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S 5332

Relates to invoking coverage of a health insurance plan for long term care for an incapacitated individual

2025 Regular Session Introduced by Jamaal Bailey

Bill S 5332 mandates health insurance coverage for long-term care of incapacitated individuals, ensuring access to necessary services and protecting consumers from claim denials.

REPORTED AND COMMITTED TO FINANCE
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WeVote Research Nonpartisan
Bill Summary · S 5332

Summary of Bill S 5332

Bill Information

  • Bill Number: S 5332
  • Title: Relates to invoking coverage of a health insurance plan for long term care for an incapacitated individual
  • Status: Reported and Committed to Finance
  • Introduced: February 20, 2025
  • Classification: Bill

Purpose and Intent

Bill S 5332 aims to enhance access to long-term care coverage under health insurance plans for individuals who are incapacitated. The bill seeks to clarify and expand the circumstances under which health insurance policies must provide coverage for long-term care services, ensuring that incapacitated individuals receive necessary support without undue financial burden.

Key Provisions

  • Coverage Invocation: The bill establishes clear guidelines for invoking health insurance coverage for long-term care services. This includes defining what constitutes an "incapacitated individual" and outlining the types of care that must be covered.
  • Insurance Policy Requirements: Health insurance providers will be required to include specific provisions in their policies that address long-term care for incapacitated individuals, ensuring that such coverage is not arbitrarily denied.
  • Consumer Protections: The bill includes measures to protect consumers from potential denial of claims related to long-term care, enhancing transparency in the claims process and requiring insurers to provide clear justifications for any coverage denials.

Who Would Be Affected

  • Incapacitated Individuals: The primary beneficiaries of this bill are individuals who are incapacitated and require long-term care services. This includes those with chronic illnesses, disabilities, or other conditions that impair their ability to perform daily activities.
  • Health Insurance Providers: Insurers will need to adjust their policies to comply with the new requirements, which may involve changes to their coverage terms and claims processes.
  • Caregivers and Families: Families and caregivers of incapacitated individuals will benefit from the increased access to necessary long-term care services, potentially reducing the financial strain associated with such care.

Procedural Aspects

  • Legislative Timeline:
    • February 20, 2025: The bill was introduced and referred to the Insurance Committee.
    • May 5, 2025: The bill was reported out of committee and committed to the Finance Committee for further consideration.

Related Bills

  • S 9860: This bill is related to a prior session's legislation, indicating ongoing legislative efforts to address long-term care insurance issues.

Conclusion

Bill S 5332 represents a significant step towards improving access to long-term care for incapacitated individuals by mandating health insurance coverage. By establishing clear guidelines and protections, the bill aims to alleviate the financial burdens faced by families and ensure that those in need receive appropriate care. The bill is currently under review by the Finance Committee following its reporting from the Insurance Committee.

Compiled from official sources — confirm details with the bill’s official record.

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