ATLANTA (March 26, 2012) –The Georgia Senate today passed House Bill 1166 by a vote of 42 to 2. Sponsored in the Senate by Sen. William Ligon (R-Waverly), this legislation requires insurers issuing individual health policies to offer at least one child-only policy.
“I am pleased by the passage of HB 1166 in the Senate today, said Sen. Ligon. “During a time when insurance rates are at an all time high, this bill provides a cost effective alternative for families seeking to insure their children.”
According to HB 1166, insurers issuing individual health plans must offer at least one child-only policy to families who have children that are under the age of 19. This policy does not include dependent health insurance for a child under another person’s health insurance.
Under this bill, insurers must offer guaranteed-issued coverage to primary subscribers under the age of 19 during open enrollment periods or during a special enrollment period within 30 days of a qualifying event. Qualifying events are defined as the loss of employer-sponsored health insurance or the involuntary loss of other existing health insurance for any reason other than fraud, misrepresentation, or failure to pay the premium.
A special enrollment period must last 30 days from the date the insurer receives notice of loss of coverage, if the notice is provided to the insurer no later than the sixtieth day after the loss of coverage and the loss of other coverage results from:
- Birth or adoption;
- Marriage or divorce;
- Loss of employer sponsored insurance Medicaid, or PeachCare coverage;
- Entry of a valid court or administrative order mandating the child be covered;
- Involuntary loss of other coverage for reasons other than fraud, misrepresentation, or failure to pay premium.
An insurance carrier may deny coverage to an applicant if the applicant is currently enrolled in a high-risk pool insurance policy. In the event that the applicant is a dependent on a policy with a primary subscriber who is over the age of 19, and the primary subscriber drops the policy, the child may apply for child-only policies during the open enrollment period or, in the case of a qualifying event, during a special enrollment period.
This legislation does not prohibit an insurer from setting a premium rate for individuals based upon medical underwriting if the rate is in compliance with the applicable policy’s rate filing on record with the Insurance Department. An insurer may impose a surcharge of up to 50 percent for up to one year if an individual enrolls in a child-only policy without prior credible coverage in the 63 day period preceding the date of application.
HB 1166 will now travel to the Governor’s desk for final approval.
RELEASE
March 26, 2012
For Information Contact:
Natalie Dale, Director
Shawna Mercer,Sr. Communications Specialist
shawna.mercer@senate.ga.gov
404.656.0028