00                              SENATE BILL NO. 4                                                                          
01 "An Act relating to a health care insurance policy incentive program; relating to health                                
02 care services; and providing for an effective date."                                                                    
03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
04    * Section 1. The uncodified law of the State of Alaska is amended by adding a new section                          
05 to read:                                                                                                                
06       SHORT TITLE. This Act may be known as the Alaska Health Care Consumer's Right                                     
07 to Shop Act.                                                                                                            
08    * Sec. 2. AS 21.06.110 is amended to read:                                                                         
09            Sec. 21.06.110. Director's annual report. As early in each calendar year as is                             
10       reasonably possible, the director shall prepare and deliver an annual report to the                               
11       commissioner, who shall notify the legislature that the report is available, showing,                             
12       with respect to the preceding calendar year,                                                                      
13                 (1)  a list of the authorized insurers transacting insurance in this state,                             
14       with a summary of their financial statement as the director considers appropriate;                                
01 (2)  the name of each insurer whose certificate of authority was                                                        
02 surrendered, suspended, or revoked during the year and the cause of surrender,                                          
03       suspension, or revocation;                                                                                        
04 (3)  the name of each insurer authorized to do business in this state                                                   
05 against which delinquency or similar proceedings were instituted and, if against an                                     
06 insurer domiciled in this state, a concise statement of the facts with respect to each                                  
07       proceeding and its present status;                                                                                
08 (4)  a statement in regard to examination of rating organizations,                                                      
09 advisory organizations, joint underwriters, and joint reinsurers as required by                                         
10       AS 21.39.120;                                                                                                     
11                 (5)  the receipts [RECEIPT] and expenses of the division for the year;                              
12 (6)  recommendations of the director as to amendments or                                                                
13       supplementation of laws affecting insurance or the office of the director;                                    
14 (7)  statistical information regarding health insurance, including the                                                  
15 number of individual and group policies sold or terminated in the state; this paragraph                                 
16       does not authorize the director to require an insurer to release proprietary information;                         
17 (8)  the annual percentage of health claims paid in the state that meet                                             
18       [MEETS] the requirements of AS 21.36.495(a) and (d);                                                              
19 (9)  the total amount of contributions reported and the total amount of                                                 
20       credit claimed under AS 21.96.070;                                                                                
21 (10)  the total number of public comments received and the director's                                                   
22 efforts, to the extent allowable by law, to improve or maintain public access to                                        
23 information on individual health insurance rate filings before they become effective;                                   
24       [AND]                                                                                                             
25 (11)  the most recent incentive program report compiled under                                                       
26       AS 21.96.260; and                                                                                             
27 (12)  other pertinent information and matters the director considers                                                
28       proper.                                                                                                           
29    * Sec. 3. AS 21.36.100 is amended to read:                                                                         
30 Sec. 21.36.100. Rebates. Except as provided in AS 21.96.220 or otherwise                                          
31 expressly provided by law, a person may not knowingly permit or offer to make or                                        
01 make a contract of life insurance, life annuity or health insurance, or agreement under                                 
02 the contract other than as plainly expressed in the contract, or pay, allow, give or offer                              
03 to pay, allow, or give, directly or indirectly, as inducement to the insurance, or                                      
04 annuity, a rebate of premiums payable on the contract, or a special favor or advantage                                  
05 in the dividends or other benefits, or paid employment or contract for services of any                                  
06 kind, or any valuable consideration or inducement whatever not specified in the                                         
07 contract; or directly or indirectly give, sell, purchase or offer to agree to give, sell,                               
08 purchase, or allow as inducement to the insurance or annuity or in connection                                           
09 therewith, whether or not to be specified in the policy or contract, an agreement of any                                
10 form or nature promising returns, profits, stocks, bonds, or other securities, or interest                              
11 present or contingent in the contract or as measured by the contract, of an insurance                                   
12 company or other corporation, association, or partnership, or dividends or profits                                      
13 accrued or to accrue under the contract; or offer, promise, or give anything of value                                   
14       that is not specified in the contract.                                                                            
15    * Sec. 4. AS 21.96 is amended by adding new sections to read:                                                      
16             Article 2. Health Care Insurance Policy Incentive Program.                                                
17 Sec. 21.96.210. Access to payment information. A health care insurer that                                             
18 offers a health care insurance policy in the group or individual market shall provide                                   
19 comprehensive comparison guidance by telephone and make available on the Internet                                       
20 website of the insurer a price comparison tool that, to the extent practicable, allows an                               
21 individual enrolled in or covered under a health care insurance policy to compare the                                   
22 amount of cost sharing that the individual would be responsible for paying under the                                    
23 policy for a specific item or service provided in the same policy year and geographic                                   
24 region by each provider participating in the policy. At a minimum, the health care                                      
25       insurer shall comply with 42 U.S.C. 300gg-114.                                                                    
26 Sec. 21.96.220. Incentive program. (a) A health care insurer that offers a                                            
27 health care insurance policy in the group or individual market shall develop and                                        
28 implement a program that provides a monetary incentive for a covered person enrolled                                    
29 in a health care insurance policy to elect to receive a covered health care service under                               
30 the health care insurance policy from a health care provider that charges less than the                                 
31 median contracted rate recognized by the health care insurer for that health care                                       
01       service.                                                                                                          
02 (b)  A health care insurer that offers a health care insurance policy in the group                                      
03 or individual market shall provide an incentive payment to a covered person as                                          
04 provided in this subsection. An incentive may be calculated as a percentage of the                                      
05 difference in price as a flat dollar amount or by another reasonable methodology                                        
06 adopted by the director by regulation. A health care insurer is not required to provide                                 
07 an incentive payment to a covered person if the cost saved by the health care insurer is                                
08       $200 or less.                                                                                                     
09 (c)  If a covered person receives coverage under a group health care insurance                                          
10 policy offered by an employer, a health care insurer shall provide the covered person                                   
11 with an incentive of at least 33.4 percent of the costs saved by the health care insurer                                
12 resulting from the covered person's election to receive a health care service from a                                    
13 health care provider that charges less than the median of the contracted rates                                          
14 recognized by the health care insurer for that health care service. The health care                                     
15 insurer shall provide the employer with at least 33.3 percent of the costs saved by the                                 
16       health care insurer resulting from the covered person's election.                                                 
17 (d)  If a covered person receives coverage under a health care insurance policy                                         
18 offered in the individual market, a health care insurer shall provide the covered person                                
19 with an incentive of at least 50 percent of the costs saved by the health care insurer                                  
20       resulting from the covered person's election.                                                                     
21            (e)  An incentive payment to a covered person under this section is not                                      
22                 (1)  a violation of AS 21.36.100; or                                                                    
23 (2)  an administrative expense of the health care insurer for rate                                                      
24       development or rate filing purposes.                                                                              
25 Sec. 21.96.230. Program availability. A health care insurer that offers a                                             
26 health care insurance policy in the group or individual market shall make an incentive                                  
27 program under AS 21.96.220 available as a component of a health care insurance                                          
28 policy offered in this state. Annually, at enrollment or renewal, a health care insurer                                 
29 shall provide notice about the availability of the program to a person covered under a                                  
30       health care insurance policy eligible for the program.                                                            
31 Sec. 21.96.240. Filing requirements. Before offering an incentive program                                             
01 under AS 21.96.220, a health care insurer that offers a health care insurance policy in                                 
02 the group or individual market shall file a description of the program with the director                                
03 in the manner determined by the director. The director may review the filing to                                         
04 determine whether the incentive program complies with the requirements of                                               
05       AS 21.96.210 - 21.96.300.                                                                                         
06 Sec. 21.96.250. Out-of-network health care providers. If a covered person                                             
07 participates in an incentive program under AS 21.96.220 and elects to receive a health                                  
08 care service under AS 21.96.220(a) from an out-of-network health care provider that                                     
09 results in a savings for the health care insurer, the health care insurer shall apply the                               
10 amount paid for the health care service toward the cost sharing owed by the covered                                     
11 person as specified in the applicable health care insurance policy as if the health care                                
12       services were provided by an in-network health care provider.                                                     
13 Sec. 21.96.260. Reporting requirements. (a) A health care insurer shall, at the                                       
14 request of the director, annually provide information to the director relating to an                                    
15       incentive program under AS 21.96.220 for the most recent calendar year that includes                              
16                 (1)  the total number of incentive payments;                                                            
17 (2)  information on the use of the incentive program by category of                                                     
18       service;                                                                                                          
19                 (3)  the total amount of incentive payments;                                                            
20 (4)  the average amount of each incentive payment for each category of                                                  
21       service;                                                                                                          
22 (5)  the total savings achieved below the average price of the health                                                   
23       care service in each category of service; and                                                                     
24 (6)  the total number and percentage of covered persons who                                                             
25       participated in the incentive program.                                                                            
26 (b)  The director shall include the information provided under this section in                                          
27 the director's annual report under AS 21.06.110 and shall submit the annual report to                                   
28 the chairs of the committee in each house of the legislature with jurisdiction over labor                               
29       and commerce.                                                                                                     
30 Sec. 21.96.270. Applicability. (a) Except as provided in (b) of this section,                                         
31 AS 21.96.210 - 21.96.300 apply to a health care insurance policy or contract but do                                     
01       not apply to excepted benefits.                                                                                   
02            (b)  AS 21.96.210 - 21.96.300 apply to excepted benefits provided under a                                    
03       dental insurance policy or a vision insurance policy.                                                             
04            (c)  In this section, "excepted benefits" has the meaning given in AS 21.54.160.                             
05            Sec. 21.96.300. Definitions. In AS 21.96.210 - 21.96.300,                                                  
06                 (1)  "health care insurance" has the meaning given in AS 21.12.050;                                     
07                 (2)  "health care insurer" has the meaning given in AS 21.54.500;                                       
08                 (3)  "health care provider" has the meaning given in AS 18.23.400(n);                                   
09                 (4)  "health care service" has the meaning given in AS 18.23.400(n);                                    
10                 (5)  "policy" has the meaning given in AS 21.97.900.                                                    
11    * Sec. 5. AS 29.10.200 is amended by adding a new paragraph to read:                                               
12 (68)  AS 29.35.142 (disclosure and reporting of health care services and                                                
13       price information).                                                                                               
14    * Sec. 6. AS 29.35 is amended by adding a new section to read:                                                     
15 Sec. 29.35.142. Regulation of disclosure and reporting of health care                                                 
16 services and price information. (a) The authority to regulate the disclosure or                                       
17 reporting of price information for health care services by health care providers, health                                
18 care facilities, or health care insurers is reserved to the state, and, except as                                       
19 specifically provided by statute, a municipality may not enact or enforce an ordinance                                  
20 regulating the disclosure or reporting of price information for health care services by                                 
21       health care providers, health care facilities, or health care insurers.                                           
22            (b)  This section applies to home rule and general law municipalities.                                       
23            (c)  In this section,                                                                                        
24                 (1)  "health care facility" has the meaning given in AS 18.23.400(n);                                   
25                 (2)  "health care insurer" has the meaning given in AS 21.54.500;                                       
26                 (3)  "health care provider" has the meaning given in AS 18.23.400(n);                                   
27                 (4)  "health care service" has the meaning given in AS 18.23.400(n).                                    
28    * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to                          
29 read:                                                                                                                   
30 DEPARTMENT OF ADMINISTRATION ANALYSIS; REPORT TO                                                                        
31 LEGISLATURE. The Department of Administration shall analyze whether the state or                                        
01 employees covered by a group health care insurance policy for a participating governmental                              
02 unit would benefit if a group health care insurance policy obtained or provided under                                   
03 AS 39.30.090 or 39.30.091 were required to comply with the provisions of AS 21.96.210 -                                 
04 21.96.300, added by sec. 4 of this Act. The Department of Administration shall complete the                             
05 analysis and compile the information into a report to the legislature, submit the report to the                         
06 senate secretary and chief clerk of the house of representatives before January 31, 2026, and                           
07 notify the legislature that the report is available.                                                                    
08    * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to                          
09 read:                                                                                                                   
10 TRANSITION: REGULATIONS. The director of the division of insurance may adopt                                            
11 regulations necessary to implement this Act. The regulations take effect under AS 44.62                                 
12 (Administrative Procedure Act), but not before the effective date of the law implemented by                             
13 the regulation.                                                                                                         
14    * Sec. 9. Sections 7 and 8 of this Act take effect immediately under AS 01.10.070(c).                              
15    * Sec. 10. Except as provided in sec. 9 of this Act, this Act takes effect January 1, 2026.