THE SENATE

S.B. NO.

2439

THIRTIETH LEGISLATURE, 2020

S.D. 1

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH INSURANCE.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to part I of article 10A to be appropriately designated and to read as follows:

     "§431:10A-A  Coverage for auto-injectable epinephrine; minors.  (a)  Each policy of individual accident and health or sickness issued or renewed in this State after December 31, 2020, shall provide coverage for the cost of medically necessary auto-injectable epinephrine, based on appropriate weight-based dosage, for individuals covered under the policy who are eighteen years of age or younger.

     (b)  Coverage required under this section may be subject to deductibles, copayments, coinsurance, or annual or maximum payment limits that are consistent with deductibles, copayments, coinsurance, and annual or maximum payment limits applicable to other similar coverage under the policy.

     (c)  Every insurer shall provide notice to its policyholders regarding the coverage required by this section.  The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders within calendar year 2020 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2020.

     (d)  This section shall not apply to limited health benefit insurance as provided in section 431:10A-607."

     SECTION 2.  Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to part II of article 10A to be appropriately designated and to read as follows:

     "§431:10A-B  Coverage for auto-injectable epinephrine; minors.  (a)  Each policy of group accident and health or sickness issued or renewed in this State after December 31, 2020, shall provide coverage for the cost of medically necessary auto-injectable epinephrine, based on appropriate weight-based dosage, for individuals covered under the policy who are eighteen years of age or younger.

     (b)  Coverage required under this section may be subject to deductibles, copayments, coinsurance, or annual or maximum payment limits that are consistent with deductibles, copayments, coinsurance, and annual or maximum payment limits applicable to other similar coverage under the policy.

     (c)  Every insurer shall provide notice to its policyholders regarding the coverage required by this section.  The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders within calendar year 2020 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2020.

     (d)  This section shall not apply to limited health benefit insurance as provided in section 431:10A-607."

     SECTION 3.  Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article I to be appropriately designated and to read as follows:

     "§432:1-    Coverage for auto-injectable epinephrine; minors.  (a)  Each individual and group hospital or medical service plan contract issued or renewed in this State after December 31, 2020, shall provide coverage for the cost of medically necessary auto-injectable epinephrine, based on appropriate weight-based dosage, for individuals covered under the individual and group hospital or medical service plan contract who are eighteen years of age or younger.

     (b)   Coverage required under this section may be subject to deductibles, copayments, coinsurance, or annual or maximum payment limits that are consistent with deductibles, copayments, coinsurance, and annual or maximum payment limits applicable to other similar coverage under the individual and group hospital or medical service plan contract.

     (c)  Every mutual benefit society shall provide notice to its members regarding the coverage required by this section.  The notice shall be in writing and prominently positioned in any literature or correspondence sent to members and shall be transmitted to members within calendar year 2020 when annual information is made available to members, or in any other mailing to members, but in no case later than December 31, 2020."

     SECTION 4.  Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

     "§432D-23  Required provisions and benefits.  Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-134, 431:10A-140, [and 431:10A-134,] 431:10A-A, and 431:10A-B, and chapter 431M."

     SECTION 5.  The benefit to be provided by health maintenance organizations corresponding to the benefit provided under sections 431:10A-A and 431:10A-B, Hawaii Revised Statutes, as contained in the amendment to section 432D-23, Hawaii Revised Statutes, in section 4 of this Act, shall take effect for all policies, contracts, plans, or agreements issued in the State after December 31, 2020.

     SECTION 6.  The requirements of section 23-51, Hawaii Revised Statutes, shall not apply to the statutory provisions established or amended by this Act.

     SECTION 7.  In codifying the new sections added by sections 1 and 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

     SECTION 8.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 9.  This Act shall take effect upon its approval.

 

 

Report Title:

Health Insurance; Coverage; Auto-injectable Epinephrine; Minors

 

Description:

Requires insurers, mutual benefit societies, and health maintenance organizations to provide coverage for the cost of auto-injectable epinephrine based on appropriate weight-based dosage for insured persons eighteen years of age or younger, beginning 1/1/2021.  (SD1)

 

 

 

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