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 insertions include the establishment of a new annual reporting structure where payers must submit aggregated data to the commissioner, detailing total health care expenditures and primary care spending. Payers are also required to provide an opt-in form to employers, allowing them to choose whether to submit their health plan data, with the option to opt out of future reporting periods. The bill introduces penalties for non-compliance, specifically up to $10 per covered individual, and mandates that the commissioner prepare annual reports analyzing health care spending trends and quality benchmarks.

Additionally, the bill repeals and replaces subsection (a) of section 19a-754j, allowing the commissioner to hold annual public hearings to evaluate health care expenditure growth against benchmarks, requiring participation from key contributors to cost growth. The commissioner is tasked with preparing detailed reports on spending trends and recommendations for improving the efficiency of the health care system. The effective date for these provisions is set for October 1, 2025, and the bill emphasizes that the opt-in form is exclusive to self-funded plans, prohibiting payers from charging employers for data inclusion in aggregate reports.

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