SB1187 - Right to Shop Act

• Requires health insurance carriers to develop and implement incentive programs for enrollees who choose to receive health care services from providers charging less than the average in-network allowed amount, effective January 1, 2020.

• Allows incentives to be calculated as a percentage of savings, flat dollar amounts, or other methods approved by the Department of Insurance, distributed as cash payments, gift cards, or credits toward deductibles, out-of-pocket limits, or premiums.

• Mandates carriers establish interactive website tools enabling enrollees to compare allowed amounts among network providers, estimate out-of-pocket costs, and obtain average payment information for procedures within one year.

• Permits enrollees to use out-of-network providers at prices equal to or less than the carrier's average network payment, with such payments applying toward the enrollee's deductible and out-of-pocket maximum upon request.

• Requires the Director of Central Management Services to analyze cost-effectiveness of implementing an incentive-based program for State group health benefits plan enrollees and retirees within one year, with implementation if found cost-effective.