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ID H0299
Bill
AI Summary
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Amends Section 41-5904 of Idaho Code regarding the Idaho Health Carrier External Review Act's applicability and scope.
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Excludes single employer self-funded employee benefit plans that comply with the Employee Retirement Income Security Act of 1974 (ERISA) from mandatory compliance with the external review requirements.
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Allows single employer self-funded ERISA plans to voluntarily elect compliance with external review provisions through written notice to the director, either for individual plan beneficiaries or specific time periods.
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Authorizes the director to establish rules governing the voluntary compliance procedure and to charge administrative fees to employee benefit plan administrators for each voluntary external review request.
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Clarifies that external review availability does not alter the standard of review used by courts when adjudicating health carrier final adverse benefit determinations.
Legislative Description
Amends existing law to delete language relating to certain final adverse benefit determinations and to provide an opt-in election for single employer self-funded benefit plans subject to and operated in compliance with the Federal Employee Retirement Income Security Act of 1974.
HEALTH CARRIER EXTERNAL REVIEW ACT
Last Action
Governor signed Session Law Chapter 258 Effective: 07/01/11
4/8/2011