HB1295
To Create The Healthcare Cost-sharing Collections Transparency Act.
Last Action (May 5, 2025): Died in House at Sine Die adjournment.
Sponsors
AI-Generated Summary
House Bill 1295, the 'Healthcare Cost-Sharing Collections Transparency Act,' mandates increased reporting and transparency requirements for healthcare insurers operating in Arkansas. The bill requires insurers to file annual financial reports with the Insurance Commissioner detailing assets, liabilities, net premiums, claims paid, claims denied, and price data across various lines of business. Additionally, insurers must provide individual reports to enrollees that itemize premiums, cost-sharing amounts, provider payments, and specific operational expenses such as marketing, administration, and executive compensation. The bill also introduces new regulatory considerations for the Insurance Commissioner when reviewing proposed increases in premium rates or cost-sharing, specifically factoring in risk-based capital levels and restricted medical loss ratio calculations. Finally, the legislation categorizes violations of these reporting requirements as deceptive acts under the state's Trade Practices Act, subjecting violators to relevant penalties and enforcement actions.
Potential Impact Analysis
Who Might Benefit?
The primary beneficiaries of this bill are healthcare enrollees and policyholders, who would receive detailed, personalized disclosures regarding how their insurance premiums and cost-sharing amounts are being utilized and how their claims are being adjudicated. Additionally, state regulators and legislative committees would benefit from increased access to granular financial data, allowing for greater oversight of insurance company solvency and rate-setting practices. Increased transparency may also assist employers and other entities that provide health benefit plans in better understanding the administrative costs and premium structures of the plans they purchase for their members.
Who Might Suffer?
Healthcare insurers and related entities such as health maintenance organizations, third-party administrators, and prescription benefit management companies would be most negatively impacted, as they would face increased administrative burdens and costs associated with collecting, organizing, and reporting this extensive financial and operational data. These entities may also face heightened regulatory scrutiny and potential legal consequences under the Trade Practices Act if their reporting or premium-setting practices are found to be non-compliant. Furthermore, the stricter criteria for justifying premium increases could potentially limit their financial flexibility or profitability in the Arkansas market.
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