NC H862

Establishes habilitative services coverage for non-grandfathered health benefit plans in individual and small group markets issued or renewed on or after January 1, 2014, defined according to North Carolina Health Choice Program standards as of January 1 of the preceding calendar year.

Terminates basic and standard health benefit plans for small employers that are not grandfathered plans, effective on the next anniversary date on or after January 1, 2014, with 90-day notice required and replacement coverage to be offered.

Creates new Part 8 establishing uniform rating standards for non-grandfathered health benefit plans, requiring minimum 80% medical loss ratios in individual and small group markets and creating single risk pools for rating purposes.

Requires state utilization review, grievance, and external review laws for non-grandfathered health benefit plans to align with the Affordable Care Act, with state provisions that are more protective of consumers to be enforced.

Directs the Department of Insurance to monitor the health insurance market for negative impacts of the Affordable Care Act and publish quarterly reports from October 1, 2013, through July 1, 2015.