HARRY HUGHES, Governor

1535

SUBCOMMITTEE OF THE BOARD IN ACCORDANCE WITH SUBSECTION (B) OF
THIS SECTION.

(D)  ANY NONPROFIT HEALTH SERVICE PLAN THAT HAS A PREMIUM
INCOME FOR THE PRECEDING YEAR OF LESS THAN $30,000,000 IS EXEMPT
FROM THIS SECTION.

(E)  THE PROVISIONS OF THIS SECTION DO SHALL NOT APPLY TO AN
ANY EXISTING FOREIGN NONPROFIT HEALTH SERVICE PLAN UNTIL JULY 1,
1987 1989.

438C.

(A)  ANY INSURER PROVIDING HOSPITAL BENEFITS IN THIS STATE
THAT OFFERS BENEFITS TO AN INSURED OR BENEFICIARY WHO UTILIZES
CERTAIN DESIGNATED LOW-COST HOSPITALS, DIFFERENT FROM THE
BENEFITS OFFERED FOR UTILIZATION OF OTHER HOSPITALS, SHALL BASE
ITS DESIGNATION OF A LOW-COST HOSPITAL ON INFORMATION WHICH:

(1)  EXCLUDES THE REASONABLE COST OF MEDICAL EDUCATION
AS DETERMINED BY THE HEALTH SERVICES COST REVIEW COMMISSION;

(2)  EXCLUDES THE REASONABLE COST OF UNCOMPENSATED
CARE AS DETERMINED BY THE HEALTH SERVICES COST REVIEW COMMISSION;
AND

(3) EXCLUDES ANY HOSPITAL FROM CONSIDERATION THAT IS
DETERMINED BY THE HEALTH RESOURCES PLANNING COMMISSION TO BE A
SOLE COMMUNITY PROVIDER;

(4) EXCLUDES THE AMOUNT IN RATES AS APPROVED BY THE
HEALTH SERVICES COST REVIEW COMMISSION FOR UNDERGRADUATE NURSING
EDUCATION;

(4) (5) EXCLUDES THE COST, AS DETERMINED BY THE
HEALTH SERVICES COST REVIEW COMMISSION, ASSOCIATED WITH:

(I) ANY SHOCK TRAUMA FACILITY; OR

(II) ANY SPECIALTY CARE UNIT; AND

(3) (5) (6) COMPARES HOSPITALS ON A REGIONAL BASIS
UNLESS THE INSURER DEMONSTRATES TO THE SATISFACTION OF THE
INSURANCE COMMISSIONER THAT A STATEWIDE COMPARISON IS MORE
APPROPRIATE UNDER THE CIRCUMSTANCES.

(B) AN INSURER PROVIDING HOSPITAL BENEFITS UNDER SUBSECTION
(A) OF THIS SECTION MAY NOT SUBSIDIZE THESE BENEFITS FROM
PREMIUMS EARNED BY OTHER BENEFIT PLANS OR POLICIES.

477CC.

(A) ANY INSURER PROVIDING GROUP HEALTH INSURANCE OR BLANKET
HEALTH INSURANCE IN THIS STATE THAT OFFERS BENEFITS TO AN INSURED
OR BENEFICIARY WHO UTILIZES CERTAIN DESIGNATED LOW-COST