers, with a minimum of at least two plans. Current law requires two plans to be offered. All health benefit plans used by the insurer shall be filed with the Director of Insurance; the director may disapprove them if they violate the law. The availability requirement is not applied to bona fide associations and purchasing alliances.

Preexisting condition limits must be reduced by the period of creditable coverage if such coverage was continuous to within 63 days of the enrollment date of new coverage. Affiliation periods and waiting periods are limited. Preexisting conditions may not be imposed for pregnancy or adoption. Special provisions are made for network plans.

INDIVIDUALS - All eligible individuals under the federal law and all other individual with creditable coverage of at least 12 months are covered under this act. Insurers in the individual market shall make all individual health benefit plans available to such individuals, with exceptions. Insurers shall renew all such plans as well, with exceptions. No preexisting condition exclusions are allowed. Provisions are made for policy disclosures and discrimination, similar to the small group statutes.

EMERGENCY CLAUSE - The act goes into effect on July 1, 1997 or when approved by the Governor, whichever comes later.
CHERYL GRAZIER