This bill amends existing law to enhance the access of employers sponsoring self-funded health benefit plans to their claims data. Specifically, it stipulates that if an employer opts in writing to authorize the submission of its claims data to the state's comprehensive health care information system, the insurance commissioner is required to provide the employer with access to an annual utilization report based on de-identified and aggregated claims data associated with their plan. The bill also mandates that health carriers and third-party administrators notify employers of their option to authorize data submission and inform them about the benefits of opting in, including privacy protections and access to their own claims data.

Additionally, the bill includes provisions that require health carriers and third-party administrators to provide this notification to employers annually upon renewal of their plans. It clarifies that there is no obligation for self-funded employers or plan sponsors to report data or adhere to specific administration requirements for their plans. The effective date of the act is set for 60 days after its passage, which is August 18, 2026.

Statutes affected:
Introduced: 420-G:11
As Amended by the House: 420-G:11
Version adopted by both bodies: 420-G:11
CHAPTERED FINAL VERSION: 420-G:11