Bill > HR346

This bill, the Health Care Choice Act of 2011, proposes to amend the Public Health Service Act to allow health insurance issuers to designate a single "primary state" whose laws will govern their individual health insurance coverage, even when sold in other "secondary states." This means that if an issuer chooses a primary state, the laws of that primary state will apply to policies sold in both the primary and any secondary states, provided the issuer and coverage meet certain conditions. The bill exempts issuers from most laws of secondary states that would otherwise regulate their operations, with specific exceptions allowing secondary states to require issuers to pay taxes, register, undergo financial examinations if the primary state hasn't, comply with lawful orders in financial distress, adhere to court injunctions, participate in insolvency guaranty associations, and follow state laws regarding fraud, abuse, and unfair claims settlement practices. Issuers must provide clear notice to consumers in secondary states that their policy is governed by the laws of the primary state and may be subject to different regulations. The bill also requires issuers to offer coverage in a secondary state only if it's already offered in their primary state, prohibits certain reclassifications and premium increases based on health status upon renewal, and mandates that the primary state must meet a federal minimum standard for capital and surplus requirements before an issuer can sell into secondary states. Furthermore, it requires an independent external appeals process for denied claims and mandates that insurance commissioners in both primary and secondary states receive specific documentation from issuers, including plans of operation and financial statements. Finally, the Comptroller General is required to study the impact of this Act on various health insurance issues.