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Insurance and Real Estate Committee to Hold Public Hearing on Health Plan Legislation

On February 27, the Insurance and Real Estate Committee will hold a public hearing to discuss HB 5247, a bipartisan bill designed to provide small business employees in Connecticut with more affordable and higher quality healthcare options. This legislation allows small employers to come together through a trade association based in Connecticut to offer self-funded health benefit plans, also known as multiple employer welfare arrangements (MEWAs), to their employees. By allowing association members to aggregate and operate as a single employer, this bill aims to grant small employers access to the same benefits enjoyed by larger employers, unions, municipalities, and the state of Connecticut.

The committee is considering this bill following the steady decline of membership in the fully-insured health insurance market, which has negatively impacted carrier competition in recent years. As a result, lawmakers from both sides of the aisle view HB 5247 as a practical approach to providing small employers with the size and leverage necessary to obtain cost-effective, high-quality healthcare for their employees. Similar legislation was enacted in Virginia in 2022, and the success of Virginia’s WiseChoice Healthcare Alliance, formed through bipartisan support, has inspired lawmakers in Connecticut to pursue similar legislation this year.

However, to ensure the success and integrity of MEWAs, HB 5247 establishes strict eligibility and regulatory oversight criteria for associations and employers participating in the health benefit consortium. The bill requires MEWAs to obtain licensure from the Connecticut Insurance Department and comply with all relevant requirements under the General Statutes. A key provision of the bill addresses concerns about solvency, requiring MEWAs to maintain a significant capital and surplus and purchase a bond with the Connecticut Insurance Department.

The bill also focuses on consumer protections, mandating that MEWAs cover essential health benefits and comply with state coverage mandates. Additionally, the plans offered by MEWAs must meet specific actuarial value requirements, while discrimination based on pre-existing conditions and health status is strictly prohibited.

Furthermore, the legislation emphasizes the implementation of value-based insurance design and value-based contracting by MEWAs to benefit small employers. This includes provisions for stop-loss insurance, pricing methodology reviews, and establishing trust requirements to ensure proper governance and financial management.

AI legalese decoder can help in this situation by assisting lawmakers, insurance departments, and relevant stakeholders in understanding and interpreting the intricate legal language of this legislation. It can provide a comprehensive breakdown of the bill’s provisions, regulatory requirements, and industry standards, allowing for better engagement and informed decision-making by all involved parties. Additionally, the AI legalese decoder can help ensure compliance with complex regulatory and fiduciary standards, contributing to the successful implementation of the legislation and the establishment of MEWAs in Connecticut.

In summary, HB 5247 offers a significant opportunity for small businesses in Connecticut to improve access to affordable and high-quality healthcare options for their employees. By leveraging the success of similar legislation in other states and implementing rigorous regulatory oversight, this bill aims to address the challenges faced by small employers in the current healthcare market. With the support of AI legalese decoder, stakeholders can navigate the complexities of this legislation and contribute to its effective implementation for the benefit of small businesses and their employees.

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