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General Assembly Raised Bill No. 1004
January Session, 2019
LCO No. 5179
Referred to Committee on LABOR AND PUBLIC
EMPLOYEES
Introduced by:
(LAB)
AN ACT CONCERNING PU BLIC INSURANCE OPTIONS FOR SMALL
BUSINESS EMPLOYEES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 5-259 of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective October 1, 2019): 2
(a) The Comptroller, with the approval of the Attorney General and 3
of the Insurance Commissioner, shall arrange and procure a group 4
hospitalization and medical and surgical insurance plan or plans for 5
(1) state employees, (2) members of the General Assembly who elect 6
coverage under such plan or plans, (3) participants in an alternate 7
retirement program who meet the service requirements of section 5-8
162 or subsection (a) of section 5-166, (4) anyone receiving benefits 9
under section 5-144 or from any state-sponsored retirement system, 10
except the teachers' retirement system and the municipal employees 11
retirement system, (5) judges of probate and Probate Court employees, 12
(6) the surviving spouse, and any dependent children of a state police 13
officer, a member of an organized local police department, a firefighter 14
or a constable who performs criminal law enforcement duties who dies 15 Raised Bill No. 1004
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before, on or after June 26, 2003, as the result of injuries received while 16
acting within the scope of such officer's or firefighter's or constable's 17
employment and not as the result of illness or natural causes, and 18
whose surviving spouse and dependent children are not otherwise 19
eligible for a group hospitalization and medical and surgical insurance 20
plan. Coverage for a dependent child pursuant to this subdivision shall 21
terminate no earlier than the policy anniversary date on or after 22
whichever of the following occurs first, the date on which the child: 23
Becomes covered under a group health plan through the dependent's 24
own employment; or attains the age of twenty-six, (7) employees of the 25
Capital Region Development Authority established by section 32-601, 26
and (8) the surviving spouse and dependent children of any employee 27
of a municipality who dies on or after October 1, 2000, as the result of 28
injuries received while acting within the scope of such employee's 29
employment and not as the result of illness or natural causes, and 30
whose surviving spouse and dependent children are not otherwise 31
eligible for a group hospitalization and medical and surgical insurance 32
plan. For purposes of this subdivision, "employee" means any regular 33
employee or elective officer receiving pay from a municipality, 34
"municipality" means any town, city, borough, school district, taxing 35
district, fire district, district department of health, probate district, 36
housing authority, regional work force development board established 37
under section 31-3k, flood commission or authority established by 38
special act or regional council of governments. For purposes of 39
subdivision (6) of this subsection, "firefighter" means any person who 40
is regularly employed and paid by any municipality for the purpose of 41
performing firefighting duties for a municipality on average of not less 42
than thirty-five hours per week. The minimum benefits to be provided 43
by such plan or plans shall be substantially equal in value to the 44
benefits that each such employee or member of the General Assembly 45
could secure in such plan or plans on an individual basis on the 46
preceding first day of July. The state shall pay for each such employee 47
and each member of the General Assembly covered by such plan or 48
plans the portion of the premium charged for such member's or 49
employee's individual coverage and seventy per cent of the additional 50 Raised Bill No. 1004
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cost of the form of coverage and such amount shall be credited to the 51
total premiums owed by such employee or member of the General 52
Assembly for the form of such member's or employee's coverage under 53
such plan or plans. On and after January 1, 1989, the state shall pay for 54
anyone receiving benefits from any such state-sponsored retirement 55
system one hundred per cent of the portion of the premium charged 56
for such member's or employee's individual coverage and one 57
hundred per cent of any additional cost for the form of coverage. The 58
balance of any premiums payable by an individual employee or by a 59
member of the General Assembly for the form of coverage shall be 60
deducted from the payroll by the State Comptroller. The total 61
premiums payable shall be remitted by the Comp troller to the 62
insurance company or companies or nonprofit organization or 63
organizations providing the coverage. The amount of the state's 64
contribution per employee for a health maintenance organization 65
option shall be equal, in terms of dollars and cents, to the largest 66
amount of the contribution per employee paid for any other option 67
that is available to all eligible state employees included in the health 68
benefits plan, but shall not be required to exceed the amount of the 69
health maintenance organization premium. 70
(b) The insurance coverage procured under subsection (a) of this 71
section for active state employees, employees of the Connecticut 72
Institute for Municipal Studies, anyone receiving benefits from any 73
such state-sponsored retirement system and members of the General 74
Assembly, who are over sixty-five years of age, may be modified to 75
reflect benefits available to such employees or members pursuant to 76
Social Security and medical benefits programs administered by the 77
federal government, provided any payments required to secure such 78
benefits administered by the federal government shall be paid by the 79
Comptroller either directly to the employee or members or to the 80
agency of the federal government authorized to collect such payments. 81
(c) On October 1, 1972, the Comptroller shall continue to afford 82
payroll deduction services for employees participating in existing 83 Raised Bill No. 1004
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authorized plans covering state employees until such time as the 84
employee elects in writing to be covered by the plan authorized by 85
subsection (a) of this section. 86
(d) Notwithstanding the provisions of subsection (a) of this section, 87
the state shall pay for a member of any such state-sponsored 88
retirement system, or a participant in an alternate retirement program 89
who meets the service requirements of section 5-162 or subsection (a) 90
of section 5-166, and who begins receiving benefits from such system 91
or program on or after November 1, 1989, eighty per cent of the 92
portion of the premium charged for his individual coverage and eighty 93
per cent of any additional cost for his form of coverage. Upon the 94
death of any such member, any surviving spouse of such member who 95
begins receiving benefits from such system shall be eligible for 96
coverage under this section and the state shall pay for any such spouse 97
eighty per cent of the portion of the premium charged for his 98
individual coverage and eighty per cent of any additional cost for his 99
form of coverage. 100
(e) Notwithstanding the provisions of subsection (a) of this section, 101
vending stand operators eligible for membership in the state 102
employees retirement system pursuant to section 5-175a shall be 103
eligible for coverage under the group hospitalization and medical and 104
surgical insurance plans procured under this section, provided the cost 105
for such operators' insurance coverage shall be paid by the Department 106
of Rehabilitation Services from vending machine income pursuant to 107
section 10-303. 108
(f) The Comptroller, with the approval of the Attorney General and 109
of the Insurance Commissioner, shall arrange and procure a group 110
hospitalization and medical and surgical insurance plan or plans for 111
any person who adopts a child from the state foster care system, any 112
person who has been a foster parent for the Department of Children 113
and Families for six months or more, and any dependent of such 114
adoptive parent or foster parent who elects coverage under such plan 115
or plans. The Comptroller may also arrange for inclusion of such 116 Raised Bill No. 1004
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person and any such dependent in an existing group hospitalization 117
and medical and surgical insurance plan offered by the state. Any 118
adoptive parent or foster parent and any dependent who elects 119
coverage shall pay one hundred per cent of the premium charged for 120
such coverage directly to the insurer, provided such adoptive parent or 121
foster parent and all such dependents shall be included in such group 122
hospitalization and medical and surgical insurance plan. A person and 123
his dependents electing coverage pursuant to this subsection shall be 124
eligible for such coverage until no longer an adoptive parent or a foster 125
parent. An adoptive parent shall be eligible for such coverage until the 126
coverage anniversary date on or after whichever of the following 127
occurs first, the date on which the child: Becomes covered under a 128
group health plan through the dependent's own employment; or 129
attains the age of twenty-six. As used in this section "dependent" 130
means a spouse or natural or adopted child if such child is wholly or 131
partially dependent for support upon the adoptive parent or foster 132
parent. 133
(g) Notwithstanding the provisions of subsection (a) of this section, 134
the Probate Court Administration Fund established in accordance with 135
section 45a-82, shall pay for each probate judge and each probate court 136
employee not more than one hundred per cent of the portion of the 137
premium charged for the judge's or employee's individual coverage 138
and not more than fifty per cent of any additional cost for the judge's 139
or employee's form of coverage. The remainder of the premium for 140
such coverage shall be paid by the probate judge or probate court 141
employee to the State Treasurer. Payment shall be credited by the State 142
Treasurer to the fund established by section 45a-82. The total 143
premiums payable shall be remitted by the Probate Court 144
Administrator directly to the insurance company or companies or 145
nonprofit organization or organizations providing the coverage. The 146
Probate Court Administrator shall issue regulations governing group 147
hospitalization and medical and surgical insurance pursuant to 148
subsection (b) of section 45a-77. 149 Raised Bill No. 1004
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(h) For the purpose of subsection (g) of this section, "probate judge" 150
or "judge" means a duly elected probate judge who works in such 151
judge's capacity as a probate judge at least twenty hours per week, on 152
average, on a quarterly basis and certifies to that fact on forms 153
provided by and filed with the Probate Court Administrator, on or 154
before the fifteenth day of April, July, October and January, for the 155
preceding calendar quarter; and "probate court employee" or 156
"employee" means a person employed by a probate court for at least 157
twenty hours per week. 158
(i) (1) The Comptroller may provide for coverage of employees of 159
municipalities, nonprofit corporations, community action agencies 160
[and small employers] and individuals eligible for a health coverage 161
tax credit, retired members or members of an association for personal 162
care assistants under the plan or plans procured under subsection (a) 163
of this section, provided: [(1)] (A) Participation by each municipality, 164
nonprofit corporation, community action agency, [small employer,] 165
eligible individual, retired member or association for personal care 166
assistants shall be on a voluntary basis; [(2)] (B) where an employee 167
organization represents employees of a municipality, nonprofit 168
corporation [,] or community action agency, [or small employer,] 169
participation in a plan or plans to be procured under subsection (a) of 170
this section shall be by mutual agreement of the municipality, 171
nonprofit corporation [,] or community action agency [or small 172
employer] and the employee organization only and neither party may 173
submit the issue of participation to binding arbitration except by 174
mutual agreement if such binding arbitration is available; [(3)] (C) no 175
group of employees shall be refused entry into the plan by reason of 176
past or future health care costs or claim experience; [(4)] (D) rates paid 177
by the state for its employees under subsection (a) of this section are 178
not adversely affected by this [subsection] subdivision; [(5)] (E) 179
administrative costs to the plan or plans provided under this 180
[subsection] subdivision shall not be paid by the state; [(6)] (F) 181
participation in the plan or plans in an amount determined by the state 182
shall be for the duration of the period of the plan or plans, or for such 183 Raised Bill No. 1004
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other period as mutually agreed by the municipality, nonprofit 184
corporation, community action agency, [small employer,] retired 185
member or association for personal care assistants and the 186
Comptroller; and [(7)] (G) nothing in this section or section 12-202a, 187
38a-551 or 38a-556 shall be construed as requiring a participating 188
insurer or health care center to issue individual policies to individuals 189
eligible for a health coverage tax credit. The coverage provided under 190
this [section] subdivision may be referred to as the "Municipal 191
Employee Health Insurance Plan". The Comptroller may arrange and 192
procure for the employees and eligible individuals under this 193
[subsection] subdivision health benefit plans that vary from the plan or 194
plans procured under subsection (a) of this section. Notwithstanding 195
any provision of part V of chapter 700c, the coverage provided under 196
this [subsection] subdivision may be offered on either a fully 197
underwritten or risk-pooled basis at the discretion of the Comptroller. 198
For the purposes of this [subsection] subdivision, [(A)] (i) 199
"municipality" means any town, city, borough, school district, taxing 200
district, fire district, district department of health, probate district, 201
housing authority, regional work force development board established 202
under section 31-3k, regional emergency telecommunications center, 203
tourism district established under section 32-302, flood commission or 204
authority established by special act, regional council of governments, 205
transit district formed under chapter 103a, or the Children's Center 206
established by number 571 of the public acts of 1969; [(B)] (ii) 207
"nonprofit corporation" means [(i)] (I) a nonprofit corporation 208
organized under 26 USC 501 that is not a small employer and has a 209
contract with the state or receives a portion of its funding from a 210
municipality, the state or the federal government, or [(ii)] (II) an 211
organization that is not a small employer and is tax exempt pursuant 212
to 26 USC 501(c)(5); [(C)] (iii) "community action agency" means a 213
community action agency, as defined in section 17b-885; [(D)] (iv) 214
"small employer" means a small employer, as defined in section 38a-215
564; [(E)] (v) "eligible individuals" or "individuals eligible for a health 216
coverage tax credit" means individuals who are eligible for the credit 217
for health insurance costs under Section 35 of the Internal Revenue 218 Raised Bill No. 1004
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Code of 1986, or any subsequent corresponding internal revenue code 219
of the United States, as from time to time amended, in accordance with 220
the Pension Benefit Guaranty Corporation; [(F)] (vi) "association for 221
personal care assistants" means an organization composed of personal 222
care attendants who are employed by recipients of service [(i)] (I) 223
under the home-care program for the elderly under section 17b-342, 224
[(ii)] (II) under the personal care assistance program under section 17b-225
605a, [(iii)] (III) in an independent living center pursuant to sections 226
17b-613 to 17b-615, inclusive, or [(iv)] (IV) under the program for 227
individuals with acquired brain injury as described in section 17b-228
260a; and [(G)] (vii) "retired members" means individuals eligible for a 229
retirement benefit from the Connecticut municipal employees' 230
retirement system. 231
(2) Notwithstanding the provisions of subsection (a) of this section, 232
the Comptroller shall provide for coverage of employees of small 233
employers, and dependents of such employees, under the group 234
hospitalization and medical and surgical insurance plan or plans 235
procured under said subsection, provided: (A) Participation by each 236
small employer and employee shall be on a voluntary basis; (B) where 237
an employee organization represents employees of a small employer, 238
participation in such plan or plans to be procured under said 239
subsection shall be by mutual agreement of the small employer and 240
the employee organization only and neither party may submit the 241
issue of participation to binding arbitration except by mutual 242
agreement if such binding arbitration is available; (C) no group of 243
employees shall be refused entry into such plan or plans by reason of 244
past or future health care costs or claim experience; (D) rates paid by 245
the state for its employees under said subsection are not adversely 246
affected by this subdivision; (E) administrative costs attributable to 247
coverage provided pursuant to this subdivision shall not be paid by 248
the state; and (F) participation in such plan or plans in an amount 249
determined by the state shall be for the duration of the period of such 250
plan or plans, or for such other period as mutually agreed by the small 251
employer and the Comptroller. For the purposes of this subdivision, 252 Raised Bill No. 1004
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"small employer" means a small employer, as defined in section 38a-253
564, and "dependent" means a spouse or dependent child of an 254
employee unless such child has attained the age of twenty-six or is 255
covered under a group health plan through such child's own 256
employer. 257
(j) (1) Notwithstanding any provision of law to the contrary, the 258
existing rights and obligations of state employee organizations and the 259
state employer under current law and contract shall not be impaired 260
by the provisions of this section. (2) Other conditions of entry for any 261
group into the plan or plans procured under subsection (a) of this 262
section shall be determined by the Comptroller upon the 263
recommendation of a coalition committee established pursuant to 264
subsection (f) of section 5-278, except for such conditions referenced in 265
subsection (g) of this section. (3) Additional determinations by the 266
Comptroller on (A) issues generated by any group's actual or 267
contemplated participation in the plan or plans, (B) modifications to 268
the terms and conditions of any group's continued participation, (C) 269
related matters shall be made upon the recommendation of such 270
committee. (4) Notwithstanding any provision of law to the contrary, a 271
municipal employer and an employee organization may upon mutual 272
agreement reopen a collective bargaining agreement for the exclusive 273
purpose of negotiating on the participation by such municipal 274
employer or employee organization in the plan or plans offered under 275
the provisions of this section. 276
(k) The Comptroller shall submit annually to the General Assembly 277
a review of the coverage of: [employees] (1) Employees of 278
municipalities, nonprofit corporations, community action agencies [, 279
small employers under subsection (i) of this section] and eligible 280
individuals under subdivision (1) of subsection (i) of this section 281
beginning February 1, 2004; and (2) employees of small employers 282
under subdivision (2) of said subsection beginning on February 1, 283
2020. 284
(l) (1) Effective July 1, 1996, any deputies or special deputies 285 Raised Bill No. 1004
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appointed pursuant to section 6-37 of the general statutes, revision of 286
1958, revised to 1999, or section 6-43, shall be allowed to participate in 287
the plan or plans procured by the Comptroller pursuant to subsection 288
(a) of this section. Such participation shall be voluntary and the 289
participant shall pay the full cost of the coverage under such plan. 290
(2) Effective December 1, 2000, any state marshal shall be allowed to 291
participate in the plan or plans procured by the Comptroller pursuant 292
to subsection (a) of this section. Such participation shall be voluntary 293
and the participant shall pay the full cost of the coverage under such 294
plan. 295
(3) Effective December 1, 2000, any judicial marshal shall be allowed 296
to participate in the plan or plans procured by the Comptroller 297
pursuant to subsection (a) of this section. Such participation shall be 298
voluntary and the participant shall pay the full cost of the coverage 299
under such plan unless and until the judicial marshals participate in 300
the plan or plans procured by the Comptroller under this section 301
through collective bargaining negotiations pursuant to subsection (f) of 302
section 5-278. 303
(m) (1) Notwithstanding any provision of the general statutes, the 304
Comptroller shall begin procedures to convert the group 305
hospitalization and medical and surgical insurance plans set forth in 306
subsection (a) of this section, including any prescription drug plan 307
offered in connection with or in addition to such insurance plans, to 308
self-insured plans, except that any dental plan offered in connection 309
with or in addition to such self-insured plans may be fully insured. 310
(2) The Comptroller may enter into contracts with third-party 311
administrators to provide administrative services only for the self-312
insured plans set forth in subdivision (1) of this subsection. Any such 313
third-party administrator shall be required under such contract to 314
charge such third-party administrator's lowest available rate for such 315
services. 316 Raised Bill No. 1004
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(3) (A) (i) The Comptroller shall offer nonstate public employers the 317
option to purchase prescription drugs for their employees, employees' 318
dependents and retirees under the purchasing authority of the state 319
pursuant to section 1 of public act 09-206, subject to the provisions of 320
subparagraph (E) of this subdivision. 321
(ii) For purposes of this subdivision, "nonstate public employer" 322
means (I) a municipality or other political subdivision of the state, 323
including a board of education, quasi-public agency or public library, 324
as defined in section 11-24a, or (II) the Teachers' Retirement Board. 325
(B) The Comptroller shall establish procedures to determine (i) the 326
eligibility requirements for, (ii) the enrollment procedures for, (iii) the 327
duration of, (iv) requirements regarding payment for, and (v) the 328
procedures for withdrawal from and termination of, the purchasing of 329
prescription drugs for nonstate public employers under subparagraph 330
(A) of this subdivision. 331
(C) The Comptroller may offer to nonstate public employers that 332
choose to purchase prescription drugs pursuant to subparagraph (A) 333
of this subdivision the option to purchase stop loss coverage from an 334
insurer at a rate negotiated by the Comptroller. 335
(D) Two or more nonstate public employers may join together for 336
the purpose of purchasing prescription drugs for their employees, 337
employees' dependents and retirees. Such arrangement shall not 338
constitute a multiple employer welfare arrangement, as defined in 339
Section 3 of the Employee Retirement Income Security Act of 1974, as 340
amended from time to time. 341
(E) (i) The Comptroller shall offer nonstate public employers the 342
option to purchase prescription drugs through the plan set forth in the 343
State Employees' Bargaining Agent Coalition's collective bargaining 344
agreement with the state only if the Health Care Cost Containment 345
Committee, established in accordance with the ratified agreement 346
between the state and said coalition pursuant to subsection (f) of 347 Raised Bill No. 1004
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section 5-278, has indicated in writing to the Comptroller that allowing 348
such nonstate public employers such option is consistent with said 349
coalition's collective bargaining agreement. 350
(ii) Such writing shall not be required if the Comptroller establishes 351
a separate prescription drugs purchasing plan for nonstate public 352
employers. 353
(iii) Nonstate public employers that purchase prescription drugs 354
pursuant to this subdivision shall pay the full cost of their own claims 355
and prescription drugs. 356
Sec. 2. Subsection (b) of section 38a-556a of the general statutes is 357
repealed and the following is substituted in lieu thereof (Effective 358
October 1, 2019): 359
(b) Said association shall, in consultation with the Insurance 360
Commissioner and the Healthcare Advocate, develop, within available 361
appropriations, a web site, telephone number or other method to serve 362
as a clearinghouse for information about individual and small 363
employer health insurance policies and health care plans that are 364
available to consumers in this state, including, but not limited to, the 365
HUSKY Health program, the Municipal Employee Health Insurance 366
Plan set forth in subdivision (1) of subsection (i) of section 5-259, as 367
amended by this act, and any individual or small employer health 368
insurance policies or health care plans an insurer, health care center or 369
other entity chooses to list with the Connecticut Clearinghouse. 370
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2019 5-259
Sec. 2 October 1, 2019 38a-556a(b)
LAB Joint Favorable