Enrolled Bill Summary

Senate Bill 51	Senate Author:  Nelson
Effective:  9-1-05	House Sponsor:  Smithee

            Senate Bill 51 amends the Insurance Code to require a contract between an insurer and a group policyholder under a preferred provider benefit plan, or between a health maintenance organization (HMO) and a group contract holder, to provide that the policy or contract holder is liable for the payment of an individual insured's or enrollee's premiums from the time the individual leaves the group until the end of the month in which the policy or contract holder notifies the insurer or HMO that the individual is ineligible for coverage. 

            Senate Bill 51 exempts an HMO that provides routine vision or dental services as a single health care service plan from extended hours of telephone coverage required for other medical services and requires the HMO to provide physicians and providers with verification and preauthorization information for such services via a toll-free telephone number between 8 a.m. and 5 p.m. central time on weekdays except for legal holidays.  It provides for alternate coverage at other times and requires the HMO to respond to such calls not later than the next business day.