SB 42 Summary

• Caps coinsurance and deductibles in health insurance policies at the lesser of: the insurer's amount owed, the provider's charged amount (minus discounts), or what the insured would pay without insurance, effective January 1, 2020.

• Prohibits copayments exceeding the amount an insured would have paid without insurance coverage.

• Prevents health carriers from entering contracts that require parties to violate fiduciary duties owed to insureds.

• Makes it an unfair trade practice for health care providers to request payment from patients for covered services, emergency services from out-of-network providers, or surprise bills when the health carrier is primarily responsible for payment.

• Prohibits health care providers from reporting to credit agencies an enrollee's failure to pay bills for covered services when the health carrier has primary payment responsibility.