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3 | 3 | | LCO No. 2213 1 of 13 |
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4 | 4 | | |
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5 | 5 | | General Assembly Raised Bill No. 346 |
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6 | 6 | | February Session, 2020 |
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7 | 7 | | LCO No. 2213 |
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8 | 8 | | |
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9 | 9 | | |
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10 | 10 | | Referred to Committee on INSURANCE AND REAL ESTATE |
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12 | 12 | | |
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13 | 13 | | Introduced by: |
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14 | 14 | | (INS) |
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16 | 16 | | |
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17 | 17 | | |
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18 | 18 | | |
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19 | 19 | | AN ACT CONCERNING PU BLIC OPTIONS FOR HEALTH CARE IN |
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20 | 20 | | CONNECTICUT. |
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21 | 21 | | Be it enacted by the Senate and House of Representatives in General |
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22 | 22 | | Assembly convened: |
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23 | 23 | | |
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24 | 24 | | Section 1. (NEW) (Effective July 1, 2020) For the purposes of this 1 |
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25 | 25 | | section and sections 2 to 5, inclusive, of this act: 2 |
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26 | 26 | | (1) "Account" means the ConnectHealth Trust Account established 3 |
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27 | 27 | | under section 4 of this act. 4 |
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28 | 28 | | (2) "Advisory council" means the ConnectHealth Advisory Council 5 |
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29 | 29 | | established under section 3 of this act. 6 |
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30 | 30 | | (3) "Affordable Care Act" means the Patient Protection and 7 |
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31 | 31 | | Affordable Care Act, P.L. 111-148, as amended by the Health Care and 8 |
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32 | 32 | | Education Reconciliation Act, P.L. 111-152, as both may be amended 9 |
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33 | 33 | | from time to time, and regulations adopted thereunder. 10 |
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34 | 34 | | (4) "ConnectHealth Plan" means the health benefit plan designed and 11 |
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35 | 35 | | made available to individuals in this state as part of the program. 12 |
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36 | 36 | | (5) "Essential health benefits" means benefits that are essential health 13 Raised Bill No. 346 |
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37 | 37 | | |
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38 | 38 | | |
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39 | 39 | | |
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40 | 40 | | LCO No. 2213 2 of 13 |
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41 | 41 | | |
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42 | 42 | | benefits within the meaning of (A) the Affordable Care Act, or (B) 14 |
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43 | 43 | | section 38a-492q or 38a-518q of the general statutes. 15 |
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44 | 44 | | (6) "Exchange" means the Connecticut Health Insurance Exchange 16 |
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45 | 45 | | established under section 38a-1081 of the general statutes. 17 |
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46 | 46 | | (7) "Health benefit plan" has the same meaning as provided in section 18 |
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47 | 47 | | 38a-1080 of the general statutes. 19 |
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48 | 48 | | (8) "Internal Revenue Code" means the Internal Revenue Code of 20 |
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49 | 49 | | 1986, or any subsequent corresponding internal revenue code of the 21 |
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50 | 50 | | United States, as amended from time to time. 22 |
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51 | 51 | | (9) "Medical loss ratio" means the ratio, expressed as a percentage, of 23 |
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52 | 52 | | incurred claims to earned premiums for the prior calendar year for the 24 |
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53 | 53 | | ConnectHealth Plan, provided, for purposes of this subdivision, claims 25 |
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54 | 54 | | shall be limited to medical expenses for services and supplies provided 26 |
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55 | 55 | | to enrollees in the ConnectHealth Plan and shall not include expenses 27 |
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56 | 56 | | for stop-loss coverage, reinsurance, enrollee educational programs or 28 |
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57 | 57 | | other cost containment programs or features. 29 |
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58 | 58 | | (10) "Program" means the ConnectHealth Program established by the 30 |
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59 | 59 | | Comptroller pursuant to section 2 of this act. 31 |
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60 | 60 | | (11) "Qualified health plan" has the same meaning as provided in 32 |
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61 | 61 | | section 38a-1080 of the general statutes. 33 |
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62 | 62 | | (12) "Third-party administrator" has the same meaning as provided 34 |
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63 | 63 | | in section 38a-720 of the general statutes. 35 |
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64 | 64 | | Sec. 2. (NEW) (Effective July 1, 2020) (a) The Comptroller shall, within 36 |
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65 | 65 | | available appropriations and in consultation with the advisory council 37 |
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66 | 66 | | and the Office of Health Strategy, establish a program to be known as 38 |
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67 | 67 | | the "ConnectHealth Program". The purpose of the program shall be to 39 |
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68 | 68 | | offer high-quality, low-cost health insurance coverage to enrollees in 40 |
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69 | 69 | | this state under a ConnectHealth Plan. Under the program, the 41 |
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70 | 70 | | Comptroller, in consultation with the advisory council and the Office of 42 |
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71 | 71 | | Health Strategy, shall: 43 Raised Bill No. 346 |
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72 | 72 | | |
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73 | 73 | | |
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74 | 74 | | |
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75 | 75 | | LCO No. 2213 3 of 13 |
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76 | 76 | | |
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77 | 77 | | (1) Establish enrollment criteria for the ConnectHealth Plan; 44 |
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78 | 78 | | (2) Design and offer the ConnectHealth Plan, which shall, at a 45 |
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79 | 79 | | minimum: (A) Be made available to prospective enrollees in this state 46 |
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80 | 80 | | not later than January 1, 2022; (B) provide coverage for essential health 47 |
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81 | 81 | | benefits; (C) provide a level of covered benefits that meets or exceeds 48 |
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82 | 82 | | the level of covered benefits provided under qualified health plans; (D) 49 |
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83 | 83 | | impose premiums, deductibles and enrollee cost-sharing in amounts 50 |
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84 | 84 | | that do not exceed the amounts imposed under qualified health plans; 51 |
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85 | 85 | | (E) include an affordability scale for premiums, deductibles and enrollee 52 |
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86 | 86 | | cost-sharing that varies according to an enrollee's household income; 53 |
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87 | 87 | | and (F) have a medical loss ratio of not less than ninety per cent; 54 |
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88 | 88 | | (3) Determine whether to offer the ConnectHealth Plan through the 55 |
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89 | 89 | | exchange as a qualified health plan; 56 |
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90 | 90 | | (4) Subject to the provisions of subsection (c) of this section: (A) 57 |
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91 | 91 | | Establish a schedule of payments and reimbursement rates for the 58 |
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92 | 92 | | ConnectHealth Plan; (B) provide, within available appropriations, state-59 |
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93 | 93 | | financed cost-sharing subsidies to enrollees in the ConnectHealth Plan 60 |
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94 | 94 | | who do not qualify for cost-sharing subsidies under the Affordable Care 61 |
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95 | 95 | | Act; and (C) seek a waiver from the United States Department of the 62 |
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96 | 96 | | Treasury or the United States Department of Health and Human 63 |
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97 | 97 | | Services, as applicable, pursuant to Section 1332 of the Affordable Care 64 |
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98 | 98 | | Act; 65 |
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99 | 99 | | (5) Use any data submitted to the all-payer claims database program 66 |
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100 | 100 | | established under section 19a-755a of the general statutes to evaluate, 67 |
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101 | 101 | | on an ongoing basis, the impact of the ConnectHealth Plan on: (A) 68 |
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102 | 102 | | Individuals in this state; (B) health care providers and health care 69 |
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103 | 103 | | facilities in this state; and (C) the individual and group health insurance 70 |
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104 | 104 | | markets in this state; and 71 |
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105 | 105 | | (6) Implement a competitive process to select, and enter into a 72 |
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106 | 106 | | contract with, one or more third-party administrators to administer the 73 |
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107 | 107 | | ConnectHealth Plan, and permit such third-party administrator or 74 |
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108 | 108 | | third-party administrators to directly receive individual premiums and 75 Raised Bill No. 346 |
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109 | 109 | | |
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110 | 110 | | |
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111 | 111 | | |
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112 | 112 | | LCO No. 2213 4 of 13 |
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113 | 113 | | |
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114 | 114 | | federal premium tax credits in accordance with all applicable provisions 76 |
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115 | 115 | | of the Affordable Care Act and the Internal Revenue Code. 77 |
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116 | 116 | | (b) The Comptroller may, in the Comptroller's discretion and within 78 |
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117 | 117 | | available appropriations, engage the services of such third-party 79 |
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118 | 118 | | actuaries, professionals and specialists that the Comptroller deems 80 |
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119 | 119 | | necessary to assist the Comptroller in performing the Comptroller's 81 |
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120 | 120 | | duties under subsection (a) of this section. 82 |
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121 | 121 | | (c) (1) Not later than March 1, 2021, the Comptroller, in consultation 83 |
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122 | 122 | | with the advisory council and the Office of Health Strategy, shall 84 |
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123 | 123 | | submit, in accordance with the provisions of section 11-4a of the general 85 |
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124 | 124 | | statutes, to the joint standing committee of the General Assembly 86 |
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125 | 125 | | having cognizance of matters relating to insurance: 87 |
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126 | 126 | | (A) A plan to make the ConnectHealth Plan available to prospective 88 |
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127 | 127 | | enrollees in this state not later than January 1, 2022; 89 |
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128 | 128 | | (B) Strategies to ensure that health care providers and health care 90 |
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129 | 129 | | facilities in this state participate in the ConnectHealth Plan; 91 |
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130 | 130 | | (C) An analysis of the likely impact of the ConnectHealth Plan on the 92 |
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131 | 131 | | individual and group health insurance markets in this state; 93 |
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132 | 132 | | (D) A proposed schedule of the initial payments and reimbursement 94 |
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133 | 133 | | rates for the ConnectHealth Plan; 95 |
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134 | 134 | | (E) A proposal to implement state-financed cost-sharing subsidies for 96 |
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135 | 135 | | enrollees in the ConnectHealth Plan who do not qualify for cost-sharing 97 |
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136 | 136 | | subsidies under the Affordable Care Act, which proposal shall include, 98 |
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137 | 137 | | but need not be limited to, (i) eligibility criteria for enrollees to receive 99 |
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138 | 138 | | such subsidies, (ii) the recommended amount or amounts of such 100 |
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139 | 139 | | subsidies, and (iii) a plan to administer and disburse such subsidies; and 101 |
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140 | 140 | | (F) A proposed application for a waiver from the United States 102 |
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141 | 141 | | Department of the Treasury or the United States Department of Health 103 |
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142 | 142 | | and Human Services, as applicable, pursuant to Section 1332 of the 104 |
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143 | 143 | | Affordable Care Act. 105 Raised Bill No. 346 |
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144 | 144 | | |
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145 | 145 | | |
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146 | 146 | | |
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147 | 147 | | LCO No. 2213 5 of 13 |
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148 | 148 | | |
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149 | 149 | | (2) If the committee does not act within sixty days after receiving a 106 |
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150 | 150 | | submittal under subdivision (1) of this subsection, each proposal 107 |
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151 | 151 | | described in subparagraphs (D) to (F), inclusive, of said subdivision 108 |
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152 | 152 | | shall be deemed to be denied by the committee. 109 |
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153 | 153 | | Sec. 3. (NEW) (Effective July 1, 2020) (a) (1) There is established the 110 |
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154 | 154 | | ConnectHealth Advisory Council. The council shall consist of ten 111 |
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155 | 155 | | members, as follows: 112 |
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156 | 156 | | (A) Two appointed by the speaker of the House of Representatives, 113 |
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157 | 157 | | one of whom shall represent the interests of hospitals in this state and 114 |
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158 | 158 | | one of whom shall represent the interests of community-based health 115 |
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159 | 159 | | care providers in this state; 116 |
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160 | 160 | | (B) Two appointed by the president pro tempore of the Senate, one of 117 |
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161 | 161 | | whom shall represent the interests of consumers in this state and one of 118 |
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162 | 162 | | whom shall represent the interests of nurses practicing in this state; 119 |
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163 | 163 | | (C) One appointed by the majority leader of the House of 120 |
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164 | 164 | | Representatives, who shall represent the interests of patients in this 121 |
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165 | 165 | | state; 122 |
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166 | 166 | | (D) One appointed by the majority leader of the Senate, who shall 123 |
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167 | 167 | | have expertise in health policy; 124 |
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168 | 168 | | (E) Two appointed by the minority leader of the House of 125 |
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169 | 169 | | Representatives, one of whom shall represent the interests of health 126 |
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170 | 170 | | insurers offering individual health insurance policies in this state and 127 |
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171 | 171 | | one of whom shall represent the interests of physicians practicing in this 128 |
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172 | 172 | | state; and 129 |
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173 | 173 | | (F) Two appointed by the minority leader of the Senate, one of whom 130 |
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174 | 174 | | shall represent the interests of health insurers offering small group 131 |
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175 | 175 | | health insurance policies in this state and one of whom shall represent 132 |
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176 | 176 | | the interests of insurance producers licensed in this state. 133 |
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177 | 177 | | (2) The members of the advisory council shall select a chairperson 134 |
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178 | 178 | | from the membership of the advisory council, and the advisory council 135 Raised Bill No. 346 |
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179 | 179 | | |
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180 | 180 | | |
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181 | 181 | | |
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182 | 182 | | LCO No. 2213 6 of 13 |
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183 | 183 | | |
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184 | 184 | | may establish rules governing the advisory council's internal 136 |
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185 | 185 | | procedures. 137 |
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186 | 186 | | (3) The Governor, Lieutenant Governor, Comptroller, Secretary of the 138 |
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187 | 187 | | Office of Policy and Management, Insurance Commissioner and 139 |
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188 | 188 | | Commissioner of Social Services shall serve as ex-officio, nonvoting 140 |
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189 | 189 | | members of the advisory council. 141 |
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190 | 190 | | (b) Initial appointments to the advisory council shall be made on or 142 |
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191 | 191 | | before October 1, 2020. If an appointing authority fails to appoint an 143 |
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192 | 192 | | advisory council member on or before October 1, 2020, the president pro 144 |
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193 | 193 | | tempore of the Senate and the speaker of the House of Representatives 145 |
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194 | 194 | | shall jointly appoint an advisory council member who meets the 146 |
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195 | 195 | | required specifications on behalf of such appointing authority and such 147 |
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196 | 196 | | advisory council member shall serve for the duration of the initial term 148 |
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197 | 197 | | for such advisory council member. The presence of not less than six 149 |
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198 | 198 | | advisory council members shall constitute a quorum for the transaction 150 |
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199 | 199 | | of business. The initial term for advisory council members appointed by 151 |
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200 | 200 | | the minority leader of the House of Representatives and the minority 152 |
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201 | 201 | | leader of the Senate shall be three years. The initial term for advisory 153 |
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202 | 202 | | council members appointed by the majority leader of the House of 154 |
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203 | 203 | | Representatives and the majority leader of the Senate shall be four years. 155 |
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204 | 204 | | The initial term for the advisory council members appointed by the 156 |
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205 | 205 | | speaker of the House of Representatives and the president pro tempore 157 |
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206 | 206 | | of the Senate shall be five years. Terms pursuant to this subsection shall 158 |
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207 | 207 | | expire on June thirtieth in accordance with the provisions of this 159 |
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208 | 208 | | subsection. Any vacancy shall be filled by the appointing authority for 160 |
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209 | 209 | | the balance of the unexpired term. Not later than thirty days prior to the 161 |
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210 | 210 | | expiration of a term as provided for in this subsection, the appointing 162 |
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211 | 211 | | authority may reappoint the current advisory council member or shall 163 |
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212 | 212 | | appoint a new member to the advisory council. Other than an initial 164 |
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213 | 213 | | term, an advisory council member shall serve for a term of five years 165 |
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214 | 214 | | and until a successor advisory council member is appointed. Each 166 |
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215 | 215 | | member of the advisory council shall be eligible for reappointment. Any 167 |
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216 | 216 | | member of the advisory council may be removed by the appropriate 168 |
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217 | 217 | | appointing authority for misfeasance, malfeasance or wilful neglect of 169 Raised Bill No. 346 |
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218 | 218 | | |
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219 | 219 | | |
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220 | 220 | | |
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221 | 221 | | LCO No. 2213 7 of 13 |
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222 | 222 | | |
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223 | 223 | | duty. 170 |
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224 | 224 | | (c) The advisory council shall advise the Comptroller and the Office 171 |
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225 | 225 | | of Health Strategy on matters concerning the program and the 172 |
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226 | 226 | | ConnectHealth Plan, including, but not limited to: 173 |
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227 | 227 | | (1) Implementation of the ConnectHealth Plan; 174 |
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228 | 228 | | (2) Affordability of the ConnectHealth Plan; 175 |
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229 | 229 | | (3) Marketing of the ConnectHealth Plan to prospective enrollees; 176 |
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230 | 230 | | (4) Outreach to prospective enrollees and enrollees in the 177 |
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231 | 231 | | ConnectHealth Plan; and 178 |
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232 | 232 | | (5) Periodic evaluations of the ConnectHealth Plan. 179 |
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233 | 233 | | (d) The advisory council shall not be construed to be a department, 180 |
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234 | 234 | | institution or agency of this state. The staff of the joint standing 181 |
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235 | 235 | | committee of the General Assembly having cognizance of matters 182 |
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236 | 236 | | relating to insurance shall provide administrative support to the 183 |
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237 | 237 | | advisory council. 184 |
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238 | 238 | | Sec. 4. (NEW) (Effective July 1, 2020) There is established an account 185 |
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239 | 239 | | to be known as the "ConnectHealth Trust Account", which shall be a 186 |
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240 | 240 | | separate, nonlapsing account within the General Fund. The account 187 |
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241 | 241 | | shall contain all moneys required by law to be deposited in the account. 188 |
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242 | 242 | | Investment earnings from any moneys in the account shall be credited 189 |
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243 | 243 | | to the account and shall become part of the assets of the account. Any 190 |
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244 | 244 | | balance remaining in the account at the end of any fiscal year shall be 191 |
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245 | 245 | | carried forward in the account for the fiscal year next succeeding. The 192 |
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246 | 246 | | moneys in the account shall be allocated to the Comptroller for the 193 |
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247 | 247 | | purposes of lowering the cost of the ConnectHealth Plan and providing 194 |
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248 | 248 | | state-financed cost-sharing subsidies to enrollees in such plan who do 195 |
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249 | 249 | | not qualify for cost-sharing subsidies under the Affordable Care Act. 196 |
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250 | 250 | | Sec. 5. (NEW) (Effective July 1, 2020) The Comptroller may adopt 197 |
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251 | 251 | | regulations, in accordance with chapter 54 of the general statutes, to 198 Raised Bill No. 346 |
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252 | 252 | | |
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253 | 253 | | |
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254 | 254 | | |
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255 | 255 | | LCO No. 2213 8 of 13 |
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256 | 256 | | |
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257 | 257 | | implement the provisions of sections 1 to 4, inclusive, of this act. 199 |
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258 | 258 | | Sec. 6. Section 3-123rrr of the 2020 supplement to the general statutes 200 |
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259 | 259 | | is repealed and the following is substituted in lieu thereof (Effective July 201 |
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260 | 260 | | 1, 2020): 202 |
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261 | 261 | | As used in this section, section 7 of this act and sections 3-123sss to 3-203 |
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262 | 262 | | 123vvv, inclusive, as amended by this act, and section 3-123xxx: 204 |
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263 | 263 | | (1) "Health Care Cost Containment Committee" means the committee 205 |
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264 | 264 | | established in accordance with the ratified agreement between the state 206 |
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265 | 265 | | and the State Employees Bargaining Agent Coalition pursuant to 207 |
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266 | 266 | | subsection (f) of section 5-278. 208 |
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267 | 267 | | (2) "Health enhancement program" means the program established in 209 |
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268 | 268 | | accordance with the provisions of the Revised State Employees 210 |
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269 | 269 | | Bargaining Agent Coalition agreement, approved by the General 211 |
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270 | 270 | | Assembly on August 22, 2011, for state employees, as amended by 212 |
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271 | 271 | | stipulated agreements. 213 |
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272 | 272 | | (3) "Multiemployer plan" has the same meaning as provided in 214 |
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273 | 273 | | Section 3 of the Employee Retirement Income Security Act of 1974, as 215 |
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274 | 274 | | amended from time to time; 216 |
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275 | 275 | | [(2)] (4) "Nonstate public employee" means any employee or elected 217 |
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276 | 276 | | officer of a nonstate public employer. 218 |
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277 | 277 | | [(3)] (5) "Nonstate public employer" means a municipality or other 219 |
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278 | 278 | | political subdivision of the state, including a board of education, quasi-220 |
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279 | 279 | | public agency or public library. A municipality and a board of education 221 |
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280 | 280 | | may be considered separate employers. 222 |
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281 | 281 | | (6) "Nonprofit employer" means a nonprofit, nonstock corporation, 223 |
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282 | 282 | | other than a nonstate public employer, that employs at least one 224 |
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283 | 283 | | employee on the first day that such employer receives coverage under a 225 |
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284 | 284 | | group hospitalization, medical, pharmacy and surgical insurance plan 226 |
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285 | 285 | | offered by the Comptroller pursuant to this part. 227 Raised Bill No. 346 |
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286 | 286 | | |
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287 | 287 | | |
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288 | 288 | | |
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289 | 289 | | LCO No. 2213 9 of 13 |
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290 | 290 | | |
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291 | 291 | | (7) "Small employer" means an employer, other than a nonstate public 228 |
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292 | 292 | | employer, that employed an average of at least one but not more than 229 |
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293 | 293 | | fifty employees on business days during the preceding calendar year, 230 |
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294 | 294 | | and employs at least one employee on the first day that such employer 231 |
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295 | 295 | | receives coverage under a group hospitalization, medical, pharmacy 232 |
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296 | 296 | | and surgical insurance plan offered by the Comptroller pursuant to this 233 |
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297 | 297 | | part. 234 |
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298 | 298 | | [(4)] (8) "State employee plan" means the group hospitalization, 235 |
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299 | 299 | | medical, pharmacy and surgical insurance plan offered to state 236 |
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300 | 300 | | employees and retirees pursuant to section 5-259. 237 |
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301 | 301 | | [(5) "Health enhancement program" means the program established 238 |
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302 | 302 | | in accordance with the provisions of the Revised State Employees 239 |
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303 | 303 | | Bargaining Agent Coalition agreement, approved by the General 240 |
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304 | 304 | | Assembly on August 22, 2011, for state employees, as may be amended 241 |
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305 | 305 | | by stipulated agreements.] 242 |
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306 | 306 | | [(6)] (9) "Value-based insurance design" means health benefit designs 243 |
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307 | 307 | | that lower or remove financial barriers to essential, high-value clinical 244 |
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308 | 308 | | services. 245 |
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309 | 309 | | [(7) "Health care coverage type" means the type of health care 246 |
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310 | 310 | | coverage offered by nonstate public employers, including, but not 247 |
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311 | 311 | | limited to, coverage for a nonstate public employee, nonstate public 248 |
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312 | 312 | | employee plus spouse and nonstate public employee plus family.] 249 |
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313 | 313 | | Sec. 7. (NEW) (Effective July 1, 2020) (a) (1) Notwithstanding any 250 |
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314 | 314 | | provision of title 38a of the general statutes, the Comptroller shall offer 251 |
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315 | 315 | | to plan participants and beneficiaries in this state under a 252 |
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316 | 316 | | multiemployer plan, nonprofit employers and their employees and 253 |
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317 | 317 | | small employers and their employees coverage under the state 254 |
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318 | 318 | | employee plan or another group hospitalization, medical, pharmacy 255 |
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319 | 319 | | and surgical insurance plan developed by the Comptroller to provide 256 |
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320 | 320 | | coverage for plan participants and beneficiaries in this state under a 257 |
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321 | 321 | | multiemployer plan, nonprofit employers and their employees and 258 |
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322 | 322 | | small employers and their employees. Plan participants and 259 Raised Bill No. 346 |
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323 | 323 | | |
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324 | 324 | | |
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325 | 325 | | |
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326 | 326 | | LCO No. 2213 10 of 13 |
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327 | 327 | | |
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328 | 328 | | beneficiaries in this state under a multiemployer plan, nonprofit 260 |
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329 | 329 | | employers and their employees and small employers and their 261 |
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330 | 330 | | employees receiving coverage provided pursuant to this section shall be 262 |
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331 | 331 | | pooled with state employees and retirees under the state employee plan, 263 |
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332 | 332 | | provided the administrator of the multiemployer plan, the nonprofit 264 |
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333 | 333 | | employer or the small employer files an application with the 265 |
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334 | 334 | | Comptroller for coverage pursuant to this section and the Comptroller 266 |
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335 | 335 | | approves such application. The administrators of multiemployer plans, 267 |
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336 | 336 | | nonprofit employers or small employers shall remit to the Comptroller 268 |
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337 | 337 | | payments for coverage provided pursuant to this section. Such 269 |
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338 | 338 | | payments shall be equal to the payments paid by the state for state 270 |
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339 | 339 | | employees covered under the state employee plan, inclusive of any 271 |
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340 | 340 | | premiums paid by state employees pursuant to the state employee plan, 272 |
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341 | 341 | | except that premium payments may be adjusted to reflect the cost of 273 |
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342 | 342 | | health care in the geographic area in which the majority of a 274 |
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343 | 343 | | multiemployer plan's plan participants and beneficiaries, a nonprofit 275 |
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344 | 344 | | employer's employees or a small employer's employees work, 276 |
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345 | 345 | | differences from the benefits and networks provided to state employees, 277 |
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346 | 346 | | the demographic makeup of the multiemployer plan's plan participants 278 |
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347 | 347 | | and beneficiaries, nonprofit employer's employees or small employer's 279 |
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348 | 348 | | employees or as otherwise provided in this section. The Comptroller 280 |
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349 | 349 | | shall phase in the geographic adjustment established in this subsection 281 |
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350 | 350 | | over a two-year period for existing participants. Beginning on July 1, 282 |
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351 | 351 | | 2021, the Comptroller may charge each multiemployer plan, nonprofit 283 |
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352 | 352 | | employer and small employer participating in the state employee plan 284 |
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353 | 353 | | an administrative fee calculated on a per member, per month basis. 285 |
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354 | 354 | | (2) Any group hospitalization, medical, pharmacy and surgical 286 |
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355 | 355 | | insurance plan developed by the Comptroller pursuant to subdivision 287 |
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356 | 356 | | (1) of this subsection shall (A) include the health enhancement program, 288 |
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357 | 357 | | (B) be consistent with value-based insurance design principles, and (C) 289 |
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358 | 358 | | be approved by the Health Care Cost Containment Committee prior to 290 |
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359 | 359 | | being offered to small employers and their employees. 291 |
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360 | 360 | | (b) The Comptroller shall offer participation in each plan described 292 |
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361 | 361 | | in subsection (a) of this section for intervals lasting not less than three 293 Raised Bill No. 346 |
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362 | 362 | | |
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363 | 363 | | |
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364 | 364 | | |
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365 | 365 | | LCO No. 2213 11 of 13 |
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366 | 366 | | |
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367 | 367 | | years. The administrator of the multiemployer plan, nonprofit employer 294 |
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368 | 368 | | or small employer may apply for renewal of coverage prior to expiration 295 |
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369 | 369 | | of each interval. 296 |
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370 | 370 | | (c) The Comptroller shall develop procedures by which 297 |
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371 | 371 | | administrators of multiemployer plans, nonprofit employers and small 298 |
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372 | 372 | | employers may initially apply for, renew and withdraw from coverage 299 |
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373 | 373 | | provided pursuant to this section, as well as rules of participation that 300 |
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374 | 374 | | the Comptroller, in the Comptroller's discretion, deems necessary. 301 |
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375 | 375 | | (d) The Comptroller shall establish accounting procedures to track 302 |
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376 | 376 | | claims and premium payments paid by multiemployer plans, nonprofit 303 |
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377 | 377 | | employers and small employers receiving coverage provided pursuant 304 |
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378 | 378 | | to this section. 305 |
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379 | 379 | | Sec. 8. Section 3-123vvv of the 2020 supplement to the general statutes 306 |
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380 | 380 | | is repealed and the following is substituted in lieu thereof (Effective July 307 |
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381 | 381 | | 1, 2020): 308 |
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382 | 382 | | The Comptroller shall not offer coverage under the state employee 309 |
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383 | 383 | | plan pursuant to sections 3-123rrr to 3-123uuu, inclusive, as amended 310 |
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384 | 384 | | by this act, or section 7 of this act until the State Employees' Bargaining 311 |
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385 | 385 | | Agent Coalition has provided its consent to the clerks of both houses of 312 |
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386 | 386 | | the General Assembly to incorporate the terms of sections 3-123rrr to 3-313 |
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387 | 387 | | 123uuu, inclusive, as amended by this act, and section 7 of this act into 314 |
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388 | 388 | | its collective bargaining agreement. 315 |
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389 | 389 | | Sec. 9. Section 17b-282b of the general statutes is repealed and the 316 |
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390 | 390 | | following is substituted in lieu thereof (Effective from passage): 317 |
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391 | 391 | | (a) Not later than July 1, 2004, and prior to the implementation of a 318 |
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392 | 392 | | state-wide dental plan that provides for the administration of the dental 319 |
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393 | 393 | | services portion of the department's medical assistance, the 320 |
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394 | 394 | | Commissioner of Social Services shall amend the federal waiver 321 |
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395 | 395 | | approved pursuant to Section 1915(b) of the Social Security Act. Such 322 |
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396 | 396 | | waiver amendment shall be submitted to the joint standing committees 323 |
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397 | 397 | | of the General Assembly having cognizance of matters relating to 324 Raised Bill No. 346 |
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398 | 398 | | |
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399 | 399 | | |
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400 | 400 | | |
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401 | 401 | | LCO No. 2213 12 of 13 |
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402 | 402 | | |
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403 | 403 | | human services and appropriations and the budgets of state agencies in 325 |
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404 | 404 | | accordance with the provisions of section 17b-8. 326 |
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405 | 405 | | (b) (1) Not later than July 1, 2020, the Commissioner of Social Services 327 |
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406 | 406 | | shall seek to amend the federal waiver described in subsection (a) of this 328 |
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407 | 407 | | section to provide the state-wide dental plan, which provides for the 329 |
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408 | 408 | | administration of the dental services portion of the department's 330 |
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409 | 409 | | medical assistance, to: 331 |
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410 | 410 | | (A) Enable each individual in this state who is insured under an 332 |
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411 | 411 | | individual health insurance policy or a group health insurance policy 333 |
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412 | 412 | | for a small employer, as defined in section 3-123rrr, as amended by this 334 |
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413 | 413 | | act, or a nonprofit employer, as defined in section 3-123rrr or who is a 335 |
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414 | 414 | | plan participant or beneficiary in this state under a multiemployer plan, 336 |
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415 | 415 | | as defined in Section 3 of the Employee Retirement Income Security Act 337 |
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416 | 416 | | of 1974, as amended from time to time, to receive coverage for the dental 338 |
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417 | 417 | | services portion of such medical assistance; and 339 |
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418 | 418 | | (B) Enable the Commissioner of Social Services to prescribe premium 340 |
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419 | 419 | | and underwriting standards for the dental services portion of such 341 |
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420 | 420 | | medical assistance for individuals described in subparagraph (A) of this 342 |
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421 | 421 | | subdivision. 343 |
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422 | 422 | | (2) Such waiver amendment shall be submitted to the joint standing 344 |
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423 | 423 | | committees of the General Assembly having cognizance of matters 345 |
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424 | 424 | | relating to human services and appropriations and the budgets of state 346 |
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425 | 425 | | agencies in accordance with the provisions of section 17b-8. 347 |
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426 | 426 | | This act shall take effect as follows and shall amend the following |
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427 | 427 | | sections: |
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428 | 428 | | |
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429 | 429 | | Section 1 July 1, 2020 New section |
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430 | 430 | | Sec. 2 July 1, 2020 New section |
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431 | 431 | | Sec. 3 July 1, 2020 New section |
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432 | 432 | | Sec. 4 July 1, 2020 New section |
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433 | 433 | | Sec. 5 July 1, 2020 New section |
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434 | 434 | | Sec. 6 July 1, 2020 3-123rrr |
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435 | 435 | | Sec. 7 July 1, 2020 New section Raised Bill No. 346 |
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436 | 436 | | |
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437 | 437 | | |
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438 | 438 | | |
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439 | 439 | | LCO No. 2213 13 of 13 |
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440 | 440 | | |
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441 | 441 | | Sec. 8 July 1, 2020 3-123vvv |
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442 | 442 | | Sec. 9 from passage 17b-282b |
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443 | 443 | | |
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444 | 444 | | Statement of Purpose: |
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445 | 445 | | To: (1) Establish the ConnectHealth Program, the ConnectHealth Trust |
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446 | 446 | | Account and the ConnectHealth Advisory Board; (2) require the |
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447 | 447 | | Comptroller, in consultation with the ConnectHealth Advisory Board |
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448 | 448 | | and the Office of Health Strategy, to establish the ConnectHealth Plan; |
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449 | 449 | | (3) authorize the Comptroller to offer coverage to plan participants and |
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450 | 450 | | beneficiaries in this state under a multiemployer plan, nonprofit |
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451 | 451 | | employers and their employees, and small employers and their |
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452 | 452 | | employees; and (4) require the Commissioner of Social Services to seek |
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453 | 453 | | to amend the federal waiver for the state-wide dental plan that provides |
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454 | 454 | | for the administration of the dental services portion of the department's |
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455 | 455 | | medical assistance to expand coverage to include additional individuals |
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456 | 456 | | in this state. |
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457 | 457 | | [Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except |
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458 | 458 | | that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not |
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459 | 459 | | underlined.] |
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460 | 460 | | |
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