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 enrollment 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 section 9A of chapter 176O by removing the previous subsection (a) and replacing it with new language that limits the obligations of carriers regarding provider participation in select and tiered network plans. The new provisions clarify that carriers are not required to guarantee participation for all providers, nor must they place all members of a provider group in the same tier or include them on an all-or-nothing basis in select network plans. This change aims to provide carriers with greater flexibility in managing their networks while still promoting competition and access to care.

Statutes affected:
Bill Text: 176J-11