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House approves substitute to require insurers to disclose exclusions for secondary medical conditions
Summary
A substitute to SB62 passed the House requiring health insurers to disclose to enrollees when secondary medical conditions resulting from excluded procedures or drugs may be excluded from coverage; sponsors said the measure mandates notice, not new exclusions. Vote: 57–15.
The Utah House voted to substitute and pass changes to SB62, which requires insurers to provide notice to enrollees about exclusions for secondary medical conditions that can arise from excluded procedures, drugs or conditions. Representative Last, presenting the substitute, said the bill "simply amends [the] insurance code and requires insurance providers ... to give notice to enrollees about exclusions of coverage from a secondary medical condition."
Several representatives asked whether the substitute creates new exclusions or merely requires disclosure; Representative Vazquez asked for clarification and Last said the change "is exactly right" — the bill requires insurers to disclose conditions that are already excluded under contract terms rather than creating new exclusions. Representative Tilton raised concerns about scenarios where complications arise long after elective procedures and noted that time limits are contractually defined and not set by this bill. The sponsor also said insurers must report to interim committees about how they will provide the information to enrollees.
On the roll call the substitute passed the House 57 yes, 15 no and will return to the Senate for further action.
