Substitute House Bill No. 7115 seeks to enhance the Health Care Cost Growth Benchmark Program by revising the reporting requirements for payers of self-funded employee health plans. Key provisions include the establishment of a structured opt-in process for employers to submit their health plan data, which must be facilitated through a form prescribed by the commissioner. Payers are required to provide this form within fifteen days of retaining claim administration services and must include the submitted data in their annual reports to the commissioner. The bill also mandates that payers report a list of employers who opted in or out of data submission, along with a certification of compliance. Notably, it prohibits payers from imposing additional costs on employers for including their self-funded data in aggregate reporting, except for actual submission costs.

Additionally, the bill modifies existing laws related to the Office of Health Strategy (OHS) commissioner's annual informational hearings, allowing the commissioner to dictate participation requirements for payers and other entities. It establishes a framework for these hearings to assess health care expenditure growth against benchmarks, requiring significant contributors to participate and provide testimony on cost mitigation efforts. The bill also clarifies that the opt-in form is exclusively for employers with self-funded plans and sets penalties for non-compliance. The effective date for these provisions is October 1, 2025, and the bill repeals and substitutes subsection (a) of section 19a-754j to implement these changes.

Statutes affected:
Raised Bill:
INS Joint Favorable Substitute:
File No. 472: