Virginia 2023 Regular Session Status: Enacted

SB 1011 — Health insurance; tobacco surcharge.

Last action — Acts of Assembly Chapter text (CHAP0683)

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed House of Delegates
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced January 06, 2023. Enacted.

Signed by Governor Glenn Youngkin (Republican) on March 27, 2023.

Prognosis

Advancing 38% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

  • Failed a recorded vote

    Failed 5 recorded votes so far — a real headwind.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Bill Text

What changed in the latest version

87 added · 85 removed

Plain-language change summary

The updated text of § 38.2-3447 now excludes "rating areas" as a factor for developing premium rates for individual or small group health insurance coverage. This means insurance carriers will not be able to set premium rates based on different regional factors, which could lead to more uniform pricing across areas. The change simplifies the criteria for rate development, ensuring variations are only based on individual or family coverage, age, and tobacco use.

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SESSION ENROLLED VIRGINIA ACTS OF ASSEMBLY –– CHAPTER E An Act to amend and reenact § 38.2-3447 of the Code of Virginia, relating to health insurance;
VIRGINIA ACTS OF ASSEMBLY -- 2023 SESSION CHAPTER 683 An Act to amend and reenact § 38.2-3447 of the Code of Virginia, relating to health insurance;
R O [S 1011] Approved L L Be it enacted by the General Assembly of Virginia:
[S 1011] Approved March 27, 2023 Be it enacted by the General Assembly of Virginia:
E § 38.2-3447.
§ 38.2-3447.
D this title to the contrary, a health carrier offering a health benefit plan providing individual or small group health insurance coverage shall develop its premium rates based on the following:
A.
Notwithstanding any provision of § 38.2-3432.2, 38.2-3501, 38.2-4306, or any other section of this title to the contrary, a health carrier offering a health benefit plan providing individual or small group health insurance coverage shall develop its premium rates based on the following:
2.
3.
Rating areas, as may be established by the Commission;
and 3.
A premium rate shall not vary with respect to any particular health benefit plan by any oBher factor not described in subsection A.
A premium rate shall not vary with respect to any particular health benefit plan by any other factor not described in subsection A.
0 attributable to each family member covered under the health benefit plan.
C.
portion of the premiu1 that is D.
Rating variations for family coverage shall be applied based on the portion of the premium that is attributable to each family member covered under the health benefit plan.
D.
A comparison of the area rate factor for individual and small group health benefit plans that utilize the same provider network and provider reimbursement levels of the health benefit plans that are subject to b.
A comparison of the area rate factor for individual and small group health benefit plans that utilize the same provider network and provider reimbursement levels of the health benefit plans that are subject to the filing;
b.
(v) incurred claims including their rating areas in that market;
(v) incurred claims including anticipated or, if available, actual risk adjustment payments or receipts;
andisk adjustment payments or receipts;
and (vi) loss ratio for each of their rating areas in that market;
and (vi) loss ratio for each of (2) Aggregated incurred claims for any health system exceeding 30 percent of total incurred claims for that rating area in that market.
and (2) Aggregated incurred claims for any health system exceeding 30 percent of total incurred claims for that rating area in that market.
The Commission shall not approve the proposed rate filing if (i) a variance in area rate factors, indexed to the same rating region for both the individual and small group markets, of 15 percent or more exists between health benefit plans a carrier intends to offer in the individual market and health provider network and provider reimbursement levels and (ii) the methodologies used to calculate the area rate factors are different between the two markets.
The Commission shall not approve the proposed rate filing if (i) a variance in area rate factors, indexed to the same rating region for both the individual and small group markets, of 15 percent or more exists between health benefit plans a carrier intends to offer in the individual market and health benefit plans intended to be offered in the small group market, when those plans utilize the same provider network and provider reimbursement levels and (ii) the methodologies used to calculate the area rate factors are different between the two markets.
(iv) incurred claims excluding anticipated if available, actual risk adjustment payments or receipts;
(iv) incurred claims excluding anticipated or, if available, actual risk adjustment payments or receipts;
(v) incurred claims including anticipated or, if available, actual risk adjustment payments or receipts;
and (vii) aggregate incurred or, claims, for each health system exceeding 25 percent of total incurred claims for that rating area.
and (vii) aggregate incurred claims, for each health system exceeding 25 percent of total incurred claims for that rating area.
The of 2 health carrier shall make each such quarterly report publicly available, without redaction, not later than 45 days after the end of the calendar quarter.
The health carrier shall make each such quarterly report publicly available, without redaction, not later than days after the end of the calendar quarter.
F.
of 2 F.
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Action History

  1. Acts of Assembly Chapter text (CHAP0683)

  2. Approved by Governor-Chapter 683 (effective 7/1/23)

  3. Governor's Action Deadline 11:59 p.m., March 27, 2023

  4. Enrolled Bill Communicated to Governor on March 2, 2023

  5. Impact statement from SCC (SB1011ER)

  6. Signed by Speaker

  7. Signed by President

  8. Bill text as passed Senate and House (SB1011ER)

  9. Enrolled

  10. VOTE: Passage (91-Y 5-N)

  11. Passed House (91-Y 5-N)

  12. Read third time

  13. Read second time

  14. Reported from Commerce and Energy (22-Y 0-N)

  15. Referred to Committee on Commerce and Energy

  16. Read first time

  17. Placed on Calendar

  18. Impact statement from SCC (SB1011E)

  19. Read third time and passed Senate (38-Y 0-N)

  20. Printed as engrossed 23101373D-E

  21. Engrossed by Senate as amended SB1011E

  22. Committee amendment agreed to

  23. Reading of amendment waived

  24. Read second time

  25. Constitutional reading dispensed (37-Y 0-N)

  26. Reported from Commerce and Labor with amendment (15-Y 0-N)

  27. Senate committee, floor amendments and substitutes offered

  28. Impact statement from SCC (SB1011)

  29. Referred to Committee on Commerce and Labor

  30. Prefiled and ordered printed; offered 01/11/23 23101373D

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 147 not signed on

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.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Subjects

health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors SB 1011?
SB 1011 is sponsored by Edwards, John S..
What is the current status of SB 1011?
This bill has been enacted into law. Introduced January 06, 2023. Enacted.
Where can I track SB 1011?
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