The bill amends the General Laws to prevent health insurance carriers and health benefit plans from setting annual and lifetime dollar limits on essential health benefits for any individual. For plan years starting on or after January 1, 2014, annual limits on essential health benefits are not allowed, with exceptions for certain accounts and non-essential benefits. Lifetime limits on essential health benefits are also prohibited, but carriers may impose limits on non-essential benefits in accordance with federal laws. These rules apply to both individual and group health plans, including those that are grandfathered, while explicitly excluding certain types of insurance like hospital indemnity and long-term care. The bill also clarifies that these prohibitions do not apply to grandfathered individual health insurance coverage and are not retroactive to policy years before January 1, 2014, or to plans with a federal waiver.

The bill includes a notable deletion, removing the provision that allowed the health insurance commissioner to suspend enforcement of the section on lifetime and annual limits if the federal Patient Protection and Affordable Care Act's corresponding provisions were invalidated or repealed. This ensures that the state's protections against such limits will persist independently of federal legislation. The act is set to take effect immediately upon passage, emphasizing the state's dedication to upholding these health insurance consumer protections.

Statutes affected:
2382: 27-18-73, 27-19-63, 27-20-59, 27-41-76