S.B. No. 351 Summary

• Health plan issuers must release claims data to group policyholders upon request within fourteen business days of receipt.

• Released data must include net claims paid by month, monthly enrollment information, claims reserves, claims over $10,000 with diagnosis information, and complete listings of potential catastrophic diagnoses.

• Health plan issuers may require policyholders to execute an agreement absolving them of civil liability related to use of the data and are immune from liability for subsequent uses of disclosed information.

• Group policyholders must provide certification that plan documents comply with 45 C.F.R. 164.504(f)(2) to receive protected health information; without certification, they receive only general claim information.

• Health plan issuers that fail to comply are subject to unfair and deceptive practice penalties; the bill takes effect January 1, 2017.