The proposed bill SB1402 allows health insurers to establish a savings incentive program for enrollees who receive medically necessary covered health care services at a price below the insurer's usual reimbursement. This program would enable eligible enrollees to apply the amount they pay towards their deductible and out-of-pocket maximum, as well as receive reimbursement for a portion of the difference between the price paid and the insurer's usual reimbursement. The bill also defines key terms such as "health care facility," "health care provider," and "usual reimbursement."

Key changes from current law include the shift from requiring insurers to establish such programs to allowing them to do so at their discretion. The bill removes previous requirements for program disclosures and payment procedures, and it modifies the reimbursement structure, allowing enrollees to be reimbursed for a portion of the difference rather than a fixed amount. Additionally, the bill clarifies the definition of "usual reimbursement" to specify it as the amount the insurer would typically pay to in-network providers or facilities.

Statutes affected:
Introduced Version: 20-111, 32-3216
Senate Engrossed Version: 20-111
Chaptered Version: 20-111