SB462: SB462 "Surprise Billing Consumer Protection Act"; insurance coverage for certain out-of-network ambulance transportation service; provide

This bill makes two separate changes to Georgia insurance law. First, it revises a reserved section of the insurance code to require auto insurers to report detailed financial data each year, starting July 1, 2028, so the Department of Insurance can check whether the insurer earned more profit than allowed. If the Commissioner of Insurance finds excess profit, defined as underwriting gains exceeding expected profit plus 6 percent of earned premiums over five years, the insurer must submit a refund plan and pay policyholders back through a cash refund or a credit toward their next premium, unless the refund would make the insurer financially unstable. Second, the bill amends the state's Surprise Billing Consumer Protection Act to address out-of-network ground ambulance bills. It sets a minimum reimbursement rate insurers must pay ambulance providers, caps what patients can be charged in copayments or deductibles, and requires insurers to pay ambulance providers directly within 30 days of a clean claim. The auto insurance provisions and most ambulance provisions take effect July 1, 2026, while the ambulance payment section takes effect January 1, 2027.

• Requires private passenger auto insurers to report five years of premium, loss, and expense data annually to the Department of Insurance starting no later than July 1, 2028.
• Lets the Commissioner of Insurance order refunds when an auto insurer's underwriting gains exceed anticipated profit plus 6 percent of earned premiums, defined as 'excess profit'.
• Gives insurers notice and a right to a hearing before being required to refund excess profit, and lets them avoid refunds if it would cause financial impairment.
• Sets a minimum payment rate for out-of-network ground ambulance rides, based on local government contracts or, absent those, 325 percent of Medicare's rate or the provider's billed charge, whichever is lower.
• Caps patient copayments, coinsurance, and deductibles for out-of-network ambulance rides at the same level charged for in-network ambulance service.
• Requires insurers to pay ambulance providers directly within 30 days of a clean (complete) claim, rather than sending payment to the patient.

Private passenger auto insurance companies operating in Georgia, policyholders who may be owed refunds, ground ambulance providers (including local fire and EMS agencies), patients who use out-of-network ambulance transport, and the Georgia Department of Insurance, which gains new reporting and enforcement duties.

Georgians who use out-of-network ambulances would face capped copayments and be shielded from surprise balance bills, while ambulance providers would get a guaranteed minimum payment and faster processing. Auto insurance customers could see refunds or premium credits if regulators find their insurer earned excess profits.

• Section 1 rewrites O.C.G.A. § 33-9-41 to define 'excess profit' and require annual data filings from auto insurers by July 1, 2028, covering premiums, losses, expenses, and dividends.
• Section 1 lets the Commissioner order a refund plan, require cash refunds within 60 days of a final order, or apply credits to renewal premiums, and bars insurers from adjusting commissions or taxes because of a refund.
• Section 2 rewrites O.C.G.A. § 33-20E-23 to require healthcare plans to treat ambulance transport requested by a first responder as a covered service.
• Section 2 sets the minimum reimbursement rate for out-of-network ambulance service at a local government-negotiated rate, or otherwise the lesser of 325 percent of Medicare rates or the provider's billed charge.
• Section 2 caps patient copayments, coinsurance, and deductibles for out-of-network ambulance rides at in-network levels and requires direct payment to the provider within 30 days of a clean claim.
• Section 3 sets the effective date as July 1, 2026 for most provisions, but January 1, 2027 specifically for the ambulance payment rules in Section 2.

1. 2026-03-31House Passed/Adopted By Substitute (House)
2. 2026-03-31House Third Readers (House)
3. 2026-03-20House Committee Favorably Reported By Substitute (House)
4. 2026-03-09House Withdrawn, Recommitted (House)
5. 2026-02-20House Second Readers (House)
6. 2026-02-19House First Readers (House)
7. 2026-02-18Senate Passed/Adopted (Senate)
8. 2026-02-18Senate Third Read (Senate)

• Shawn Still (R, SD-048)Primary sponsor
• Jason Anavitarte (R, SD-031)
• Ben Watson (R, SD-001)
• Sally Harrell (D, SD-040)
• Bo Hatchett (R, SD-050)
• Sonya Halpern (D, SD-039)
• Chuck Hufstetler (R, SD-052)
• Kay Kirkpatrick (R, SD-032)
• Matt Reeves (R, HD-099)

1. PassedSenate voteFebruary 18, 2026

   51 yea, 1 nay (0 not voting, 2 absent)

   Passage: Senate Vote #557

2. PassedHouse voteMarch 31, 2026

   167 yea, 0 nay (4 not voting, 5 absent)

   Passage: House Vote #806

• surprise billing
• ambulance costs
• auto insurance regulation
• insurance refunds
• health insurance coverage