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Other proposed regulatory ideas include the concept of Optional Federal Chartering (OFC), which would keep state regulation in place but allow an insurer to choose to be regulated under a single federal charter instead of on a state-by-state basis. An example is the National Insurance Act of 2007, S. 40, 110th Cong. (2007), introduced by Sens. Sununu (R-NH) and Johnson (D-SD). The bill was also introduced in companion form H.R.3200, 110th Cong. (2007) by Reps. Bean (D-IL) and Royce (R-CA). To date, the major OFC proposals have not included medical insurance.Google Scholar

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Property and casualty insurers (P/C insurers) have traditionally employed this antitrust exception to pool information through rating bureaus in order to forecast claims trend and market analysis, with the goal of reducing administrative costs and promoting a more competitive insurance market. These bureaus are sanctioned under state law to comply with state antitrust laws in all states in which they operate.Google Scholar

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These states include the following: Alaska, Arkansas, California, Connecticut, Florida, Kansas, Kentucky, Maine, Maryland, Massachusetts, Nevada, New York, North Carolina, Oregon, South Carolina, Tennessee, Vermont, Virginia, West Virginia, and Wisconsin. Id.Google Scholar

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State PASL legislation has been building momentum. See, e.g., H.B. 1327, 66th Gen. Assem., 2d Reg. Sess. (Colo. 2008) (allowing a carrier that is not subject to Colorado law to sell a policy to a Colorado resident if the policy is lawfully sold in another state; the out-of-state policy would be subject to Colorado's prompt pay law and the state's claim denial and internal appeals requirements); S.B. 1190, 190th Gen. Assem. (Pa. 2007) (providing that a state resident has the right to purchase health insurance from a foreign insurer, regardless of whether the foreign insurer is licensed or in compliance with state laws); H.B. 214, 2007–2008 Legis. Sess. (Vt. 2007) (allowing Vermont residents to purchase health insurance policies sold in other states, provided certain financial and consumer protection requirements of Vermont law are met, such as surplus and reserve requirements, disclosure and reporting requirements, and grievance procedures).Google Scholar

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