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Bill > SB91


GA SB91

State Employees' Health Insurance Plan; Board of Community Health from entering into, executing, or renewing a contract with any pharmacy benefits manager that owns or has an ownership interest in any retail pharmacy; prohibit


summary

Introduced
02/04/2025
In Committee
04/02/2025
Crossed Over
03/04/2025
Passed
Dead

Introduced Session

2025-2026 Regular Session

Bill Summary

AN ACT To amend Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to general provisions regarding insurance, so as to require major medical coverage for annual prostate cancer screenings for certain men; to provide for definitions; to amend Chapter 43 of Title 33 of the Official Code of Georgia Annotated, relating to Medicare supplement insurance, so as to provide for Medicare supplement policies to be issued and renewed for individuals under 65 years of age who are eligible by reason of disability or end stage renal disease under federal law; to provide for open enrollment periods; to prohibit an insurer from charging premium rates for such policies for such individuals that exceed premium rates charged for individuals who are 65 years of age; to provide for related matters; to provide for effective dates and applicability; to repeal conflicting laws; and for other purposes.

AI Summary

This bill makes two primary changes to health insurance regulations in Georgia. First, it requires health benefit policies to provide annual prostate cancer screenings for men considered at high risk, which includes men aged 40-49 with a family history of prostate cancer, men 50 years and older, and other men as determined by a physician. The screenings must include a digital rectal examination and a prostate-specific antigen test. Second, the bill modifies Medicare supplement insurance policies to expand coverage and protections for individuals under 65 who are eligible for Medicare due to disability or end-stage renal disease. These modifications include establishing a guaranteed renewable basis for such policies, creating open enrollment periods, and prohibiting insurers from charging excessive premium rates compared to policies for individuals 65 and older. Specifically, for certain standardized Medicare supplement policies, insurers cannot charge premium rates for individuals under 65 that exceed the rates for 65-year-olds, and for other policies, rates cannot exceed 200 percent of the rates for 65-year-olds. The bill will become fully effective on January 1, 2026, and will apply to insurance policies issued or renewed on or after that date.

Committee Categories

Health and Social Services

Sponsors (26)

Last Action

House Withdrawn, Recommitted (on 04/04/2025)

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