SB 364 — Commonwealth Care Health Benefits Program; association health plans for individual market.
Last action — Tabled in Rules (13-Y 5-N)
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✓Introduced
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✓In Committee
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3Passed Senate
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4Passed House of Delegates
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5To Executive
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6Enacted
This bill died with 2020 Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there are no live odds of enactment. It would have to be reintroduced in the current session to move again.
Summary
Joint Commission on Health Care; association health plans for the individual market; review. Directs the Joint Commission on Health Care (JCHC) to examine and review the implications of the establishment, implementation, and administration of a program, to be known as the Commonwealth Care Health Benefits Program (the Program), under which a division of the State Corporation Commission (the Commission), or nonprofit corporation established by the Commission, will be the sponsor of association health plans through which it will sell individual health insurance coverage in the Commonwealth. The bill provides that JCHC shall request and consider information and input from the Commission's Bureau of Insurance and the Secretary of Health and Human Resources. The bill provides that elements of the Program to be reviewed and examined by JCHC shall include the following: (i) implementation of the Program would be contingent on the approval of the U.S. Secretary of Health and Human Services of a state innovation waiver under § 1332 of the Patient Protection and Affordable Care Act (ACA); (ii) the Commission will retain staff sufficient to establish and implement the Program; (iii) the Program will arrange for a number of third-party administrators, sufficient to ensure competition but in no event fewer than two; (iv) the Program will design and implement health plans that are comparable those currently sold through the federal exchange; (v) the covered benefits provided under a plan offered through the Program would provide coverage that a large group plan or association health plan subject to the federal Employee Retirement Income Security Act of 1974 (ERISA) is required to provide so long as one or more health plans provide additional benefits as may be required to provide coverage that is at least as comprehensive and affordable as plans currently offered on the exchange pursuant to the ACA or otherwise to comply with the Guardrail requirements of the ACA; (vi) the Program will address the establishment of a reinsurance program; (vii) health plan premiums for individuals with a household income between 100 percent and 400 percent of the federal poverty level would be subsidized; (viii) the Program will offer a cost-sharing reduction feature that removes disincentives to Program participation by low-income individuals who are enrolled in the Medicaid program; (ix) individuals will still be able to purchase individual health insurance coverage outside of the Program; (x) premiums for the plans offered through the Program will be set by the third-party administrators, subject to approval by the Commission with assistance of qualified actuaries; (xi) the Program would be designed and operated in order to ensure that any shortfall in revenues is addressed by the reinsurance program and by self-funding a reserve that is determined by the corporation's actuary to be adequate, and (xii) the Program will include premium incentives for compliance with wellness or chronic disease management benefit programs. The bill requires JCHC to report its findings and conclusions to the Joint Committee for Health and Human Resources Oversight.
Bill Text
What changed in the latest version
107 added · 144 removedPlain-language change summary
The bill SB 364 has been amended to transfer the responsibility of examining the Commonwealth Care Health Benefits Program from the Joint Legislative Audit and Review Commission (JLARC) to the Joint Commission on Health Care (JCHC). This change matters because it puts the review in the hands of a commission that may have more focused expertise in health care issues, potentially leading to better insights and recommendations about the proposed health insurance program for individuals in the Commonwealth. Additionally, the amendment now includes a list of legislative sessions for reference, clarifying the timeline of the bill's development.
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SESSION history | hilite | pdf | print version 20101921D20107384D SENATE BILL NO.
364 OfferedAMENDMENT JanuaryIN 8,THE 2020NATURE PrefiledOF A SUBSTITUTE (Proposed by the Senate Committee on Rules on January 6,31, 20202020) (Patron Prior to Substitute--Senator Dunnavant) A BILL to direct the Joint Commission on Health Care to review the implications of establishing association health plans for the individual market;
---------- Patron-- Dunnavant ---------- Referred to Committee on Commerce and Labor ---------- Be it enacted by the General Assembly of Virginia:
The Joint Legislative Audit and Review Commission (JLARC),on as part of its review and evaluation of the agencies and programs under the Secretary of Health andCare Human(JCHC) Services, shall examine and review the implications of the establishment, implementation, and administration of a program, to be known as the Commonwealth Care Health Benefits Program (the Program), under which a division of the State Corporation Commission (the Commission), or nonprofit corporation established by the Commission, will be the sponsor of association health plans through which it will sell individual health insurance coverage in the Commonwealth.
In conducting its examination and review, JLARCJCHC shall request and consider information and input from the Commission's Bureau of Insurance and the Secretary of Health and Human Resources.
Technical assistance shall be provided to JLARCJCHC by the Bureau of Insurance and the Secretary of Health and Human Resources.
All agencies of the Commonwealth shall provide assistance to JLARCJCHC for this study, upon request.
Elements of the Program to be reviewed and examined by JLARCJCHC shall include the following:
§ 18052) for the Program that provides federal funding for (i) the Program to offset the elimination of subsidies for eligible individuals previously purchasing health insurance coverage on the health benefit exchange and (ii) a reinsurance program that partially reimburses the Program for high-cost claims, with such attachment points, coinsurance rates, and reinsurance caps as the Corporation'scorporation's actuary determines appropriate.
The Program will be designed and operated in order to ensure that any shortfall in revenues from such sources is addressed by the reinsurance program described in clause (ii) of subdivision 3 and by self-funding a reserve that is determined by the Corporation'scorporation's actuary to be adequate.
The Program will establish how enrollment is to be conducted, including open enrollment periods, by the Corporation,corporation, the third-party administrators, and direct enrollment partners.
The Joint LegislativeCommission Auditon andHealth ReviewCare Commission shall report its findings and conclusions to the Joint Committee for Health and Human Resources Oversight.
View plain text versions (2)
- Committee Substitute Engrossed by Senate - committee substitute SB364S1 Current html January 31, 2020
- Impact statement from DPB (SB364) View text html January 06, 2020
Action History
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Tabled in Rules (13-Y 5-N)
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Referred to Committee on Rules
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Read first time
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Placed on Calendar
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Impact statement from DPB (SB364S1)
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Read third time and passed Senate (40-Y 0-N)
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Engrossed by Senate - committee substitute SB364S1
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Committee substitute agreed to 20107384D-S1
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Reading of substitute waived
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Read second time
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Constitutional reading dispensed (40-Y 0-N)
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Committee substitute printed 20107384D-S1
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Reported from Rules with substitute (15-Y 0-N)
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Rereferred to Rules
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Rereferred from Commerce and Labor (15-Y 0-N)
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Impact statement from DPB (SB364)
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Referred to Committee on Commerce and Labor
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Prefiled and ordered printed; offered 01/08/20 20101921D
Sponsors
- Siobhan S. Dunnavant · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 147 not signed on · 5 voted No
Sponsors (1)
Co-sponsors (0)
None.
Not signed on (147)
147 members have not signed on to this bill.
Show all 147 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 13 | 5 | 0 | 0 |
| Total | 13 | 5 | 0 | 0 |
| % of votes cast | 72% | 28% | 0% | 0% |
How each member voted (18)
| Member | Party | Vote |
|---|---|---|
| Alfonso H. Lopez | — | Yea |
| Betsy B. Carr | — | Yea |
| Charniele L. Herring | — | Yea |
| Cox, M. Kirkland | — | Nay |
| Delores L. McQuinn | — | Yea |
| Filler-Corn, Eileen | — | Yea |
| Gilbert, C. Todd | — | Nay |
| Jeion A. Ward | — | Yea |
| Knight, Barry D. | — | Nay |
| Lamont Bagby | — | Yea |
| Luke E. Torian | — | Yea |
| Marcus B. Simon | — | Yea |
| Mullin, Michael P. | — | Yea |
| Richard C. "Rip" Sullivan, Jr. | — | Yea |
| Sickles, Mark D. | — | Yea |
| Terry G. Kilgore | — | Nay |
| Terry L. Austin | — | Nay |
| Vivian E. Watts | — | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 40 | 0 | 0 | 0 |
| Total | 40 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (40)
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 40 | 0 | 0 | 0 |
| Total | 40 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (40)
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 15 | 0 | 0 | 0 |
| Total | 15 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (15)
| Member | Party | Vote |
|---|---|---|
| Barbara A. Favola | — | Yea |
| Barker, George L. | — | Yea |
| David W. Marsden | — | Yea |
| Edwards, John S. | — | Yea |
| Howell, Janet D. | — | Yea |
| Jeremy S. McPike | — | Yea |
| L. Louise Lucas | — | Yea |
| Lewis, Lynwood W., Jr. | — | Yea |
| Mamie E. Locke | — | Yea |
| Norment, Thomas K., Jr. | — | Yea |
| Petersen, J. Chapman | — | Yea |
| R. Creigh Deeds | — | Yea |
| Ryan T. McDougle | — | Yea |
| Saslaw, Richard L. | — | Yea |
| Vogel, Jill Holtzman | — | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 15 | 0 | 0 | 0 |
| Total | 15 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (15)
| Member | Party | Vote |
|---|---|---|
| Saslaw, Richard L. | — | Yea |
| Norment, Thomas K., Jr. | — | Yea |
| Spruill, Lionell, Sr. | — | Yea |
| Newman, Stephen D. | — | Yea |
| Edwards, John S. | — | Yea |
| Barker, George L. | — | Yea |
| Bell, John J. | — | Yea |
| Lewis, Lynwood W., Jr. | — | Yea |
| Mason, T. Montgomery "Monty" | — | Yea |
| Adam P. Ebbin | — | Yea |
| David W. Marsden | — | Yea |
| L. Louise Lucas | — | Yea |
| Mark D. Obenshain | — | Yea |
| R. Creigh Deeds | — | Yea |
| Scott A. Surovell | — | Yea |
Subjects
Frequently asked questions
- What does SB 364 do?
- Joint Commission on Health Care; association health plans for the individual market; review. Directs the Joint Commission on Health Care (JCHC) to examine and review the implications of the establishment, implementation, and administration of a program, to be known as the Commonwealth Care Health Benefits Program (the Program), under which a division of the State Corporation Commission (the Commission), or nonprofit corporation established by the Commission, will be the sponsor of association health plans through which it will sell individual health insurance coverage in the Commonwealth. The bill provides that JCHC shall request and consider information and input from the Commission's Bureau of Insurance and the Secretary of Health and Human Resources. The bill provides that elements of the Program to be reviewed and examined by JCHC shall include the following: (i) implementation of the Program would be contingent on the approval of the U.S. Secretary of Health and Human Services of a state innovation waiver under § 1332 of the Patient Protection and Affordable Care Act (ACA); (ii) the Commission will retain staff sufficient to establish and implement the Program; (iii) the Program will arrange for a number of third-party administrators, sufficient to ensure competition but in no event fewer than two; (iv) the Program will design and implement health plans that are comparable those currently sold through the federal exchange; (v) the covered benefits provided under a plan offered through the Program would provide coverage that a large group plan or association health plan subject to the federal Employee Retirement Income Security Act of 1974 (ERISA) is required to provide so long as one or more health plans provide additional benefits as may be required to provide coverage that is at least as comprehensive and affordable as plans currently offered on the exchange pursuant to the ACA or otherwise to comply with the Guardrail requirements of the ACA; (vi) the Program will address the establishment of a reinsurance program; (vii) health plan premiums for individuals with a household income between 100 percent and 400 percent of the federal poverty level would be subsidized; (viii) the Program will offer a cost-sharing reduction feature that removes disincentives to Program participation by low-income individuals who are enrolled in the Medicaid program; (ix) individuals will still be able to purchase individual health insurance coverage outside of the Program; (x) premiums for the plans offered through the Program will be set by the third-party administrators, subject to approval by the Commission with assistance of qualified actuaries; (xi) the Program would be designed and operated in order to ensure that any shortfall in revenues is addressed by the reinsurance program and by self-funding a reserve that is determined by the corporation's actuary to be adequate, and (xii) the Program will include premium incentives for compliance with wellness or chronic disease management benefit programs. The bill requires JCHC to report its findings and conclusions to the Joint Committee for Health and Human Resources Oversight.
- Who sponsors SB 364?
- SB 364 is sponsored by Dunnavant, Siobhan S..
- What is the current status of SB 364?
- This bill died with 2020 Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track SB 364?
- Track SB 364 free on One Click Politics — get push/email alerts when it moves.
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