HB 199 - Self-Funded Health Care Plans Summary

• Extends self-funded health care plan regulations to include postsecondary educational institutions offering student health benefit plans, with institutions prohibited from serving as trustees or administrators of such plans.

• Requires plans offering only dental and/or vision benefits (limited to $5,000 per beneficiary per year) to be exempt from registration, but exemption is lost if combined with other health benefits.

• Mandates written notice to student participants and prospective participants that the plan is not insurance and does not participate in the Idaho life and health guaranty association.

• Establishes minimum surplus requirements of 30% of unpaid claims liability (10% for newly formed plans in first year), with trusts required to maintain these amounts throughout the year and notify the director if surplus falls below minimums.

• Increases penalties for violations to up to $15,000 in fines and 15 years imprisonment for false statements or fraudulent entries, with director authorized to revoke plan registration and seek civil penalties up to $5,000 per violation.