---
title: SB 262. Insurance; health benefit policies to cover preventive services; provide
collection: bills
id: 2025-2026/sb262
cite_as: SB 262, 2025-2026 Regular Session (Ga.)
canonical_url: https://georgiacommons.org/bills/2025-2026/sb262
md_url: https://georgiacommons.org/bills/2025-2026/sb262.md
text_url: https://georgiacommons.org/bills/2025-2026/sb262/text
source_url: https://www.legis.ga.gov/legislation/70878
date: 2025-02-27
status: introduced
corpus_version: bills-2026-09-13
license: Public record of the Georgia General Assembly, via LegiScan; see about.md
publisher: Georgia Commons, an independent project of Georgia Civic Data. Not the State of Georgia. Not legal advice.
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omitted: votes and history
omitted_chars: 95
omitted_url: https://georgiacommons.org/bills/2025-2026/sb262.md?full=1
bill_number: SB 262
session: 2025-2026 Regular Session
session_slug: 2025-2026
chamber: Senate
bill_type: bill
status_date: 2025-02-26
last_action: Senate Read and Referred
sponsors:
- Sonya Halpern
- Chuck Hufstetler
- Russ Goodman
- Sam Watson
- Shawn Still
- Carden Summers
- Harold Jones
- Ben Watson
text_version: Introduced
has_text: true
legiscan_url: https://legiscan.com/GA/bill/SB262/2025
upstream_id: 1985987
summaries_model: claude-sonnet-5
topic_tags:
- health insurance
- preventive care
- insurance regulation
- health savings accounts
- insurance coverage mandates
---
# SB 262. Insurance; health benefit policies to cover preventive services; provide
## Text
Senate Bill 262
By: Senators Halpern of the 39th, Hufstetler of the 52nd, Goodman of the 8th, Watson of the
11th, Still of the 48th and others
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to
insurance generally, so as to provide for health benefit policies to cover preventive services;
to provide for definitions; to prohibit cost-sharing requirements; to protect the eligibility of
health savings accounts; to provide for review by the Commissioner of Insurance; to provide
for rules and regulations; to provide for related matters; to repeal conflicting laws; and for
other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to insurance
generally, is amended by adding a new article to read as follows:
"ARTICLE 5
33-24-100.
As used in this article, the term:
(1) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any
maximum limitation on the application of such deductible, coinsurance, copayment, or
similar out-of-pocket expense.
(2) 'Evidence based' means founded on principles and concepts supported by research,
practical strategies learned from clinical experience, and practices consistent with an
individual's needs and circumstances.
(3) 'Evidence informed' means incorporating evidence, clinical experience or
professional expertise, and the perspectives of an individual directly affected.
(4) 'Health benefit policy' means any individual or group plan, policy, or contract for
healthcare services issued, delivered, issued for delivery, executed, or renewed in this
state which provides major medical benefits, including those contracts executed by this
state on behalf of indigents and on behalf of state employees under Article 1 of
Chapter 18 of Title 45, on behalf of public school teachers and employees under Part 6
of Article 17 of Chapter 2 of Title 20, and on behalf of members and employees of the
board of regents under Code Section 31-2-4, by a healthcare corporation, health
maintenance organization, preferred provider organization, accident and sickness insurer,
fraternal benefit society, hospital service corporation, medical service corporation, or any
similar entity and any self-insured healthcare plan not subject to the exclusive jurisdiction
of the Employee Retirement Income Security Act of 1974, 29 U.S.C. Section 1001, et
seq.
(5) 'Health insurer' means an entity subject to the insurance laws and regulations of this
state, or subject to the jurisdiction of the Commissioner, that contracts, offers to contract,
or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of
the costs of healthcare services.
(6) 'Nationally recognized clinical practice guidelines' means evidence based or evidence
informed clinical practice guidelines developed by medical or public health experts in
independent organizations, medical professional societies, or the federal government
utilizing a transparent methodology and reporting structure and with a conflict-of-interest
policy such as the United States Preventive Services Task Force, and by guidelines
established by federal agencies such as the Advisory Committee on Immunization
Practices of the Centers for Disease Control and Prevention and the Health Resources and
Services Administration of the United States Department of Health and Human Services.
Such guidelines establish standards of care informed by a systematic review of evidence
and an assessment of the benefits and risks of alternative care options and include
recommendations intended to optimize patient care.
(7) 'Preventive services' means clinical products or services, including, but not limited
to, screening tests, counseling services, and prescription medicines, that are
recommended for individuals in accordance with nationally recognized clinical practice
guidelines to prevent health problems before they develop, occur, or worsen, as further
provided in Code Section 33-24-101.
33-24-101.
Preventive services includes:
(1) Evidence based items and services that are necessary for implementing the federal
Patient Protection and Affordable Care Act as it existed January 1, 2025, and have a high
or moderate net benefit for the individual directly affected;
(2) Immunizations for routine use in children, adolescents, and adults;
(3) Evidence informed preventive care and screenings for infants, children, and
adolescents;
(4) Evidence informed preventive care for women; and
(5) Any preventive services as required under federal or state law in existence
January 1, 2025.
33-24-102.
(a) Every health insurer shall provide coverage for preventive services for covered persons
under such policy.
(b) The coverage provided for in subsection (a) of this Code section shall not be subject
to any cost-sharing requirement of the covered person's health benefit policy and shall not
diminish or limit any other benefits provided under such policy.
(c) Nothing in this article shall prohibit a health insurer from providing coverage for items
and services in addition to those provided for in subsection (a) of this Code section or from
denying coverage for items and services that are not provided for in subsection (a) of this
Code section.
33-24-103.
If application of the provisions of this Code section would result in health savings account
ineligibility under 26 U.S.C. Section 223 as it existed on January 1, 2025, then such
provisions shall apply only to health savings accounts with qualified high deductible health
plans with respect to the deductibles of such plans after the individual has satisfied the
minimum deductibles; provided, however, that the provisions of this Code section shall
apply to items and services that are deemed to be preventive care.
33-24-104.
(a) No later than January 1, 2026, and annually thereafter, the Commissioner shall review
health benefit policies provided by health insurers to ensure compliance with this article.
(b) No later than October 1, 2025, the Commissioner shall promulgate rules and
regulations necessary to implement the provisions of this article in accordance with
nationally recognized clinical practice guidelines. The Commissioner shall regularly
review nationally recognized clinical practice guidelines to determine if rules and
regulations promulgated pursuant to this subsection require modification."
SECTION 2.
All laws and parts of laws in conflict with this Act are repealed.
## Summaries written by Georgia Commons
The following was written by claude-sonnet-5 from the text above and is not part of the bill. Quote the text, not the summary.
A Georgia Senate bill would require health insurers in the state to cover preventive care, such as screenings, immunizations, and preventive medicines, without charging deductibles, copays, or coinsurance.
### Plain-language summary
Currently, Georgia law does not separately guarantee that health insurance plans must cover preventive care like cancer screenings, vaccines, and preventive prescriptions without out-of-pocket costs. This bill adds a new article to Georgia's insurance code (O.C.G.A. Title 33, Chapter 24) requiring every health insurer offering a health benefit policy in the state to cover preventive services recommended by nationally recognized clinical guidelines, such as those from the U.S. Preventive Services Task Force and the CDC's immunization advisory committee.
The bill defines preventive services broadly to include items required under the federal Affordable Care Act as it existed on January 1, 2025, childhood and adult immunizations, and preventive screenings for children and women. Insurers cannot apply deductibles, copays, or coinsurance to this coverage. The bill protects health savings account eligibility by limiting the no-cost-sharing rule for high deductible health plans until the minimum deductible is met. The Commissioner of Insurance must write implementing rules by October 1, 2025, and review insurer compliance starting January 1, 2026.
### What it does
- Requires every health insurer in Georgia to cover preventive services, including screenings, immunizations, counseling, and certain prescription medicines.
- Prohibits insurers from applying deductibles, copays, coinsurance, or similar out-of-pocket costs to this preventive care coverage.
- Defines preventive services by reference to nationally recognized clinical guidelines and to items required under the Affordable Care Act as it existed January 1, 2025.
- Protects eligibility for health savings accounts by allowing cost-sharing to apply to high deductible health plans until the minimum deductible is met, except for preventive care.
- Directs the Commissioner of Insurance to issue implementing rules by October 1, 2025 and to annually review insurer compliance starting January 1, 2026.
### Who it affects
Georgia residents with individual or group health benefit policies, including state employees, public school teachers and employees, university system employees, and Medicaid enrollees covered under state contracts. Health insurers, HMOs, and similar entities that must provide the coverage, and the Georgia Department of Insurance, which must write rules and monitor compliance.
### Why it matters
If enacted, Georgians with covered health plans would be able to get preventive screenings, vaccines, and certain preventive medicines without paying a deductible, copay, or coinsurance, potentially lowering costs for routine and preventive care while adding a new compliance requirement for insurers operating in the state.
### Key provisions
- Section 1 adds a new Article 5 to Chapter 24 of Title 33, defining terms like 'cost-sharing requirement,' 'health benefit policy,' 'health insurer,' and 'nationally recognized clinical practice guidelines' (O.C.G.A. § 33-24-100).
- Code Section 33-24-101 lists categories of required preventive services, including ACA-based items, immunizations, and preventive care for children, adolescents, and women.
- Code Section 33-24-102 requires health insurers to cover these preventive services without cost-sharing and without reducing other policy benefits, while allowing insurers to offer additional coverage voluntarily.
- Code Section 33-24-103 limits the no-cost-sharing rule for high deductible health plans linked to health savings accounts, so those accounts remain eligible under federal tax law (26 U.S.C. § 223).
- Code Section 33-24-104 requires the Commissioner of Insurance to issue implementing rules by October 1, 2025 and to review insurer compliance annually starting January 1, 2026.
- Section 2 repeals any conflicting Georgia laws.
## Status
- Status: Introduced (2025-02-26)
- Last action: Senate Read and Referred (2025-02-27)
- Sponsors: Sonya Halpern, Chuck Hufstetler, Russ Goodman, Sam Watson, Shawn Still, Carden Summers, Harold Jones, Ben Watson
- Official page: https://www.legis.ga.gov/legislation/70878
> The history, votes, and amendments (95 characters) are at https://georgiacommons.org/bills/2025-2026/sb262.md?full=1