HB1041
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O'Quinn |
Health insurance; cost-sharing, pharmacy benefits managers' compensation and duties, civil penalty. |
Summary:
Health insurance; cost-sharing; pharmacy benefits managers' compensation and duties: civil penalty.
Amends provisions related to rebates provided by carriers and health benefit plans to health plan enrollees by defining "defined cost-sharing," "price protection rebates," and "pharmacy benefits management services." The bill requires that an enrollee's defined cost-sharing for each prescription drug be calculated at the point of sale based on a price that is reduced by an amount equal to at least 80 percent of all rebates received or expected to be received in connection with the dispensing or administration of the prescription drug.The bill prohibits a pharmacy benefits manager from deriving income from pharmacy benefits management services provided to a carrier or health benefit plan except for income derived from a pharmacy benefits management fee. The bill requires the amount of any pharmacy benefits management fees to be set forth in the agreement between the pharmacy benefits manager and the carrier or health benefit plan and that such fee not be based on the acquisition cost or any other price metric of a drug; the amount of savings, rebates, or other fees charged, realized, or collected by or generated based on the activity of the pharmacy benefits manager; or the amount of premiums, deductibles, or other cost-sharing or fees charged, realized, or collected by the pharmacy benefits manager from enrollees or other persons on behalf of an enrollee. The bill requires a pharmacy benefits manager to annually certify to the State Corporation Commission that it has met certain requirements.The bill establishes a pharmacy benefits manager duty, which includes the duties of care and good faith and fair dealing, owed to any enrollee, provider, or health benefit plan that receives pharmacy benefits management services from the pharmacy benefits manager or that furnishes, covers, receives, or is administered a unit of a prescription drug for which the pharmacy benefits manager has provided pharmacy benefits management services. The bill requires the Commission to define by regulation the scope of such duty and provides for a private cause of action for any person aggrieved by the breach of such duty.
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Fiscal Impact
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Last Five Actions:
1/10/2024 - Referred to Committee on Labor and Commerce 1/23/2024 - Assigned L & C sub: Subcommittee #1 2/1/2024 - Impact statement from DPB (HB1041) 2/6/2024 - Subcommittee recommends continuing to 2025 2/8/2024 - Continued to 2025 in Labor and Commerce
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Subcommittee #1
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Subcommittee recommends continuing to 2025
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HB218
|
Orrock |
Health insurance; health care provider panels, continuity of care. |
Summary:
Health insurance; health care provider panels; continuity of care.
Requires a provider to continue to render health care services to any of the carrier's enrollees who have an existing provider-patient relationship with the provider for a period of at least 90 days from the date of a provider's termination from the carrier's provider panel, except when a provider is terminated for cause. The bill provides that for an enrollee who has an existing provider-patient relationship with a provider, and, at the time of the provider's termination, (i) has been medically confirmed to be pregnant, the provider is required to continue care through the postpartum period; (ii) is determined to be terminally ill, the provider is required to continue care for the remainder of the enrollee's life; (iii) has been determined by a medical professional to have a life-threatening condition, the provider is required to continue care for up to 180 days; and (iv) is admitted to and receiving treatment in an inpatient facility, the provider is required to continue care until the enrollee is discharged from the inpatient facility. Under current law, the carrier is required to permit the provider to provide such continuity of care. The bill provides that the continuity of care provisions also apply to plans administered by the Department of Medical Assistance Services that provide benefits pursuant to Title XIX or Title XXI of the Social Security Act.
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Fiscal Impact
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Last Five Actions:
3/6/2024 - Enrolled 3/6/2024 - Bill text as passed House and Senate (HB218ER) 3/6/2024 - Signed by Speaker 3/8/2024 - Impact statement from SCC (HB218ER) 3/11/2024 - Enrolled Bill communicated to Governor on March 11, 2024
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Senate Committee Actions:
2/26/2024 - Reported from Commerce and Labor (15-Y 0-N) 2/28/2024 - Constitutional reading dispensed (39-Y 0-N) 2/29/2024 - Read third time 2/29/2024 - Passed Senate (39-Y 0-N) 3/7/2024 - Signed by President
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Health and Human Resources Subcommittee
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Subcommittee recommends reporting (7-Y 0-N)
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HB489
|
Garrett |
Fire Programs Fund; increases annual assessment used to fund. |
Summary:
Insurance; Fire Programs Fund; purposes.
Provides that the portion of the Fire Programs Fund allocated to localities may be used for the additional purposes of (i) constructing, improving, or expanding fire station facilities, (ii) providing mental health resources, or (iii) hiring additional fire personnel and funding recruitment and retention programs. The bill also prohibits such funds from being used, except as provided, for the purposes of investments, operating expenses, debt repayment, taxes, or fees.
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Fiscal Impact
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Last Five Actions:
2/12/2024 - Committee substitute agreed to 24107326D-H1 2/12/2024 - Engrossed by House - committee substitute HB489H1 2/13/2024 - Read third time and passed House BLOCK VOTE (99-Y 0-N) 2/13/2024 - VOTE: Block Vote Passage (99-Y 0-N) 2/16/2024 - Impact statement from SCC (HB489H1)
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Senate Committee Actions:
2/14/2024 - Constitutional reading dispensed 2/14/2024 - Referred to Committee on Commerce and Labor 2/26/2024 - Reported from Commerce and Labor (15-Y 0-N) 2/26/2024 - Rereferred to Finance and Appropriations 2/29/2024 - Continued to 2025 in Finance and Appropriations (10-Y 4-N)
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Transportation and Public Safety Subcommittee
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Subcommittee recommends reporting (7-Y 0-N)
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HB601
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Kilgore |
Health insurance; patient access to emergency services, mobile crisis response services. |
Summary:
Health insurance; emergency services; mobile crisis response services.
Provides that emergency services, with respect to an emergency medical condition, include, as it relates to any mental health services or substance abuse services rendered at a behavioral health crisis service provider, (i) a behavioral health assessment that is within the capability of a behavioral health crisis service provider, including ancillary services routinely available to evaluate such emergency medical condition, and (ii) such further examination and treatment, to the extent that they are within the capabilities of the staff and facilities available at the behavioral health crisis service provider, as are required so that the patient's condition does not deteriorate. This bill is identical to SB 543.
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Fiscal Impact
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Last Five Actions:
3/7/2024 - Enrolled 3/7/2024 - Bill text as passed House and Senate (HB601ER) 3/7/2024 - Impact statement from DPB (HB601ER) 3/7/2024 - Signed by Speaker 3/11/2024 - Enrolled Bill communicated to Governor on March 11, 2024
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Senate Committee Actions:
2/29/2024 - Reading of amendment waived 2/29/2024 - Committee amendment agreed to 2/29/2024 - Engrossed by Senate as amended 2/29/2024 - Passed Senate with amendment (39-Y 0-N) 3/8/2024 - Signed by President
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Related Bills:
SB543 (Bagby) - Health insurance; patient access to emergency services, mobile crisis response services.
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Subcommittee #1
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Subcommittee recommends reporting with substitute (6-Y 0-N)
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HB794
|
Henson |
Statutory agents; service of process. |
Summary:
Statutory agents; service of process.
Adds the Clerk of the State Corporation Commission to the definition of "statutory agent" when such Clerk is appointed for the purpose of service of process on any individual, corporation, or limited partnership. The bill further applies certain methods of service of process currently applicable to limited liability corporations to nonstock corporations and domestic stock corporations. The bill provides that domestic or foreign limited liability partnerships may be served by personal service on its registered agent as directed by applicable provisions of Title 50 (Partnerships). The bill further provides that whenever the Clerk of the State Corporation Commission is appointed as the statutory agent service shall be deemed sufficient upon the person or entity being served and shall be effective on the date when service is made on the Clerk, provided, however, that the time for such person or entity to respond to process sent by the Clerk shall run from the date when the certificate of compliance is filed. This bill is a recommendation of the Boyd-Graves Conference.
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Fiscal Impact
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Last Five Actions:
3/8/2024 - Enrolled 3/8/2024 - Bill text as passed House and Senate (HB794ER) 3/8/2024 - Signed by Speaker 3/11/2024 - Enrolled Bill communicated to Governor on March 11, 2024 4/22/2024 - Impact statement from SCC (HB794ER)
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Senate Committee Actions:
2/28/2024 - Reported from Courts of Justice (15-Y 0-N) 3/1/2024 - Constitutional reading dispensed (40-Y 0-N) 3/4/2024 - Read third time 3/4/2024 - Passed Senate (39-Y 0-N) 3/9/2024 - Signed by President
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Subcommittee #1
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Subcommittee recommends reporting (7-Y 0-N)
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HB1019
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Wilt |
Health insurance; locality to allow local employees to participate in its group insurance programs. |
Summary:
Health insurance for local employees.
Permits any locality to allow participation in its group health insurance program by any non-benefitted employee, including members of governing bodies, if such non-benefitted employee or governing body member is not otherwise entitled to participate, provided that such non-benefitted employees reimburse the locality for the full cost of their participation. The bill provides that reimbursement may include forgoing all or a part of a local government salary.
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Last Five Actions:
2/13/2024 - VOTE: Block Vote Passage (99-Y 0-N) 3/25/2024 - Enrolled 3/25/2024 - Bill text as passed House and Senate (HB1019ER) 3/26/2024 - Signed by Speaker 3/27/2024 - Enrolled Bill communicated to Governor on March 27, 2024
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Senate Committee Actions:
3/4/2024 - Reported from Commerce and Labor (12-Y 0-N) 3/5/2024 - Constitutional reading dispensed (40-Y 0-N) 3/6/2024 - Read third time 3/6/2024 - Passed Senate (40-Y 0-N) 3/25/2024 - Signed by President
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Subcommittee #1
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Subcommittee recommends reporting with amendments (6-Y 0-N)
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HB1060
|
Tran |
Long-term care insurance; rate increases, notice requirements. |
Summary:
Long-term care insurance; rate increases; notice requirements.
Requires an insurer providing long-term care insurance policies to issue a written notice to each policyholder of the insurer's filing for a rate increase with the State Corporation Commission within 60 days of making such filing. Additionally, the bill requires the insurer to (i) if the Commission denies the rate increase, issue a written notice to each policyholder of the Commission's final decision to deny the rate increase within 90 days of such decision or (ii) if the Commission approves the rate increase, issue a written notice to each policyholder of the rate increase at least 90 days before its effective date that includes certain information listed in the bill. The bill requires the Commission, in reviewing requests to increase long-term care insurance rates, to consider, to the extent practicable, how the rate increase will impact policyholders.
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Fiscal Impact
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Last Five Actions:
3/25/2024 - Enrolled 3/25/2024 - Bill text as passed House and Senate (HB1060ER) 3/26/2024 - Signed by Speaker 3/27/2024 - Enrolled Bill communicated to Governor on March 27, 2024 4/22/2024 - Impact statement from SCC (HB1060ER)
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Senate Committee Actions:
3/6/2024 - Reading of amendment waived 3/6/2024 - Committee amendment agreed to 3/6/2024 - Engrossed by Senate as amended 3/6/2024 - Passed Senate with amendment 3/25/2024 - Signed by President
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Subcommittee #1
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Subcommittee recommends reporting with amendments (5-Y 2-N)
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HB1132
|
Hayes |
Insurance; annual actual loss ratio report by dental carriers. |
Summary:
Insurance; dental carriers; annual report.
Requires each dental carrier, beginning in 2025, to annually, on or before April 30, file with the State Corporation Commission a report that includes the actual loss ratio, defined in the bill, for the preceding calendar year and any such other information as the Commission may require. The bill requires the Commission to post such reports on its website. The bill requires the Bureau of Insurance to evaluate the effectiveness of informing the public on the information being reported and to make recommendations, if any, on the continuation or modification of the obligation of dental carriers to report such information. The bill also requires the Commission to convene a work group of interested stakeholders to determine if any revisions are necessary to the Code of Virginia regarding ethics and fairness in dental carrier business practices and of health care providers of dental services. The work group is required to report its recommendations to the Chairs of the House Committee on Labor and Commerce and the Senate Committee on Commerce and Labor on or before October 1, 2024. This bill is identical to SB 257.
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Fiscal Impact
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Last Five Actions:
3/8/2024 - Enrolled 3/8/2024 - Bill text as passed House and Senate (HB1132ER) 3/8/2024 - Signed by Speaker 3/11/2024 - Enrolled Bill communicated to Governor on March 11, 2024 4/22/2024 - Impact statement from SCC (HB1132ER)
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Senate Committee Actions:
2/29/2024 - Reading of amendment waived 2/29/2024 - Committee amendment agreed to 2/29/2024 - Engrossed by Senate as amended 2/29/2024 - Passed Senate with amendment (39-Y 0-N) 3/9/2024 - Signed by President
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Related Bills:
SB257 (Surovell) - Insurance; annual actual loss ratio report by dental carriers.
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Subcommittee #1
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Subcommittee recommends reporting with amendments (7-Y 0-N)
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HB1134
|
Willett |
Health insurance; if prior authorization request is approved for prescription drugs. |
Summary:
Health insurance; prior authorization.
Requires that any provider contract between a carrier and a participating health care provider contain specific provisions that require that if a prior authorization request is approved for prescription drugs and such prescription drugs have been scheduled, provided, or delivered to the patient consistent with the authorization, the carrier shall not revoke, limit, condition, modify, or restrict that authorization unless (i) there is evidence that the authorization was obtained based on fraud or misrepresentation; (ii) final actions by the U.S. Food and Drug Administration, other regulatory agencies, or the manufacturer remove the drug from the market, limit its use in a manner that affects the authorization, or communicate a patient safety issue that would affect the authorization alone or in combination with other authorizations; (iii) a combination of drugs prescribed would cause a drug interaction; or (iv) a generic or biosimilar is added to the prescription drug formulary. The bill provides that such provisions do not require a carrier to cover any benefit not otherwise covered or cover a prescription drug if the enrollee is no longer covered by a health plan on the date the prescription drug was scheduled, provided, or delivered. This bill is identical to SB 98.
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Fiscal Impact
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Last Five Actions:
3/6/2024 - Enrolled 3/6/2024 - Bill text as passed House and Senate (HB1134ER) 3/6/2024 - Signed by Speaker 3/8/2024 - Impact statement from SCC (HB1134ER) 3/11/2024 - Enrolled Bill communicated to Governor on March 11, 2024
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Senate Committee Actions:
2/26/2024 - Reported from Commerce and Labor (15-Y 0-N) 2/28/2024 - Constitutional reading dispensed (39-Y 0-N) 2/29/2024 - Read third time 2/29/2024 - Passed Senate (39-Y 0-N) 3/7/2024 - Signed by President
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Related Bills:
SB98 (Favola) - Health insurance; if prior authorization request is approved for prescription drugs.
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Subcommittee #1
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Subcommittee recommends reporting with substitute (7-Y 0-N)
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HB1153
|
Cordoza |
Benefits consortium; governing bodies of three or more cities, counties, or school boards to form. |
Summary:
Benefits consortium for localities.
Authorizesthe governing bodies of three or more cities, counties, or schoolboards to form a benefits consortium for the purpose of establishinga self-funded employee welfare benefit plan. Under current law, suchgoverning bodies or school boards are authorized to form such a benefitsconsortium if they comprised the membership of a multiple employerwelfare arrangement as of December 31, 2014. Such a benefits consortiumis required to be a nonstock corporation established to operate abenefits plan. Each member of the benefits consortium is contractuallyliable for its allocated share of the consortium's liabilities, andthe benefits consortium is exempt from taxation and from insuranceregulations.
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Last Five Actions:
2/8/2024 - Reported from Labor and Commerce (17-Y 5-N) 2/11/2024 - Read first time 2/12/2024 - Read second time and engrossed 2/13/2024 - Read third time and defeated by House (48-Y 51-N) 2/13/2024 - VOTE: Defeated (48-Y 51-N)
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Subcommittee #1
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Subcommittee recommends reporting (7-Y 0-N)
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HB1210
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Hayes |
Health Insurance Reform Commission; assessment of certain legislation, report. |
Summary:
Health Insurance Reform Commission; assessment of certain legislation.
Requires the Health Insurance Reform Commission, whenever the Chairman of the House Committee on Labor and Commerce or the Senate Committee on Commerce and Labor requests that the Commission assess a legislative measure containing a mandated health insurance benefit or provider, to complete its assessment and submit a report for each such request within 24 months. This bill is identical to SB 132.
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Fiscal Impact
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Last Five Actions:
3/25/2024 - Enrolled 3/25/2024 - Bill text as passed House and Senate (HB1210ER) 3/26/2024 - Signed by Speaker 3/27/2024 - Enrolled Bill communicated to Governor on March 27, 2024 3/28/2024 - Impact statement from DPB (HB1210ER)
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Senate Committee Actions:
3/1/2024 - Reported from Rules (13-Y 0-N) 3/4/2024 - Constitutional reading dispensed (40-Y 0-N) 3/5/2024 - Read third time 3/5/2024 - Passed Senate (40-Y 0-N) 3/25/2024 - Signed by President
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Related Bills:
SB132 (Head) - Health Insurance Reform Commission; assessment of certain legislation, report.
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Subcommittee #1
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Subcommittee recommends reporting (6-Y 0-N)
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HB1220
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Scott, P.A. |
State Corporation Commission; insurance coverage regulations. |
Summary:
State Corporation Commission; insurance coverage regulations.
Requires the State Corporation Commission to amendregulations to reduce the mandatory limit of liability imposed uponinsurers for household and personal property coverage from at least50 percent of the dwelling limit of liability to at least 25 percent of the dwelling limit of liability.
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Fiscal Impact
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Last Five Actions:
2/12/2024 - Read second time 2/12/2024 - Committee substitute agreed to 24106514D-H1 2/12/2024 - Engrossed by House - committee substitute HB1220H1 2/13/2024 - Read third time and defeated by House (49-Y 50-N) 2/13/2024 - VOTE: Passage (49-Y 50-N)
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Subcommittee #1
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Subcommittee recommends reporting with substitute (7-Y 0-N)
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HB1257
|
Milde |
Insurance; optional coverage for the diminished value of personal property. |
Summary:
Insurance; coverage for the diminished value of personal property.
Requires any insurer who issues or delivers a new or renewal homeowner's insurance policy or a stand-alone policy that covers scheduled personal property in the Commonwealth to offer in writing a provision providing coverage for the diminution in the value of any such scheduled personal property, if the schedule provides for the repair of such property. Under the bill, the diminution in value of the personal property is the amount, if any, by which the market value of the personal property immediately following the completion of repair of the damage to the personal property is less than the market value of the personal property immediately prior to the damage and the change in market value is a direct result of damage from the covered loss. The provisions of the bill shall apply to every such policy that is issued, delivered, or renewed by an insurer licensed in the Commonwealth on or after July 1, 2025.
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Fiscal Impact
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Last Five Actions:
3/25/2024 - Enrolled 3/25/2024 - Bill text as passed House and Senate (HB1257ER) 3/26/2024 - Signed by Speaker 3/27/2024 - Enrolled Bill communicated to Governor on March 27, 2024 4/22/2024 - Impact statement from SCC (HB1257ER)
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Senate Committee Actions:
3/4/2024 - Reported from Commerce and Labor (11-Y 0-N 2-A) 3/5/2024 - Constitutional reading dispensed (40-Y 0-N) 3/6/2024 - Read third time 3/6/2024 - Passed Senate (39-Y 0-N 1-A) 3/25/2024 - Signed by President
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Subcommittee #1
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Subcommittee recommends reporting with substitute (4-Y 2-N)
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HB1392
|
Jones |
Local government; employee insurance programs. |
Summary:
Local government employee insurance programs.
Authorizes any locality to include in its group life, accident, andhealth insurance programs any person to whom coverage could be extendedunder the provision of current law that sets out who may be coveredunder a private group accident and sickness insurance policy.
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Fiscal Impact
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Last Five Actions:
2/14/2024 - Impact statement from DPB (HB1392) 3/25/2024 - Enrolled 3/25/2024 - Bill text as passed House and Senate (HB1392ER) 3/26/2024 - Signed by Speaker 3/27/2024 - Enrolled Bill communicated to Governor on March 27, 2024
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Senate Committee Actions:
3/4/2024 - Reported from Commerce and Labor (14-Y 0-N) 3/5/2024 - Constitutional reading dispensed (40-Y 0-N) 3/6/2024 - Read third time 3/6/2024 - Passed Senate (40-Y 0-N) 3/25/2024 - Signed by President
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Subcommittee #1
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Subcommittee recommends reporting (4-Y 2-N)
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