The bill aims to enhance enrollment in affordable health plan networks by amending existing laws related to health insurance carriers. Specifically, it introduces provisions that allow the commissioner to exempt carriers from certain compliance requirements based on criteria such as the concentration of their membership in a single rate region, the proportion of members enrolled in subsidized coverage, and the percentage of income derived from government programs. This flexibility is intended to encourage carriers to participate in the market and expand access to affordable health plans.

Additionally, the bill modifies the regulations governing select and tiered network plans by removing the previous restrictions that guaranteed health care providers a right to participation and mandated that all members of a provider group be placed in the same tier or included on an all-or-nothing basis. The new language allows carriers greater discretion in managing their network plans, which could lead to more innovative and cost-effective health care options for consumers.

Statutes affected:
Bill Text: 176J-11