The bill amends R.S. 22:1047(B) to enhance coverage for severe obesity treatment by introducing new requirements for health insurance issuers. It mandates that, starting August 1, 2026, insurers offering qualified health plans must submit annual cost estimates for the benefits required under this section, which must be prepared by a member of the American Academy of Actuaries. Additionally, the Department of Insurance is tasked with publishing an estimated cost for the state to defray these services by December 1, 2026, and notifying health insurance issuers of the funding ratio and minimum coverage standards by July 1, 2027.

The bill also establishes that beginning January 1, 2028, if the published funding ratio meets or exceeds 1.0, health insurance issuers cannot impose a numerical cap on the required services. If the funding ratio is below 1.0, a cap may be applied, but it must be clearly stated in the insurance plan documents. The legislation aims to ensure comprehensive coverage for severe obesity treatment while providing a structured approach to cost estimation and funding for these services.

Statutes affected:
SB464 Original: 22:1047(B)
SB464 Engrossed: 22:1047(B)
SB464 Enrolled: 22:1047(B)
SB464 Act 519: 22:1047(B)