SB 462: "Surprise Billing Consumer Protection Act"; insurance coverage for certain out-of-network ambulance transportation service; provide

This bill amends Georgia's insurance code in two main ways. First, it revives a currently reserved section of law to require companies that sell private passenger auto insurance to report detailed financial data to the Department of Insurance every year starting July 1, 2028. If the Commissioner of Insurance finds an insurer made 'excess profit,' defined as underwriting gains exceeding expected profit plus 6 percent of earned premiums over five years, the Commissioner can order the company to refund policyholders in cash or as a credit toward renewal premiums, unless the refund would make the insurer insolvent. Second, the bill rewrites the ambulance billing section of Georgia's Surprise Billing Consumer Protection Act (O.C.G.A. § 33-20E-23). It sets minimum reimbursement rates health plans must pay out-of-network ground ambulance providers, caps what patients can be charged in copayments or coinsurance, and requires insurers to pay clean claims directly to ambulance providers within 30 days. Most provisions take effect July 1, 2026; the ambulance section takes effect January 1, 2027.

• Requires auto insurers writing private passenger policies in Georgia to file annual financial data with the Department of Insurance starting July 1, 2028.
• Lets the Commissioner of Insurance order refunds when an insurer's underwriting gains exceed anticipated profit plus 6 percent of earned premiums over a five-year period.
• Sets a minimum reimbursement rate health plans must pay out-of-network ground ambulance providers, based on local government agreements or a formula tied to Medicare rates.
• Caps copayments, coinsurance, or deductibles for out-of-network ambulance service at the same level charged for in-network ambulance service.
• Requires insurers to pay clean ambulance claims directly to the provider within 30 days and to notify providers of denials or missing information.
• Bars insurers that issue refunds under the excess profit rule from adjusting commission, premium tax, or other tax payments because of the refund.

Auto insurance companies and their policyholders in Georgia, the Department of Insurance and Commissioner of Insurance, ground ambulance providers (public and private), health insurers and health plan enrollees who use out-of-network ambulance transport, and local governments that set ambulance reimbursement rates by ordinance or contract.

Georgia drivers could see refunds if regulators determine their auto insurer earned excess profits, while patients who use an out-of-network ambulance would face capped copayments and be shielded from most billing beyond that, with insurers paying providers directly instead of billing patients.

• Section 1 revives O.C.G.A. § 33-9-41 to define 'excess profit' and require annual data filings from private passenger auto insurers starting July 1, 2028.
• Section 1 gives the Commissioner authority to order excess profit refunds as cash within 60 days or as a credit on renewal premiums, after notice and an opportunity for a hearing.
• Section 1 exempts an insurer from refunding excess profit if doing so would cause financial impairment or insolvency.
• Section 2 rewrites O.C.G.A. § 33-20E-23 to set minimum reimbursement rates for out-of-network ground ambulance service, using local agreements or 325 percent of Medicare rates as a default.
• Section 2 caps patient copayments, coinsurance, or deductibles for out-of-network ambulance service at in-network levels.
• Section 2 requires insurers to pay clean ambulance claims within 30 days directly to the provider, not the patient.
• Section 3 sets the general effective date as July 1, 2026, while the ambulance billing provisions in Section 2 take effect January 1, 2027.

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

• Shawn Still (R, SD-048)Patrocinador principal
• 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. AprobadaVotación: Senado18 de febrero de 2026

   51 a favor, 1 en contra (0 sin votar, 2 ausentes)

   Passage: Senate Vote #557

2. AprobadaVotación: Cámara de Representantes31 de marzo de 2026

   167 a favor, 0 en contra (4 sin votar, 5 ausentes)

   Passage: House Vote #806

• auto insurance regulation
• surprise medical billing
• ambulance services
• insurance refunds
• health insurance