Health Plan Purchasing Cooperative Act of 1993

Summary

Health Plan Purchasing Cooperative Act of 1993 - Provides for a system whereby States establish voluntary health plan purchasing cooperatives (HPPCs), in which individuals without insurance and small employers could enroll and select from competing health plans providing a standard benefit plan (with a managed care, fee-for-service, and medisave option). (Sec. 2) Directs the Secretary of Health and Human Services to establish standards relating to the establishment of HPPCs, qualifications for Accountable Health Plans (AHPs) (carriers designated by a State insurance commissioner), the role of States, and a standard benefit package for small employers. Authorizes an HPPC to sue or be sued and to accept and expend grants or funds from public or private agencies. Sets forth limitations on an HPPC's authority. (Sec. 3) Requires each: (1) State to establish boundaries for HPPC areas and HPPCs for each area and a process whereby a carrier demonstrates that it has the capability to fulfill specified requirements; and (2) HPPC to establish bylaws, enter into contracts and hold policies with AHPs, provide for enrollment of eligible employees and individuals in qualified health benefit plans (HBPs), establish requirements for participation, and establish dispute resolution procedures, a fixed overhead allowance percentage, and uniform administrative and accounting procedures. (Sec. 7) Specifies that a health plan is not a qualified HBP unless the plan meets applicable financial requirements established under State law, is marketed only in accordance with specified standards, and submits to the HPPC data in accordance with uniform standards to be established by the Secretary. (Sec. 8) Requires each HPPC to use efficient and standardized means to notify small employers of the availability of health coverage through the HPPC. (Sec. 9) Directs each HPPC to submit to the State specified data on eligible employers, enrolled employers, eligible individuals, and premium ranges. (Sec. 10) Requires each State to designate an entity to monitor adverse selection in enrollment among qualified HBPs offered through HPPCs and the need for risk adjustment mechanisms. (Sec. 11) Sets forth provisions regarding: (1) oversight, dispute resolution, assuring availability of coverage and comparable treatment in and out of HPPCs, and certain antitrust protection of HPPCs; and (2) medisave coverage requirements and tax treatment of such coverage.

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 22 November 1993

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• Introduced in House (PDF)

  Introduced in House · EN · 22 November 1993

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• Introduced in House

  summary · EN · 22 November 1993

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