The NC House began discussing an important piece of legislation that aims to lower health care costs by providing small businesses with additional health insurance options. Senate Bill 228: Allow Employers to Offer EPO Benefit Plans allows insurers to offer Exclusive Provider Benefit Plans where out-of-network services would not be covered. The bill also establishes continuity of care provisions for EPOs. This transitional coverage would be available to individuals who are newly insured by the EPO and to individuals whose healthcare providers left the EPO's network.
- In general, the insurer would have to continue paying the provider for treatment received within 90 days of the provider leaving the network.
- If the care is related to surgery, organ transplantation, or inpatient care, coverage must be continued for 90 days after discharge.
- If the care is related to pregnancy, and the insured was in her second trimester when the provider left the network, coverage must continue through 60 days of postpartum care.
- Coverage for terminal illness must be extended for the duration of the insured's life.
Insurers may condition coverage for continuing care on the following:
- The provider agreeing to accept reimbursement from the insurer and not charge the patient a greater cost-share.
- The provider agreeing to comply with the insurer's quality assurance programs and policies for in network providers.
The bill received a unanimous vote from the NC Senate in June, and we are pleased to see the NC House begin to move it forward. It passed the House Insurance Committee last week and has been re-referred to the House Health Committee. Healthcare costs are a critical factor in an employer’s business model and particularly for small businesses that are often forced to make tough decisions on whether health care coverage is an option they can afford to provide. SB 228 is a great tool for businesses looking to add health care coverage to their employee benefit schedule. We will keep you posted on its progress.
Also, a PCS for House Bill 353: Winston-Salem/Forsyth and Wake Boards of Education passed the NC House last week. The PCS to House Bill 353 would do the following:
- Create staggered terms for members of the Wake County Board of Education, beginning with the election in 2022.
- Move the Wake County Board of Education election cycle to odd-numbered years, beginning in 2023
- Establish four-year terms for members of the Wake County Board of Education, beginning in 2023.
This bill passed the House on second and third readings and has been sent to the Senate for further consideration. We will keep you posted as the bill moves forward.
Finally, Gov. Cooper signed Senate Bill 507: Modify Business Corporation Act into law. We have reported on SB 507 in several blog posts as it progressed through the General Assembly, and we thank members of the House, the Senate, and Governor Cooper for their support. Please see the Raleigh Chamber Bill Tracking Chart for more information on the legislative history of SB 507.
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