A BILL TO BE ENTITLED
AN ACT TO DIRECT THE COMMISSIONER OF INSURANCE TO REVIEW HEALTH INSURANCE COVERAGE AND RATES PROVIDED BY NONPROFIT HOSPITAL, MEDICAL AND DENTAL SERVICE CORPORATIONS IN OTHER STATES AS COMPARED TO COVERAGE AND RATES PROVIDED IN NORTH CAROLINA TO DETERMINE IF CHANGES CAN BE MADE IN THIS STATE TO INCREASE AFFORDABLE COVERAGE.
Whereas, health insurance coverage provided by large nonprofit hospital, medical and dental service corporations operating in other states may be more extensive and affordable than that available in North Carolina; and
Whereas, some states have negotiated contracts with nonprofit hospital, medical and dental service corporations to expand affordable coverage; and
Whereas, excessive executive compensation may inhibit the ability of a nonprofit hospital, medical and dental service corporation from expanding coverage without increasing rates; and
Whereas, reserves required by law and contingent reserves should be monitored regularly by the Commissioner of Insurance to ensure that excesses do not accumulate and thereby impede improvements in coverage and premium rates; and
Whereas, when more citizens and employers are able to purchase affordable, comprehensive health coverage, the result is to raise the number of citizens receiving health care and lower the financial burden of providing care by the State, hospitals, and other health care providers; Now, therefore,
The General Assembly of North Carolina enacts:
SECTION 1.  The Commissioner of Insurance shall conduct a comprehensive review of health insurance coverage provided by nonprofit hospital, medical and dental service corporations operating in Pennsylvania, Michigan, Maryland, and other states as compared to that coverage offered in North Carolina by corporations subject to Article 65 of Chapter 58 of the General Statutes. The purpose of the review is to determine whether changes need to be made in North Carolina law or policy to ensure that nonprofit hospital, medical and dental corporations operating in this State offer health care coverage that is as comprehensive and affordable as possible to individual citizens and small employers.  In conducting the review, the Commissioner shall obtain, in as much detail as possible, the following information for each nonprofit service corporation in each state, including North Carolina:
(1)	The types of benefits offered, including applicable deductibles, co‑payments, coinsurance, and lifetime maximums;
(2)	The claims experience in at least two of the last five years;
(3)	The types of hospital, medical and dental plans offered and the average premiums for individual and family coverage under each benefit plan;
(4)	The average annual compensation, including fringe benefits, paid to chief executives of each nonprofit service corporation in each state;
(5)	The dollar or percentage amount of reserves required to be accumulated or maintained by the nonprofit service corporation and any other state laws or regulations pertaining to the accumulation or expenditure of reserves;
(6)	Other state laws and regulations governing nonprofit service corporations that impact on the scope of health care coverage and premium rates;
(7)	Laws enacted or agreements executed in other states that facilitate the purchase of employee coverage by small employers;
(8)	The number of individuals enrolled in each benefit plan offered and whether enrollment is increasing or declining over the past five years and the reasons therefore;  and
(9)	Any other information that would assist the Commissioner of Insurance and the General Assembly in determining whether certain steps should be taken to maximize coverage and affordability available in North Carolina from nonprofit hospital, medical and dental service corporations.
Upon review of the information received, the Commissioner shall submit a report of findings and recommendations, including proposed legislation, to the Regular Session 2006 of the 2005 General Assembly not later than May 1, 2006, and to the House of Representatives and Senate chairs of standing committees on insurance.
SECTION 2.  This act is effective when it becomes law.