Healthcare (Insurance)

passed · North Carolina · House May 1, 2025

HB 156: Increase Access for Small Employers/Insurance.

HB 156 sets minimum standards for stop loss, catastrophic, and reinsurance coverage provided to small employers in North Carolina. It directly affects small employers (defined as those with fewer than 12 eligible employees) and insurers selling these specific insurance products. The bill requires insurers to maintain a minimum annual attachment point of $20,000 per individual (adjusted annually using the Consumer Price Index) and a minimum aggregate attachment point of either 120% of expected claims or $20,000 per year. These standards apply to all new, renewed, or amended insurance contracts issued on or after October 1, 2025.

Topics ✓ HealthcareSupports HealthcareSets minimum insurance standards (e.g., $20k attachment point) for small employers, directly improving coverage access and protecting against excessive out-of-pocket costs for healthcare services.95% confidence

Sub-Topics Insurance

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in committee · North Carolina · House Mar 20, 2025

HB 463: First Responders Mental Health Plan Act.

HB 463 establishes a supplemental insurance plan for North Carolina first responders diagnosed with specific mental health conditions (like anxiety, depression, or PTSD) directly resulting from their job. It provides three key benefits: up to $5,000 annually for out-of-pocket mental health costs, 75% of salary or $5,000 monthly (max 12 weeks/year) for leave due to treatment, and disability benefits (75% salary or $5,000/month, max 36 months) if unable to work. Eligibility requires a job-related diagnosis, current employment as a defined first responder (including police, firefighters, EMTs, and dispatchers), and exclusion from workers' compensation benefits. The plan aims to support recovery and return to duty while limiting benefits to cover gaps not met by other sources.

Topics ✓ HealthcareSupports HealthcareBill establishes supplemental mental health insurance for first responders, covering out-of-pocket costs and providing income replacement during treatment. Directly expands mental health coverage and funding for a vulnerable workforce.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentProvides job-related mental health benefits including financial support and leave, strengthening worker protections for first responders.95% confidence

Sub-Topics Insurance Substance Abuse Workers' Compensation

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passed both · North Carolina · House May 12, 2026

HB 390: Medicaid Prepaid Health Plan Practices.

House Bill 390, titled "Alleviate the Dangers of Surgical Smoke," establishes new standards for surgical smoke evacuation in North Carolina. This bill requires all licensed hospitals and ambulatory surgical facilities to adopt and implement policies mandating the use of a smoke evacuation/filtering system during surgical procedures likely to generate surgical smoke. A smoke evacuation/filtering system is defined as equipment that captures, filters, and eliminates surgical smoke at its origin. The Department of Health and Human Services is authorized to take adverse action against facilities that violate these new requirements. This act is scheduled to become effective on January 1, 2026.

Topics ✓ HealthcareSupports HealthcareMandates smoke evacuation systems in hospitals to protect staff/patients from surgical smoke dangers, enhancing healthcare safety standards.90% confidence

Sub-Topics Insurance Medicaid

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in committee · North Carolina · Senate Mar 25, 2025

SB 441: Revive High-Need Retired Teachers Program.

SB 441 revives and expands a program allowing retired teachers to return to work in high-need North Carolina schools without losing their retirement benefits. The bill requires school districts to certify these teachers to the retirement system annually and mandates monthly reports on their employment terms and pay. Retired educators rehired under this program retain their full retirement allowance, and school districts must cover employer health insurance premiums for them. This directly affects retired teachers returning to high-need schools, school districts hiring them, and the state retirement system’s benefit calculations. The program expires June 30, 2027, unless IRS status is jeopardized, triggering automatic repeal.

Topics ✓ EducationSupports EducationBill revives program allowing retired teachers to return to high-need schools without losing retirement benefits or health coverage, directly supporting teacher retention and access in underserved schools.90% confidence ✓ HealthcareSupports HealthcareMandates school districts cover employer health insurance premiums for rehired retired teachers, maintaining their healthcare benefits as part of the program.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentPreserves retirement benefits and mandates health insurance coverage for rehired retired teachers, protecting their financial security and employment benefits without restrictions.95% confidence

Sub-Topics Teachers Insurance

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passed · North Carolina · House Jun 24, 2025

HB 578: The Jason Flatt Act of North Carolina.

HB 578, the Jason Flatt Act, requires all North Carolina public K-12 schools to implement suicide prevention education and training for school staff. It mandates that licensed educators complete at least one hour of annual suicide prevention training, while staff working with grades 6-12 must receive guidelines for identifying at-risk students and procedures for referrals. Schools must adopt a mental health plan including these elements, with initial staff training of six hours (within six months of hire) and two hours annually thereafter. The law applies to all public schools, charter schools, regional schools, and lab schools starting the 2025-2026 school year.

Topics ✓ EducationSupports EducationMandates suicide prevention training for K-12 staff, enhancing mental health support within educational settings per bill requirements.95% confidence ✓ HealthcareSupports HealthcareMandates suicide prevention training and mental health plans in schools, strengthening mental health services under public health initiatives.95% confidence

Sub-Topics K-12 Education School Safety Student Health Insurance

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in committee · North Carolina · Senate Mar 3, 2025

SB 218: Increase Access for Small Employers/Insurance.

SB 218 requires insurers in North Carolina to provide stop loss, catastrophic, and reinsurance coverage to small employers (those with fewer than 12 eligible employees) that meet specific minimum standards. It mandates that policies must have a per-individual claim attachment point of at least $20,000 (adjusted annually using medical inflation rates) and an aggregate attachment point of at least $20,000 or 120% of expected claims, whichever is higher. These requirements apply to all new or renewed policies issued on or after October 1, 2025, ensuring small employers receive standardized coverage thresholds. The bill does not restrict insurers from offering additional wellness-focused benefits but sets baseline protections for coverage affordability.

Topics ✓ HealthcareSupports HealthcareMandates insurers to provide stop loss/catastrophic coverage for small employers, expanding access to comprehensive health insurance options and stabilizing coverage for vulnerable groups.92% confidence

Sub-Topics Insurance

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in committee · North Carolina · House Apr 3, 2025

HB 744: Fertility Preservation Pilot Program.

HB 744 establishes a three-year fertility preservation pilot program (2025-2032) using $2.25 million annually to help cancer patients who face financial barriers to fertility treatments. It directly affects individuals diagnosed with cancer or undergoing cancer treatment who are uninsured, have limited insurance coverage for fertility services, or would pay over $1,000 out-of-pocket, including those with household incomes below 300% of the federal poverty level. The program covers up to $12,000 for egg preservation/storage (women), $1,500 for sperm preservation (men), and $26,000 for IVF/IUI procedures, administered by three designated North Carolina medical centers. Grantees must report annually on services provided and program effectiveness, with funds expiring June 30, 2032.

Topics ✓ HealthcareSupports HealthcareAllocates $2.25M annually to fund fertility preservation for cancer patients facing financial barriers, expanding access to health services and supporting cancer care continuity.95% confidence

Sub-Topics Insurance

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in committee · North Carolina · Senate Feb 25, 2025

SB 139: Restore State Emp/Teacher Retiree Med Benefit.

SB 139 prevents the elimination of medical benefits for North Carolina state teachers and employees who first earned retirement service on or after January 1, 2021. It reverses a prior change that would have cut these benefits by repealing specific sections of law, effective retroactively to December 31, 2020. The bill appropriates $500,000 annually for 2025-2026 and $2 million annually for 2026-2027 to cover increased costs for the state health plan. This restores medical coverage for affected retirees under several retirement systems, effective July 1, 2025.

Topics ✓ Budget & TaxesSupports Budget & TaxesRestores medical benefits via $500k/$2M annual appropriations, directly funding a state program through budgetary means.95% confidence ✓ EducationSupports EducationRestores medical benefits for teachers, directly supporting educator compensation and retention per bill's purpose and subjects list.95% confidence ✓ HealthcareSupports HealthcareRestores medical benefits for retirees and appropriates funds to cover increased costs, directly supporting health insurance coverage for state employees and teachers.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentRestores medical benefits for state teachers/employees by reversing cuts to retirement health coverage, directly protecting existing employment benefits under Labor & Employment.95% confidence

Sub-Topics Teachers Insurance

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in committee · North Carolina · House Mar 20, 2025

HB 456: No Surprises for Ambulance Services Act.

HB 456, the "No Surprises for Ambulance Services Act," prevents unexpected high costs for ambulance services by requiring health insurance companies to cover both emergency and non-emergency ground ambulance transport without surprise bills. Specifically, it caps out-of-network cost-sharing (like copays or deductibles) for ambulance services at 110% of what would apply for in-network providers, ensuring patients aren’t charged more for using an ambulance outside their insurance network. This directly affects insured individuals who use ambulance services, especially in emergencies or when they cannot choose a network provider. The law also mandates insurers to clearly disclose coverage details for emergency services, including cost-sharing and how to access care.

Topics ✓ HealthcareSupports HealthcarePrevents surprise bills for ambulance services, caps out-of-network costs at 110% of in-network rates, ensuring insurance coverage and protecting patient financial rights under health insurance.90% confidence

Sub-Topics Insurance Tags Public Safety

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in committee · North Carolina · Senate Mar 26, 2025

SB 572: Greater Access to Fertility Medication.

SB 572 requires health benefit plans that cover fertility treatment to remove annual or lifetime limits on ovulation medications and ovulation induction cycles, treating these medications the same as other prescription drugs. It applies to both private health plans (effective October 2025) and North Carolina’s State Health Plan for Teachers and State Employees (effective January 2026), which must eliminate such limits for in-network services. The bill does not mandate fertility treatment coverage but ensures existing coverage for ovulation medications faces no stricter restrictions than standard prescriptions. State funding of $300,000 (2025-26) and $600,000 (2026-27) will cover increased costs for the state health plan.

Topics ✓ HealthcareSupports HealthcareRemoves annual/lifetime limits on fertility medications, expanding insurance coverage for reproductive healthcare and treating these drugs equally with other prescriptions.95% confidence

Sub-Topics Insurance

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