SB 547 - This act amends or enacts several provisions of law related to health insurance. HRA ONLY PLANS - Under this act, employees are allowed to use funds from one or more employer health reimbursement arrangement (HRA) only plans to help pay for individual health insurance coverage. HRAs are employee benefit plans provided by an employer which establish an account funded solely by the employer to reimburse the employee for qualified medical expenses incurred by the employee or his or her family. HRAs allow the employee to carry forward any unused funds at the end of the coverage period to subsequent coverage periods (Section 376.1600). A similar provision is contained in HB 229 (2009). The act also provides that if an employer provides health insurance to an employee and the employee pays any portion of the cost of the premium, the employer must also provide a premium-only cafeteria plan or a health reimbursement arrangement (Section 376.453). Current law only requires the provision of a premium-only cafeteria plan. This provision is contained in HB 229 (2009). MISSOURI MINI-COBRA LAW TO MIRROR FEDERAL COBRA LAW - This act requires group health insurance policies issued by health carriers to employers not covered by the federal COBRA law (employers with 2 to 19 employees) to provide terminated employees with group insurance coverage continuation rights in the same manner as provided by the federal COBRA law (Section 376.428). This provision is contained in HB 231 (2009). CONTINUATION OF HEALTH INSURANCE COVERAGE FROM AGE 55 - Under this act, every group health insurance policy issued or renewed on or after January 1, 2010, must contain a provision that allows an employee or group member, whose continuation coverage under the federal COBRA law or state's continuation law has expired, to continue coverage under that group policy provided the employee or group member was 55 years or older when coverage under COBRA or the state continuation law expired. The extended continuation coverage provided by this act will terminate upon the earliest of the following: (1) The date the employee or group member fails to pay premiums; (2) The date the group policy is terminated as to all group members; (3) The date on which the employee or group member becomes insured under another group policy; (4) The date on which the employee or group member becomes eligible for coverage under the federal Medicare program; or (5) The date on which the group member turns 65 (Section 376.437). RATING OF MISSOURI CONTINUATION COVERAGE POLICIES - This act requires health insurance policies that are issued to individuals eligible for continuation coverage under state law to be pooled across all fully insured group business in Missouri. The rating system in which the premium for all persons covered under a continuation of coverage provision shall be based on the experience of all persons covered by a continuation of coverage provision with any cost of the pool experience spread over all fully insured premiums on an equal percentage basis (Section 376.439). CONTINUATION OF COVERAGE RIGHTS THROUGH A HSA ELIGIBLE PLAN - This act requires health carriers who provide group insurance policies to persons who are exercising their continuation of coverage rights under COBRA or the state continuation of coverage law (Section 376.428) to offer such persons the option of continuation of coverage through a HSA eligible high deductible plan rather than the underlying group policy. The premiums for the HSA eligible high deductible plans shall be consistent with the underlying group plans rated relative to the standard or manual rates for the benefits provided (Section 376.443). The provisions contained in this act are also contained in SB 415 (2009). STEPHEN WITTE