GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1999

H	1 

HOUSE BILL 1109

Short Title:  State Health Plan Coverage Explanation.  	(Public)

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Sponsors: Representatives Gibson; Baddour and Mosley.

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Referred to:  Select Committee on Health Care Delivery.

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April 15, 1999

A BILL TO BE ENTITLED
AN ACT TO REQUIRE THE EXECUTIVE ADMINISTRATOR OF THE STATE HEALTH PLAN TO PROVIDE INFORMATION TO PARTICIPANTS IN THE STATE HEALTH PLAN REGARDING DIFFERENCES IN COVERAGE BETWEEN THE STATE HEALTH PLAN AND PREPAID PLANS OFFERED TO PARTICIPANTS.
The General Assembly of North Carolina enacts:
Section 1.  G.S. 135-39.4A is amended by adding a new subsection to read:
"( i)	The Executive Administrator shall prepare a comprehensive comparison of the differences between prepaid plans offered to participants under G.S. 135-39.5B and the Comprehensive Major Medical Plan offered under Part 3 of this Article.  Such comparison shall be made available to participants either before the open enrollment period for prepaid plans or along with the plan selection materials. The comparison shall include a frequently asked questions (FAQ) format that will help participants make informed decisions during the selection process. The comparison shall disclose any limitations in the selection of health care providers within any plan including:
(1)	Individual Practice Association restrictions;
(2)	Use of drug formularies which might require preapprovals or contain limitations on the usage of federally approved drugs;
(3)	When preapprovals must be obtained and by whom."
Section 2.  This act is effective when it becomes law.