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General Assembly Raised Bill No. 7265
January Session, 2019
LCO No. 4874
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
(INS)
AN ACT AUTHORIZING A SSOCIATION HEALTH PLANS FOR GRO UP
PRACTICES AND EXEMPT ING PRACTICES COVERE D UNDER SUCH
PLANS FROM CERTAIN P ROVISIONS OF THE INSURANCE
STATUTES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective October 1, 2019) The Insurance 1
Commissioner shall adopt regulations, in accordance with chapter 54 2
of the general statutes, to enable two or more group practices, as 3
defined in section 19a-486i of the general statutes, to form a bona fide 4
group or association of employers for the purpose of offering and 5
providing health coverage to such group practices and their employees 6
in the manner prescribed in 29 CFR Part 2510, as amended from time 7
to time. 8
Sec. 2. Subdivisions (3) and (4) of section 38a-564 of the general 9
statutes are repealed and the following is substituted in lieu thereof 10
(Effective October 1, 2019): 11
(3) "Employee" means an individual employed by an employer. 12
"Employee" does not include (A) an individual and such individual's 13 Raised Bill No. 7265
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spouse with respect to an incorporated or unincorporated trade or 14
business that is wholly owned by such individual, by such individual's 15
spouse or by such individual and such individual's spouse, [or] (B) a 16
partner in a partnership and such partner's spouse with respect to such 17
partnership, or (C) an individual covered under an association health 18
plan authorized under regulations adopted pursuant to section 1 of 19
this act. 20
(4) (A) "Small employer" means (i) prior to January 1, 2016, an 21
employer that employed an average of at least one but not more than 22
fifty employees on business days during the preceding calendar year 23
and employs at least one employee on the first day of the group health 24
insurance plan year, and (ii) on and after January 1, 2016, an employer 25
that employed an average of at least one but not more than one 26
hundred employees on business days during the preceding calendar 27
year and employs at least one employee on the first day of the group 28
health insurance plan year, except the commissioner may postpone 29
said January 1, 2016, date to be consistent with any such postponement 30
made by the Secretary of the United States Department of Health and 31
Human Services under the Patient Protection and Affordable Care Act, 32
P.L. 111-148, as amended from time to time. "Small employer" does not 33
include a sole proprietorship that employs only the sole proprietor or 34
the spouse of such sole proprietor, or a group practice, as defined in 35
section 19a-486i, providing coverage through an association health 36
plan authorized under regulations adopted pursuant to section 1 of 37
this act. 38
(B) (i) For purposes of subparagraph (A) of this subdivision, the 39
number of employees shall be determined by adding (I) the number of 40
full-time employees for each month who work a normal work week of 41
thirty hours or more, and (II) the number of full-time equivalent 42
employees, calculated for each month by dividing by one hundred 43
twenty the aggregate number of hours worked for such month by 44
employees who work a normal work week of less than thirty hours, 45
and averaging such total for the calendar year. 46 Raised Bill No. 7265
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(ii) If an employer was not in existence throughout the preceding 47
calendar year, the number of employees shall be based on the average 48
number of employees that such employer reasonably expects to 49
employ in the current calendar year. 50
(C) All persons treated as a single employer under Section 414 of the 51
Internal Revenue Code of 1986, or any subsequent corresponding 52
internal revenue code of the United States, as amended from time to 53
time, shall be considered a single employer for purposes of this 54
subdivision. 55
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2019 New section
Sec. 2 October 1, 2019 38a-564(3) and (4)
Statement of Purpose:
To: (1) Require the Insurance Commissioner to adopt regulations to
enable two or more group practices to form a bona fide group or
association of employers for the purpose of offering and providing
health coverage to such group practices and their employees; and (2)
exempt such group practices from certain provisions of the insurance
statutes governing health insurance provided to small employers and
their employees.
[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.]