Alabama 2025 Regular Session

Alabama Senate Bill SB195 Compare Versions

Only one version of the bill is available at this time.

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1	1	SB195INTRODUCED
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3	3	SB195
4	4	W1Z2YE5-1
5	5	By Senator Orr
6	6	RFD: Finance and Taxation Education
7	7	First Read: 25-Feb-25
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12	12	5 W1Z2YE5-1 02/24/2025 KMS (L)cr 2025-864
13	13	Page 1
14	14	First Read: 25-Feb-25
15	15	SYNOPSIS:
16	16	Under existing law, the Public Education
17	17	Employees' Health Insurance (PEEHIP) Board is required
18	18	to renegotiate contracts for health benefit plans every
19	19	three years.
20	20	This bill would require the renegotiation of
21	21	contracts for Medicare retiree health benefit plans
22	22	every five years.
23	23	A BILL
24	24	TO BE ENTITLED
25	25	AN ACT
26	26	Relating to the Public Education Employees' Health
27	27	Insurance (PEEHIP) Board; to amend Section 16-25A-7, Code of
28	28	Alabama 1975; to require the renegotiation of contracts for
29	29	Medicare retiree health benefit plans every five years.
30	30	BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
31	31	Section 1. Section 16-25A-7 of the Code of Alabama
32	32	1975, is amended to read as follows:
33	33	"§16-25A-7
34	34	(a) The board is hereby authorized to may execute a
35	35	contract or contracts to provide for the benefits or the
36	36	administration of the plan determined in accordance with the
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66	66	administration of the plan determined in accordance with the
67	67	provisions of this article. Such The contract or contracts may
68	68	be executed with one or more agencies or corporations licensed
69	69	to transact or administer group health insurance business in
70	70	this state. All of the benefits to be provided under this
71	71	article may be included in one or more similar contracts
72	72	issued by the same or different companies. The board is
73	73	further authorized to develop a plan whereby it the board may
74	74	become self-insured upon its finding that such the arrangement
75	75	would be financially advantageous to the state and plan
76	76	participants.
77	77	(b)(1) Before entering into any contract or contracts
78	78	authorized by subsection (a), the board shall invite
79	79	competitive bids from all qualified entities who may wish to
80	80	administer or offer plans for the health insurance coverage or
81	81	the administrative services desired. The board shall award
82	82	such the contract or contracts on a competitive basis as
83	83	determined by the benefits afforded, administrative costs, the
84	84	costs to be incurred by employee, retiree, and employer, the
85	85	experience of the offering company or agency in the group
86	86	health insurance field , and its facilities for the handling of
87	87	claims. In evaluating these factors the board may employ the
88	88	services of impartial professional insurance analysts or
89	89	actuaries.
90	90	(2) The board shall reevaluate the contract or
91	91	contracts yearly, and renegotiate all contracts, except for
92	92	contracts for Medicare retiree health care, on a competitive
93	93	basis at least every three years. Contracts for Medicare
94	94	retiree health care shall be renegotiated on a competitive
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124	124	retiree health care shall be renegotiated on a competitive
125	125	basis at least every five years.
126	126	(c) The board may authorize the carrier with whom the
127	127	primary contracts are executed to reinsure portions of such
128	128	the contract with other such carriers which elect to be a
129	129	reinsurer and who are legally qualified to enter into
130	130	reinsurance agreement under the laws of this state.
131	131	(d) Each employee or retired employee who is covered by
132	132	the plan provided pursuant to this article shall receive
133	133	evidence of such the coverage. In addition, each employee or
134	134	retired employee shall receive , upon request, information
135	135	setting forth the benefits to which the employee or retired
136	136	employee and his or her dependents are entitled, to whom such
137	137	the benefits shall be payable, to whom claims shall be
138	138	submitted, and a summary of the provisions of the plan as they
139	139	affect the employee and his or her dependents.
140	140	(e) The plan shall require adequate notice in writing
141	141	to any participant whose claim for benefits under the plan has
142	142	been denied, setting forth the specific reasons for such the
143	143	denial and shall afford a reasonable opportunity to any
144	144	participant whose claim for benefits has been denied for a
145	145	full and fair review by the claims administrator upon the
146	146	written request of the participant, within 60 days of after
147	147	the date of denial, setting forth the specific reasons for
148	148	review. The claims administrator shall provide in writing,
149	149	within 60 days of after the request for review, a final
150	150	determination of the claim provided that an extension of 60
151	151	days may be obtained upon written notification to the
152	152	participant. Review of a final decision by the claims
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182	182	participant. Review of a final decision by the claims
183	183	administrator shall be by the Circuit Court of Montgomery
184	184	County as provided for the review of contested cases under the
185	185	Alabama Administrative Procedure Act, Section 41-22-20.
186	186	(f) The board may, at the end of any contract period ,
187	187	may discontinue any contract or contracts it the board has
188	188	executed with any carrier and replace same with a contract or
189	189	contracts with any other carrier or carriers meeting the
190	190	requirements of this article.
191	191	(g) The Public Education Employees' Health Insurance
192	192	Board may enter into contracts of the State Employees'
193	193	Insurance Board that were awarded through a competitive bid
194	194	process, upon the mutual consent of the State Employees'
195	195	Insurance Board and the contractor."
196	196	Section 2. This act shall become effective immediately.
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