§2766.__Forms

All plan forms, including applications, evidence of coverage, riders, amendments, endorsements and disclosure statements, must be submitted to the superintendent for approval in the same manner as required by section 2412.

§2767.__Basic care medical plan pool

Carriers that issue basic care medical plans may form a pool for the purpose of distributing among carriers in the pool the financial risk of coverage for enrollees. The pool may not become operational until the superintendent approves a plan of operation submitted by carrier members. The superintendent may approve the establishment of a pool only after a determination that the pool is in the public interest and is consistent with this chapter and any rules adopted pursuant to this chapter. The carrier members of the pool shall guarantee, without limitation, the solvency of the pool. The guarantee constitutes an ongoing financial obligation of each carrier member on a pro rata basis.

§2768.__Rules

The superintendent may adopt rules necessary to implement this chapter. Rules adopted pursuant to this chapter are routine technical rules as defined in Title 5, chapter 375, subchapter 2- A.

SUMMARY

This bill authorizes basic care medical plans to provide health insurance with high deductibles and levels of coinsurance. Individuals who have incomes at 200% or below the federal non- farm income poverty level and have no other coverage may purchase the plans. The plans cover hospitalization, prenatal, postnatal and well-baby care, surgery and emergency and outpatient care. The plans are exempt from all state laws mandating insurance coverage of certain health care services or certain health care providers. The plans are subject to provisions relating to community rating, guaranteed issuance and guaranteed renewal for individual health insurance policies. The carriers that offer basic care medical plans are authorized to form a pool to distribute the risk of providing coverage to enrollees.