Text: SF00124 Text: SF00126 Text: SF00100 - SF00199 Text: SF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. NEW SECTION. 514C.13 ALLOCATION OF PREGNANCY-
1 2 RELATED EXPENSES AMONG INSURED OR COVERED INDIVIDUALS.
1 3 1. A third-party payor offering a policy or contract
1 4 providing for third-party payment or prepayment of health or
1 5 medical expenses on an individual or nongroup basis shall, for
1 6 ratemaking purposes, allocate maternity, pregnancy, and
1 7 childbirth-related expenses equally between female and male
1 8 subscribers, policyholders, or enrollees of all such policies
1 9 and contracts, regardless if a class of policy or contract
1 10 purports to exclude coverage for such benefits for a male, or
1 11 if policies or contracts written for females are materially
1 12 different from those written for males. A contract or policy
1 13 for Medicare supplemental benefits may exclude expenses
1 14 related to maternity, pregnancy, and childbirth for both males
1 15 and females, and a Medicare supplemental policy shall not have
1 16 such expenses allocated against it.
1 17 2. For purposes of this section, "third-party payor"
1 18 includes, but is not limited to, the following:
1 19 a. A person offering individual accident and sickness
1 20 coverage on an expense-incurred basis.
1 21 b. A person offering an individual hospital or medical
1 22 service contract issued pursuant to chapter 514.
1 23 c. A person offering an individual health maintenance
1 24 organization contract regulated under chapter 514B.
1 25 EXPLANATION
1 26 This bill would require that expenses related to maternity,
1 27 pregnancy, and childbirth paid by a third-party payor be
1 28 allocated equally to individual or nongroup female and male
1 29 policyholders, subscribers, or enrollees for purposes of
1 30 ratemaking. Medicare supplemental policies are permitted to
1 31 exclude such benefits from the scope of coverage and shall not
1 32 have maternity, pregnancy, and childbirth expenses allocated
1 33 against them.
1 34 LSB 1157SS 77
1 35 mj/sc/14
Text: SF00124 Text: SF00126 Text: SF00100 - SF00199 Text: SF Index Bills and Amendments: General Index Bill History: General Index
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