Connecticut 2015 Regular Session

Connecticut Senate Bill SB01025 Compare Versions

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1-General Assembly Substitute Bill No. 1025
2-January Session, 2015 *_____SB01025INS___031215____*
1+General Assembly Raised Bill No. 1025
2+January Session, 2015 LCO No. 3851
3+ *03851_______INS*
4+Referred to Committee on INSURANCE AND REAL ESTATE
5+Introduced by:
6+(INS)
37
48 General Assembly
59
6-Substitute Bill No. 1025
10+Raised Bill No. 1025
711
812 January Session, 2015
913
10-*_____SB01025INS___031215____*
14+LCO No. 3851
15+
16+*03851_______INS*
17+
18+Referred to Committee on INSURANCE AND REAL ESTATE
19+
20+Introduced by:
21+
22+(INS)
1123
1224 AN ACT AUTHORIZING THE CONNECTICUT HEALTH INSURANCE EXCHANGE TO ESTABLISH SUBSIDIARIES.
1325
1426 Be it enacted by the Senate and House of Representatives in General Assembly convened:
1527
1628 Section 1. Subsections (a) to (c), inclusive, of section 38a-1083 of the general statutes are repealed and the following is substituted in lieu thereof (Effective from passage):
1729
1830 (a) For purposes of sections 38a-1080 to 38a-1091, inclusive, as amended by this act, "purposes of the exchange" means the purposes of and the pursuit of the goals of the exchange expressed in and pursuant to this section and the performance of the duties and responsibilities of the exchange set forth in sections 38a-1084 to 38a-1087, inclusive, which are hereby determined to be public purposes for which public funds may be expended. The powers enumerated in this section shall be interpreted broadly to effectuate the purposes of the exchange and shall not be construed as a limitation of powers.
1931
2032 (b) The goals of the exchange shall be to reduce the number of individuals without health insurance in this state and assist individuals and small employers in the procurement of health insurance by, among other services, offering easily comparable and understandable information about health insurance options.
2133
2234 (c) The exchange is authorized and empowered to:
2335
24-(1) Have perpetual [successions] succession as a body politic and corporate and to adopt bylaws for the regulation of its affairs and the conduct of its business;
36+(1) Have perpetual successions as a body politic and corporate and to adopt bylaws for the regulation of its affairs and the conduct of its business;
2537
2638 (2) Adopt an official seal and alter the same at pleasure;
2739
2840 (3) Maintain an office in the state at such place or places as it may designate;
2941
3042 (4) Employ such assistants, agents, managers and other employees as may be necessary or desirable;
3143
3244 (5) Acquire, lease, purchase, own, manage, hold and dispose of real and personal property, and lease, convey or deal in or enter into agreements with respect to such property on any terms necessary or incidental to the carrying out of these purposes, provided all such acquisitions of real property for the exchange's own use with amounts appropriated by this state to the exchange or with the proceeds of bonds supported by the full faith and credit of this state shall be subject to the approval of the Secretary of the Office of Policy and Management and the provisions of section 4b-23;
3345
3446 (6) Receive and accept, from any source, aid or contributions, including money, property, labor and other things of value;
3547
3648 (7) Charge assessments or user fees to health carriers that are capable of offering a qualified health plan through the exchange or otherwise generate funding necessary to support the operations of the exchange and impose interest and penalties on such health carriers for delinquent payments of such assessments or fees;
3749
3850 (8) Procure insurance against loss in connection with its property and other assets in such amounts and from such insurers as it deems desirable;
3951
4052 (9) Invest any funds not needed for immediate use or disbursement in obligations issued or guaranteed by the United States of America or the state and in obligations that are legal investments for savings banks in the state;
4153
4254 (10) Issue bonds, bond anticipation notes and other obligations of the exchange for any of its corporate purposes, and to fund or refund the same and provide for the rights of the holders thereof, and to secure the same by pledge of revenues, notes and mortgages of others;
4355
4456 (11) Borrow money for the purpose of obtaining working capital;
4557
4658 (12) Account for and audit funds of the exchange and any recipients of funds from the exchange;
4759
4860 (13) Make and enter into any contract or agreement necessary or incidental to the performance of its duties and execution of its powers. The contracts entered into by the exchange shall not be subject to the approval of any other state department, office or agency, provided copies of all contracts of the exchange shall be maintained by the exchange as public records, subject to the proprietary rights of any party to the contract;
4961
5062 (14) To the extent permitted under its contract with other persons, consent to any termination, modification, forgiveness or other change of any term of any contractual right, payment, royalty, contract or agreement of any kind to which the exchange is a party;
5163
5264 (15) Award grants to trained and certified individuals and institutions that will assist individuals, families and small employers and their employees in enrolling in appropriate coverage through the exchange. Applications for grants from the exchange shall be made on a form prescribed by the board;
5365
5466 (16) Limit the number of plans offered, and use selective criteria in determining which plans to offer, through the exchange, provided individuals and employers have an adequate number and selection of choices;
5567
5668 (17) Evaluate jointly with the SustiNet Health Care Cabinet the feasibility of implementing a basic health program option as set forth in Section 1331 of the Affordable Care Act;
5769
5870 (18) Establish one or more subsidiaries, in accordance with section 2 of this act, to further the purposes of the exchange;
5971
6072 (19) Make loans to each subsidiary established pursuant to section 2 of this act from the assets of the exchange and the proceeds of bonds, bond anticipation notes and other obligations issued by the exchange or assign or transfer to such subsidiary any of the rights, moneys or other assets of the exchange, provided such assignment or transfer is not in violation of state or federal law;
6173
6274 [(18)] (20) Sue and be sued, plead and be impleaded;
6375
6476 [(19)] (21) Adopt regular procedures that are not in conflict with other provisions of the general statutes, for exercising the power of the exchange; and
6577
6678 [(20)] (22) Do all acts and things necessary and convenient to carry out the purposes of the exchange, provided such acts or things shall not conflict with the provisions of the Affordable Care Act, regulations adopted thereunder or federal guidance issued pursuant to the Affordable Care Act.
6779
6880 Sec. 2. (NEW) (Effective from passage) (a) The exchange may establish one or more subsidiaries for such purposes as prescribed by resolution of the board of directors of the exchange, which purposes shall be consistent with the purposes of the exchange. Each subsidiary shall be deemed a quasi-public agency for the purposes of chapter 12 of the general statutes and shall have all the privileges, immunities, tax exemptions and other exemptions of the exchange. Any such subsidiary may be organized as a stock or nonstock corporation or a limited liability company.
6981
70-(b) Each subsidiary shall have and may exercise the powers of the exchange and such additional powers as are set forth in such resolution, except the powers of the exchange set forth in subdivisions (7), (12), (15), (16), (17) and (21) of subsection (c) of section 38a-1083 of the general statutes, as amended by this act, shall be reserved to the exchange and shall not be exercisable by any subsidiary of the exchange.
82+(b) Each subsidiary shall have and may exercise the powers of the exchange and such additional powers as are set forth in such resolution, except the powers of the exchange set forth in subdivisions (7), (12), (15), (16), (17) and (20) of subsection (c) of section 38a-1083 of the general statutes, as amended by this act, shall be reserved to the exchange and shall not be exercisable by any subsidiary of the exchange.
7183
7284 (c) (1) Each subsidiary shall act through a board of directors, at least one-half of which shall be members of the board of directors of the exchange or their designees or officers or employees of the exchange.
7385
7486 (2) The provisions of section 1-125 of the general statutes shall apply to any member of the board of directors of a subsidiary established under this section. Any such member shall not be personally liable for the debts, obligations or liabilities of any such subsidiary as provided in section 1-125 of the general statutes. Any such subsidiary shall, and the exchange may, save harmless and indemnify any such member as provided in section 1-125 of the general statutes.
7587
7688 (d) (1) Each subsidiary shall be subject to suit, provided its liability shall be limited solely to the assets, revenues and resources of such subsidiary and without recourse to the general funds, revenues or resources or any other assets of the exchange.
7789
7890 (2) Each subsidiary may convey or dispose of its assets and pledge its revenues to secure any borrowing, provided any such borrowing shall be a special obligation of the subsidiary and shall be payable solely from the assets, revenues and resources of the subsidiary.
7991
8092 (3) Each subsidiary or the exchange may take any action necessary to comply with the provisions of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time, to qualify and maintain any subsidiary as a corporation exempt from taxation under said code.
8193
8294 Sec. 3. Section 38a-1080 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
8395
8496 For purposes of sections 38a-1080 to 38a-1091, inclusive, and section 2 of this act:
8597
8698 (1) "Board" means the board of directors of the Connecticut Health Insurance Exchange;
8799
88100 (2) "Commissioner" means the Insurance Commissioner;
89101
90102 (3) "Exchange" means the Connecticut Health Insurance Exchange established pursuant to section 38a-1081;
91103
92104 (4) "Affordable Care Act" means the Patient Protection and Affordable Care Act, P.L. 111-148, as amended by the Health Care and Education Reconciliation Act, P.L. 111-152, as both may be amended from time to time, and regulations adopted thereunder;
93105
94106 (5) (A) "Health benefit plan" means an insurance policy or contract offered, delivered, issued for delivery, renewed, amended or continued in the state by a health carrier to provide, deliver, pay for or reimburse any of the costs of health care services.
95107
96108 (B) "Health benefit plan" does not include:
97109
98110 (i) Coverage of the type specified in subdivisions (5), (6), (7), (8), (9), (14), (15) and (16) of section 38a-469 or any combination thereof;
99111
100112 (ii) Coverage issued as a supplement to liability insurance;
101113
102114 (iii) Liability insurance, including general liability insurance and automobile liability insurance;
103115
104116 (iv) Workers' compensation insurance;
105117
106118 (v) Automobile medical payment insurance;
107119
108120 (vi) Credit insurance;
109121
110122 (vii) Coverage for on-site medical clinics; or
111123
112124 (viii) Other similar insurance coverage specified in regulations issued pursuant to the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended from time to time, under which benefits for health care services are secondary or incidental to other insurance benefits.
113125
114126 (C) "Health benefit plan" does not include the following benefits if they are provided under a separate insurance policy, certificate or contract or are otherwise not an integral part of the plan:
115127
116128 (i) Limited scope dental or vision benefits;
117129
118130 (ii) Benefits for long-term care, nursing home care, home health care, community-based care or any combination thereof; or
119131
120132 (iii) Other similar, limited benefits specified in regulations issued pursuant to the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended from time to time;
121133
122134 (iv) Other supplemental coverage, similar to coverage of the type specified in subdivisions (9) and (14) of section 38a-469, provided under a group health plan.
123135
124136 (D) "Health benefit plan" does not include coverage of the type specified in subdivisions (3) and (13) of section 38a-469 or other fixed indemnity insurance if (i) such coverage is provided under a separate insurance policy, certificate or contract, (ii) there is no coordination between the provision of the benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor, and (iii) the benefits are paid with respect to an event without regard to whether benefits were also provided under any group health plan maintained by the same plan sponsor;
125137
126138 (6) "Health care services" has the same meaning as provided in section 38a-478;
127139
128140 (7) "Health carrier" means an insurance company, fraternal benefit society, hospital service corporation, medical service corporation, health care center or other entity subject to the insurance laws and regulations of the state or the jurisdiction of the commissioner that contracts or offers to contract to provide, deliver, pay for or reimburse any of the costs of health care services;
129141
130142 (8) "Internal Revenue Code" means the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time;
131143
132144 (9) "Person" has the same meaning as provided in section 38a-1;
133145
134146 (10) "Qualified dental plan" means a limited scope dental plan that has been certified in accordance with subsection (e) of section 38a-1086;
135147
136148 (11) "Qualified employer" has the same meaning as provided in Section 1312 of the Affordable Care Act;
137149
138150 (12) "Qualified health plan" means a health benefit plan that has in effect a certification that the plan meets the criteria for certification described in Section 1311(c) of the Affordable Care Act and section 38a-1086;
139151
140152 (13) "Qualified individual" has the same meaning as provided in Section 1312 of the Affordable Care Act;
141153
142154 (14) "Secretary" means the Secretary of the United States Department of Health and Human Services;
143155
144156 (15) "Small employer" has the same meaning as provided in section 38a-564.
145157
146158
147159
148160
149161 This act shall take effect as follows and shall amend the following sections:
150162 Section 1 from passage 38a-1083(a) to (c)
151163 Sec. 2 from passage New section
152164 Sec. 3 from passage 38a-1080
153165
154166 This act shall take effect as follows and shall amend the following sections:
155167
156168 Section 1
157169
158170 from passage
159171
160172 38a-1083(a) to (c)
161173
162174 Sec. 2
163175
164176 from passage
165177
166178 New section
167179
168180 Sec. 3
169181
170182 from passage
171183
172184 38a-1080
173185
186+Statement of Purpose:
174187
188+To authorize the Connecticut Health Insurance Exchange to establish subsidiaries.
175189
176-INS Joint Favorable Subst.
177-
178-INS
179-
180-Joint Favorable Subst.
190+[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]