§ 26-19-308 — Health benefit plan committee

(a) The commissioner shall appoint a health benefit plan
committee. The committee shall be composed of seven (7)
members, which shall include:
(i) The commissioner;
(ii) Three (3) representatives of participating
carriers; and
(iii) One (1) representative each of a small
employer, an employee of a small employer and a health care
provider.
(b) The committee shall recommend the form and level of
coverages to be made available by small employer carriers
pursuant to W.S. 26-19-306.
(c) The committee shall recommend benefit levels, cost
sharing factors, exclusions and limitations for the basic health
benefit plan and the standard health benefit plan. One (1)
basic health benefit plan and one (1) standard health care plan
shall contain benefit and cost sharing levels that are
consistent with the basic method of operation and the benefit
plans of health maintenance organizations, including any
restrictions imposed by federal law:
(i) The plans recommended by the committee may
include cost containment features such as, but not limited to:
(A) Utilization review of health care services,
including review of medical necessity of hospital and physician
services;
(B) Case management benefit alternatives;
(C) Reasonable benefit differentials applicable
to participating and nonparticipating providers; and
(D) Other managed care provisions.
(ii) The committee shall submit the plans to the
commissioner for approval within one hundred eighty (180) days
after the appointment of the committee pursuant to this section.
If the commissioner disapproves of the plans in whole or in part
he shall submit alternative interim plans to the committee for
its approval.
(d) Members of the committee shall be reimbursed from the
assets of the program for expenses incurred by them as members
of the committee but shall not otherwise be compensated by the
program for their services.