1252ja

_________________ moved that HB 1252 be amended as follows:

     On the printed bill, delete everything after the enacting clause and insert:

"      Section 1. That chapter 58-17 be amended by adding thereto a NEW SECTION to read as follows:

     An insurer that has a policy or certificate of health insurance subject to the provisions of this chapter shall, in addition to the benefits required by this title, offer any prospective insured the option to purchase any benefits that the insurer currently offers either as a separate option, as a rider, or as part of a standard or core benefit package in a policy or certificate. The insurer shall allow the prospective insured to reject any of the standard or core benefits offered in the policy or certificate and obtain the policy or certificate at a reduced rate based upon the actuarial difference in benefit plan design. Nothing in this Act requires any insurer to offer any type of coverage that the insurer would not otherwise make available to qualified applicants. No prospective insured may reject coverage provided pursuant to §  58-17-88 or the Women's Health and Cancer Rights Act of 1998.

     Section 2. That chapter 58-17 be amended by adding thereto a NEW SECTION to read as follows:

     An insurer may file policy forms for approval to meet the requirements of this Act by including benefit provisions that are variable based upon the selection of the benefit structure by the applicant. Each policy benefit which is to be offered as a separate option must use a rate that is actuarially justified, that is filed and approved pursuant to §  58-17-4.1, and that is subject to §  58-17-64. An insurer may charge reasonable fees for extra processing costs associated with policies issued pursuant to this Act. Such fees must be separately listed on the policy schedule page. This section does not apply to provisions of the policy other than policy benefits. The provisions to which this section does not apply include free look, renewal clauses, preexisting condition clauses, consideration, general provisions, claims payment, eligibility, managed care, and termination of coverage.

     Section 3. That chapter 58-17 be amended by adding thereto a NEW SECTION to read as follows:

     Nothing in this Act applies to a basic hospital expense policy, a basic medical-surgical expense policy, a hospital confinement indemnity policy, a disability or disability income policy, an accident only policy, a specified disease policy, or a limited benefit health coverage. "