§1066.1. Benefit limits; lifetime; annual
A. Except as provided for in Subsection C of this Section, any health coverage plan
issued for delivery, delivered, renewed, or otherwise contracted for in this state on or after
January 1, 2020, shall provide coverage without any lifetime limit on the dollar amount of
benefits for any individual.
B. Except as provided for in Subsections C and D of this Section, any health
coverage plan newly issued for delivery, delivered, renewed, or otherwise contracted for in
this state on or after January 1, 2020, shall provide coverage without any annual limit on the
dollar amount of benefits for any individual.
C. This Section shall apply only to covered benefits that are either of the following:
(1) Included among the covered benefits of the base-benchmark plan selected for the
state of Louisiana for calendar year 2019 pursuant to 45 CFR Part 156.
(2) Required as a state-mandated health benefit pursuant to Title 22 of the Louisiana
Revised Statutes of 1950.
D. Subsection B of this Section shall not apply to a health coverage plan that meets
all of the following criteria:
(1) Is health insurance coverage offered only to individuals in the individual market.
(2) Covers only individuals who have been continuously covered by the health
coverage plan since March 23, 2010.
(3) Is qualified as a grandfathered health plan coverage pursuant to 29 CFR Section
2590.715-1251 as of calendar year 2019.
E. No provision of this Section shall be interpreted to require any health coverage
plan issued for delivery, delivered, renewed, or otherwise contracted for in this state to
include particular covered benefits.
F. As used in this Section, "health coverage plan" shall mean any hospital, health,
or medical expense insurance policy, hospital or medical service contract, employee welfare
benefit plan, contract or agreement with a health maintenance organization or a preferred
provider organization, health and accident insurance policy, or any other insurance contract
of this type, including a group insurance plan and the Office of Group Benefits plans.
G. The provisions of this Section shall not apply to limited benefit health insurance
policies or contracts, as defined by R.S. 22:47.
Acts 2019, No. 212, §1.