S.B. 865 Summary

• Adds definitions for "Claims Data Feed" and "Claim Payment Data" to state health plan statutes and establishes confidentiality protections for claim payment data as trade secrets.

• Requires claims processors to provide the State Health Plan with claims data feeds containing claim payment data at least monthly, while prohibiting contractual provisions that prevent disclosure of this data to the Plan.

• Increases the enrollment cap for local government employees in the State Health Plan from 10,000 to 16,000 employees and dependents, with a transition schedule through January 31, 2018.

• Allows local governments participating in the Plan as of April 1, 2016 to withdraw effective January 1, 2017 with notice by September 15, 2016.

• Establishes that employee premiums for their own coverage must conform to Plan-set premiums, while dependent coverage premiums may be set by local governments but cannot exceed Plan premiums.