UNOFFICIAL COPY 24 RS BR 1495
Page 1 of 19
XXXX 1/30/2024 9:48 AM Jacketed
AN ACT relating to prescription drugs. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 304.17A-164 is amended to read as follows: 3
(1) As used in this section: 4
(a) "Cost sharing": 5
1. Means the cost to an insured under a health plan according to any 6
coverage limit, copayment, coinsurance, deductible, or other out-of-7
pocket expense requirements imposed by the plan[, which may be 8
subject to annual limitations on cost sharing, including those imposed 9
under 42 U.S.C. secs. 18022(c) and 300gg-6(b),] in order for the insured 10
to receive a specific health care service covered by the plan; and 11
2. May be subject to annual limitations, including those imposed under 12
42 U.S.C. secs. 18022(c) and 300gg-6(b); 13
(b) "Generic alternative" means a drug that is designated to be therapeutically 14
equivalent by the United States Food and Drug Administration's Approved 15
Drug Products with Therapeutic Equivalence Evaluations, except that a drug 16
shall not be considered a generic alternative until the drug is nationally 17
available; 18
(c) "Health plan": 19
1. Means a policy, contract, certificate, or agreement offered or issued by 20
an insurer to provide, deliver, arrange for, pay for, or reimburse any of 21
the cost of health care services; and 22
2. Includes a health benefit plan; 23
(d) "Insured" means any individual who is enrolled in a health plan and on whose 24
behalf the insurer is obligated to pay for or provide health care services; 25
(e) "Insurer"[ includes]: 26
1. Has the same meaning as in KRS 304.17A-005[An insurer offering a 27 UNOFFICIAL COPY 24 RS BR 1495
Page 2 of 19
XXXX 1/30/2024 9:48 AM Jacketed
health plan providing coverage for pharmacy benefits]; and[or] 1
2. Includes limited health service organizations as defined in KRS 2
304.38A-010[Any other administrator of pharmacy benefits under a 3
health plan]; 4
(f) ["Person" means a natural person, corporation, mutual company, 5
unincorporated association, partnership, joint venture, limited liability 6
company, trust, estate, foundation, nonprofit corporation, unincorporated 7
organization, government, or governmental subdivision or agency; 8
(g) ]"Pharmacy" includes: 9
1. A pharmacy, as defined in KRS Chapter 315; 10
2. A pharmacist, as defined in KRS Chapter 315; and 11
3. Any employee of a pharmacy or pharmacist; and 12
(g)[(h)] "Pharmacy benefit manager" has the same meaning as in KRS 304.17A-13
161; 14
(h) "Price protection rebate" means a negotiated price concession that accrues 15
directly or indirectly to an insurer, pharmacy benefit manager, or any other 16
administrator of pharmacy benefits, or another party on behalf of an 17
insurer, pharmacy benefit manager, or any other administrator of 18
pharmacy benefits, if there is an increase in the wholesale acquisition cost 19
of a prescription drug above a specified threshold; and 20
(i) "Rebate" means a discount or other negotiated price concession, including 21
a base price concession whether described as a rebate or otherwise, a price 22
protection rebate, a performance-based price concession, and any 23
reasonable estimates of negotiated price concessions, fees, or other 24
administrative costs that may accrue directly or indirectly, or are anticipated 25
to be passed through, to an insurer, pharmacy benefit manager, or any 26
other administrator of pharmacy benefits from a manufacturer, dispensing 27 UNOFFICIAL COPY 24 RS BR 1495
Page 3 of 19
XXXX 1/30/2024 9:48 AM Jacketed
pharmacy, or other party in connection with the dispensing or 1
administration of a prescription drug to reduce the insurer's, pharmacy 2
benefit manager's, or other administrator's liability for the prescription 3
drug. 4
(2) (a) As used in this subsection, "cost sharing" does not include copayments. 5
(b) To the extent permitted under federal law and except as provided in 6
subsection (5) of this section: 7
1. An insured's cost sharing for a prescription drug shall be calculated at 8
the point of sale; and 9
2. All rebates received or estimated to be received by an insurer, 10
pharmacy benefit manager, or any other administrator of pharmacy 11
benefits in connection with the dispensing or administration of a 12
prescription drug to an insured shall be passed through as follows: 13
a. The cost sharing charged to the insured shall be calculated 14
based on a prescription drug price that is reduced by at least 15
eighty-five percent (85%) of the rebates received or estimated to 16
be received; and 17
b. Any rebates not used to reduce cost sharing under subdivision a. 18
of this subparagraph shall be used to reduce the premiums 19
charged by the health plan. 20
(c) Subject to the requirements of paragraph (d) of this subsection, the 21
commissioner may: 22
1. Require an insurer, pharmacy benefit manager, or any other 23
administrator of pharmacy benefits, including the insurer's, pharmacy 24
benefit manager's, or other administrator's agent, to report any 25
information necessary to determine compliance with this subsection; 26
and 27 UNOFFICIAL COPY 24 RS BR 1495
Page 4 of 19
XXXX 1/30/2024 9:48 AM Jacketed
2. Otherwise use the information reported under subparagraph 1. of this 1
paragraph in furtherance of any regulatory action authorized under 2
this chapter. 3
(d) 1. In complying with paragraphs (b) and (c) of this subsection, an 4
insurer, pharmacy benefit manager, or any other administrator of 5
pharmacy benefits, including the insurer's, pharmacy benefit 6
manager's, or other administrator's agent, shall not publish or 7
otherwise reveal information regarding the actual amounts of rebates 8
the insurer, pharmacy benefit manager, or other administrator 9
receives on a product-specific, manufacturer-specific, or pharmacy-10
specific basis. 11
2. The information referenced in subparagraph 1. of this paragraph 12
shall: 13
a. Be protected as a trade secret under KRS 365.880 to 365.900; 14
b. Not be a public record subject to disclosure under KRS 61.870 to 15
61.884; and 16
c. Not otherwise be disclosed by the insurer, pharmacy benefit 17
manager, or other administrator of pharmacy benefits, including 18
the insurer's, pharmacy benefit manager's, or other 19
administrator's agent: 20
i. Directly or indirectly; 21
ii. In a manner that would allow for identification of an 22
individual product, therapeutic class of products, or 23
manufacturer; or 24
iii. In a manner that would have the potential to compromise 25
the financial, competitive, or proprietary nature of the 26
information. 27 UNOFFICIAL COPY 24 RS BR 1495
Page 5 of 19
XXXX 1/30/2024 9:48 AM Jacketed
3. An insurer, pharmacy benefit manager, or any other administrator of 1
pharmacy benefits shall impose the confidentiality requirements of 2
this paragraph on any vendor or third party that: 3
a. Performs health care or administrative services on behalf of the 4
insurer, pharmacy benefit manager, or other administrator; and 5
b. May receive or have access to rebate information. 6
(3) To the extent permitted under federal law and except as provided in subsection 7
(5)[(4)] of this section, an insurer[ issuing or renewing a health plan on or after 8
January 1, 2022],[ or a] pharmacy benefit manager, or any other administrator of 9
pharmacy benefits shall not: 10
(a) Require an insured purchasing a prescription drug to pay a cost-sharing 11
amount greater than the amount the insured would pay for the drug if he or 12
she were to purchase the drug without coverage; 13
(b) Exclude any cost-sharing amounts paid by an insured, or on behalf of the[an] 14
insured[ by another person], for a prescription drug, including any amount 15
paid under paragraph (a) of this subsection, when calculating an insured's 16
contribution to any applicable cost-sharing requirement. The requirements of 17
this paragraph shall not apply: 18
1. In the case of a prescription drug for which there is a generic alternative, 19
unless the insured has obtained access to the brand prescription drug 20
through prior authorization, a step therapy protocol, or the insurer's 21
exceptions and appeals process; or 22
2. To any fully insured health benefit plan or self-insured plan provided to 23
any employee under KRS 18A.225; 24
(c) Prohibit a pharmacy from discussing any information under subsection 25
(4)[(3)] of this section; or 26
(d) Impose a penalty on a pharmacy for complying with this section. 27 UNOFFICIAL COPY 24 RS BR 1495
Page 6 of 19
XXXX 1/30/2024 9:48 AM Jacketed
(4)[(3)] A pharmacist shall have the right to provide an insured information regarding 1
the applicable limitations on his or her cost sharing pursuant to this section for a 2
prescription drug. 3
(5)[(4)] If the application of any requirement of subsection (2) or (3)(b) of this section 4
would be the sole cause of a health plan's failure to qualify as a Health Savings 5
Account-qualified High Deductible Health Plan under 26 U.S.C. sec. 223, as 6
amended, then the requirement shall not apply to that health plan until the minimum 7
deductible under 26 U.S.C. sec. 223, as amended, is satisfied. 8
(6) Nothing in this section shall be construed to prohibit an insurer, pharmacy 9
benefit manager, or any other administrator of pharmacy benefits from imposing 10
a cost-sharing amount that is less than the amount permitted under this section. 11
SECTION 2. A NEW SECTION OF KRS 365.880 TO 365.900 IS CREATED 12
TO READ AS FOLLOWS: 13
(1) As used in this section, the following have the same meaning as in Section 1 of 14
this Act: 15
(a) "Insurer"; 16
(b) "Pharmacy benefit manager"; and 17
(c) "Rebate." 18
(2) The actual amount of rebates received by an insurer, pharmacy benefit manager, 19
or any other administrator of pharmacy benefits on a product-specific, 20
manufacturer-specific, or pharmacy-specific basis shall be a trade secret. 21
(3) Compliance with Section 1 of this Act shall not be construed to violate KRS 22
365.880 to 365.900. 23
Section 3. KRS 304.17C-125 (Effective January 1, 2025) is amended to read as 24
follows: 25
The following[KRS 304.17A-262] shall apply to limited health service benefit plans, 26
including any limited health service contract, as defined in KRS 304.38A-010: 27 UNOFFICIAL COPY 24 RS BR 1495
Page 7 of 19
XXXX 1/30/2024 9:48 AM Jacketed
(1) KRS 304.17A-262; and 1
(2) Section 1 of this Act. 2
Section 4. KRS 304.38A-115 (Effective January 1, 2025) is amended to read as 3
follows: 4
Limited health service organizations shall comply with: 5
(1) KRS 304.17A-262; 6
(2) KRS 304.17A-265; and 7
(3) Section 1 of this Act. 8
Section 5. KRS 18A.225 (Effective January 1, 2025) is amended to read as 9
follows: 10
(1) (a) The term "employee" for purposes of this section means: 11
1. Any person, including an elected public official, who is regularly 12
employed by any department, office, board, agency, or branch of state 13
government; or by a public postsecondary educational institution; or by 14
any city, urban-county, charter county, county, or consolidated local 15
government, whose legislative body has opted to participate in the state-16
sponsored health insurance program pursuant to KRS 79.080; and who 17
is either a contributing member to any one (1) of the retirement systems 18
administered by the state, including but not limited to the Kentucky 19
Retirement Systems, County Employees Retirement System, Kentucky 20
Teachers' Retirement System, the Legislators' Retirement Plan, or the 21
Judicial Retirement Plan; or is receiving a contractual contribution from 22
the state toward a retirement plan; or, in the case of a public 23
postsecondary education institution, is an individual participating in an 24
optional retirement plan authorized by KRS 161.567; or is eligible to 25
participate in a retirement plan established by an employer who ceases 26
participating in the Kentucky Employees Retirement System pursuant to 27 UNOFFICIAL COPY 24 RS BR 1495
Page 8 of 19
XXXX 1/30/2024 9:48 AM Jacketed
KRS 61.522 whose employees participated in the health insurance plans 1
administered by the Personnel Cabinet prior to the employer's effective 2
cessation date in the Kentucky Employees Retirement System; 3
2. Any certified or classified employee of a local board of education or a 4
public charter school as defined in KRS 160.1590; 5
3. Any elected member of a local board of education; 6
4. Any person who is a present or future recipient of a retirement 7
allowance from the Kentucky Retirement Systems, County Employees 8
Retirement System, Kentucky Teachers' Retirement System, the 9
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 10
Kentucky Community and Technical College System's optional 11
retirement plan authorized by KRS 161.567, except that a person who is 12
receiving a retirement allowance and who is age sixty-five (65) or older 13
shall not be included, with the exception of persons covered under KRS 14
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 15
employed pursuant to subparagraph 1. of this paragraph; and 16
5. Any eligible dependents and beneficiaries of participating employees 17
and retirees who are entitled to participate in the state-sponsored health 18
insurance program; 19
(b) The term "health benefit plan" for the purposes of this section means a health 20
benefit plan as defined in KRS 304.17A-005; 21
(c) The term "insurer" for the purposes of this section means an insurer as defined 22
in KRS 304.17A-005; and 23
(d) The term "managed care plan" for the purposes of this section means a 24
managed care plan as defined in KRS 304.17A-500. 25
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 26
recommendation of the secretary of the Personnel Cabinet, shall procure, in 27 UNOFFICIAL COPY 24 RS BR 1495
Page 9 of 19
XXXX 1/30/2024 9:48 AM Jacketed
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 1
from one (1) or more insurers authorized to do business in this state, a group 2
health benefit plan that may include but not be limited to health maintenance 3
organization (HMO), preferred provider organization (PPO), point of service 4
(POS), and exclusive provider organization (EPO) benefit plans 5
encompassing all or any class or classes of employees. With the exception of 6
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 7
all employers of any class of employees or former employees shall enter into 8
a contract with the Personnel Cabinet prior to including that group in the state 9
health insurance group. The contracts shall include but not be limited to 10
designating the entity responsible for filing any federal forms, adoption of 11
policies required for proper plan administration, acceptance of the contractual 12
provisions with health insurance carriers or third-party administrators, and 13
adoption of the payment and reimbursement methods necessary for efficient 14
administration of the health insurance program. Health insurance coverage 15
provided to state employees under this section shall, at a minimum, contain 16
the same benefits as provided under Kentucky Kare Standard as of January 1, 17
1994, and shall include a mail-order drug option as provided in subsection 18
(13) of this section. All employees and other persons for whom the health care 19
coverage is provided or made available shall annually be given an option to 20
elect health care coverage through a self-funded plan offered by the 21
Commonwealth or, if a self-funded plan is not available, from a list of 22
coverage options determined by the competitive bid process under the 23
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 24
during annual open enrollment. 25
(b) The policy or policies shall be approved by the commissioner of insurance 26
and may contain the provisions the commissioner of insurance approves, 27 UNOFFICIAL COPY 24 RS BR 1495
Page 10 of 19
XXXX 1/30/2024 9:48 AM Jacketed
whether or not otherwise permitted by the insurance laws. 1
(c) Any carrier bidding to offer health care coverage to employees shall agree to 2
provide coverage to all members of the state group, including active 3
employees and retirees and their eligible covered dependents and 4
beneficiaries, within the county or counties specified in its bid. Except as 5
provided in subsection (20) of this section, any carrier bidding to offer health 6
care coverage to employees shall also agree to rate all employees as a single 7
entity, except for those retirees whose former employers insure their active 8
employees outside the state-sponsored health insurance program and as 9
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 10
(d) Any carrier bidding to offer health care coverage to employees shall agree to 11
provide enrollment, claims, and utilization data to the Commonwealth in a 12
format specified by the Personnel Cabinet with the understanding that the data 13
shall be owned by the Commonwealth; to provide data in an electronic form 14
and within a time frame specified by the Personnel Cabinet; and to be subject 15
to penalties for noncompliance with data reporting requirements as specified 16
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 17
to protect the confidentiality of each individual employee; however, 18
confidentiality assertions shall not relieve a carrier from the requirement of 19
providing stipulated data to the Commonwealth. 20
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 21
for timely analysis of data received from carriers and, to the extent possible, 22
provide in the request-for-proposal specifics relating to data requirements, 23
electronic reporting, and penalties for noncompliance. The Commonwealth 24
shall own the enrollment, claims, and utilization data provided by each carrier 25
and shall develop methods to protect the confidentiality of the individual. The 26
Personnel Cabinet shall include in the October annual report submitted 27 UNOFFICIAL COPY 24 RS BR 1495
Page 11 of 19
XXXX 1/30/2024 9:48 AM Jacketed
pursuant to the provisions of KRS 18A.226 to the Governor, the General 1
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 2
financial stability of the program, which shall include but not be limited to 3
loss ratios, methods of risk adjustment, measurements of carrier quality of 4
service, prescription coverage and cost management, and statutorily required 5
mandates. If state self-insurance was available as a carrier option, the report 6
also shall provide a detailed financial analysis of the self-insurance fund 7
including but not limited to loss ratios, reserves, and reinsurance agreements. 8
(f) If any agency participating in the state-sponsored employee health insurance 9
program for its active employees terminates participation and there is a state 10
appropriation for the employer's contribution for active employees' health 11
insurance coverage, then neither the agency nor the employees shall receive 12
the state-funded contribution after termination from the state-sponsored 13
employee health insurance program. 14
(g) Any funds in flexible spending accounts that remain after all reimbursements 15
have been processed shall be transferred to the credit of the state-sponsored 16
health insurance plan's appropriation account. 17
(h) Each entity participating in the state-sponsored health insurance program shall 18
provide an amount at least equal to the state contribution rate for the employer 19
portion of the health insurance premium. For any participating entity that used 20
the state payroll system, the employer contribution amount shall be equal to 21
but not greater than the state contribution rate. 22
(3) The premiums may be paid by the policyholder: 23
(a) Wholly from funds contributed by the employee, by payroll deduction or 24
otherwise; 25
(b) Wholly from funds contributed by any department, board, agency, public 26
postsecondary education institution, or branch of state, city, urban-county, 27 UNOFFICIAL COPY 24 RS BR 1495
Page 12 of 19
XXXX 1/30/2024 9:48 AM Jacketed
charter county, county, or consolidated local government; or 1
(c) Partly from each, except that any premium due for health care coverage or 2
dental coverage, if any, in excess of the premium amount contributed by any 3
department, board, agency, postsecondary education institution, or branch of 4
state, city, urban-county, charter county, county, or consolidated local 5
government for any other health care coverage shall be paid by the employee. 6
(4) If an employee moves his or her place of residence or employment out of the 7
service area of an insurer offering a managed health care plan, under which he or 8
she has elected coverage, into either the service area of another managed health care 9
plan or into an area of the Commonwealth not within a managed health care plan 10
service area, the employee shall be given an option, at the time of the move or 11
transfer, to change his or her coverage to another health benefit plan. 12
(5) No payment of premium by any department, board, agency, public postsecondary 13
educational institution, or branch of state, city, urban-county, charter county, 14
county, or consolidated local government shall constitute compensation to an 15
insured employee for the purposes of any statute fixing or limiting the 16
compensation of such an employee. Any premium or other expense incurred by any 17
department, board, agency, public postsecondary educational institution, or branch 18
of state, city, urban-county, charter county, county, or consolidated local 19
government shall be considered a proper cost of administration. 20
(6) The policy or policies may contain the provisions with respect to the class or classes 21
of employees covered, amounts of insurance or coverage for designated classes or 22
groups of employees, policy options, terms of eligibility, and continuation of 23
insurance or coverage after retirement. 24
(7) Group rates under this section shall be made available to the disabled child of an 25
employee regardless of the child's age if the entire premium for the disabled child's 26
coverage is paid by the state employee. A child shall be considered disabled if he or 27 UNOFFICIAL COPY 24 RS BR 1495
Page 13 of 19
XXXX 1/30/2024 9:48 AM Jacketed
she has been determined to be eligible for federal Social Security disability benefits. 1
(8) The health care contract or contracts for employees shall be entered into for a 2
period of not less than one (1) year. 3
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 4
State Health Insurance Subscribers to advise the secretary or the secretary's 5
designee regarding the state-sponsored health insurance program for employees. 6
The secretary shall appoint, from a list of names submitted by appointing 7
authorities, members representing school districts from each of the seven (7) 8
Supreme Court districts, members representing state government from each of the 9
seven (7) Supreme Court districts, two (2) members representing retirees under age 10
sixty-five (65), one (1) member representing local health departments, two (2) 11
members representing the Kentucky Teachers' Retirement System, and three (3) 12
members at large. The secretary shall also appoint two (2) members from a list of 13
five (5) names submitted by the Kentucky Education Association, two (2) members 14
from a list of five (5) names submitted by the largest state employee organization of 15
nonschool state employees, two (2) members from a list of five (5) names submitted 16
by the Kentucky Association of Counties, two (2) members from a list of five (5) 17
names submitted by the Kentucky League of Cities, and two (2) members from a 18
list of names consisting of five (5) names submitted by each state employee 19
organization that has two thousand (2,000) or more members on state payroll 20
deduction. The advisory committee shall be appointed in January of each year and 21
shall meet quarterly. 22
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 23
provided to employees pursuant to this section shall not provide coverage for 24
obtaining or performing an abortion, nor shall any state funds be used for the 25
purpose of obtaining or performing an abortion on behalf of employees or their 26
dependents. 27 UNOFFICIAL COPY 24 RS BR 1495
Page 14 of 19
XXXX 1/30/2024 9:48 AM Jacketed
(11) Interruption of an established treatment regime with maintenance drugs shall be 1
grounds for an insured to appeal a formulary change through the established appeal 2
procedures approved by the Department of Insurance, if the physician supervising 3
the treatment certifies that the change is not in the best interests of the patient. 4
(12) Any employee who is eligible for and elects to participate in the state health 5
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 6
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 7
state health insurance contribution toward health care coverage as a result of any 8
other employment for which there is a public employer contribution. This does not 9
preclude a retiree and an active employee spouse from using both contributions to 10
the extent needed for purchase of one (1) state sponsored health insurance policy 11
for that plan year. 12
(13) (a) The policies of health insurance coverage procured under subsection (2) of 13
this section shall include a mail-order drug option for maintenance drugs for 14
state employees. Maintenance drugs may be dispensed by mail order in 15
accordance with Kentucky law. 16
(b) A health insurer shall not discriminate against any retail pharmacy located 17
within the geographic coverage area of the health benefit plan and that meets 18
the terms and conditions for participation established by the insurer, including 19
price, dispensing fee, and copay requirements of a mail-order option. The 20
retail pharmacy shall not be required to dispense by mail. 21
(c) The mail-order option shall not permit the dispensing of a controlled 22
substance classified in Schedule II. 23
(14) The policy or policies provided to state employees or their dependents pursuant to 24
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 25
aid-related services for insured individuals under eighteen (18) years of age, subject 26
to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months 27 UNOFFICIAL COPY 24 RS BR 1495
Page 15 of 19
XXXX 1/30/2024 9:48 AM Jacketed
pursuant to KRS 304.17A-132. 1
(15) Any policy provided to state employees or their dependents pursuant to this section 2
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 3
consistent with KRS 304.17A-142. 4
(16) Any policy provided to state employees or their dependents pursuant to this section 5
shall provide coverage for obtaining amino acid-based elemental formula pursuant 6
to KRS 304.17A-258. 7
(17) If a state employee's residence and place of employment are in the same county, 8
and if the hospital located within that county does not offer surgical services, 9
intensive care services, obstetrical services, level II neonatal services, diagnostic 10
cardiac catheterization services, and magnetic resonance imaging services, the 11
employee may select a plan available in a contiguous county that does provide 12
those services, and the state contribution for the plan shall be the amount available 13
in the county where the plan selected is located. 14
(18) If a state employee's residence and place of employment are each located in 15
counties in which the hospitals do not offer surgical services, intensive care 16
services, obstetrical services, level II neonatal services, diagnostic cardiac 17
catheterization services, and magnetic resonance imaging services, the employee 18
may select a plan available in a county contiguous to the county of residence that 19
does provide those services, and the state contribution for the plan shall be the 20
amount available in the county where the plan selected is located. 21
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 22
in the best interests of the state group to allow any carrier bidding to offer health 23
care coverage under this section to submit bids that may vary county by county or 24
by larger geographic areas. 25
(20) Notwithstanding any other provision of this section, the bid for proposals for health 26
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 27 UNOFFICIAL COPY 24 RS BR 1495
Page 16 of 19
XXXX 1/30/2024 9:48 AM Jacketed
the statewide rating structure provided in calendar year 2003 and a bid scenario that 1
allows for a regional rating structure that allows carriers to submit bids that may 2
vary by region for a given product offering as described in this subsection: 3
(a) The regional rating bid scenario shall not include a request for bid on a 4
statewide option; 5
(b) The Personnel Cabinet shall divide the state into geographical regions which 6
shall be the same as the partnership regions designated by the Department for 7
Medicaid Services for purposes of the Kentucky Health Care Partnership 8
Program established pursuant to 907 KAR 1:705; 9
(c) The request for proposal shall require a carrier's bid to include every county 10
within the region or regions for which the bid is submitted and include but not 11
be restricted to a preferred provider organization (PPO) option; 12
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 13
carrier all of the counties included in its bid within the region. If the Personnel 14
Cabinet deems the bids submitted in accordance with this subsection to be in 15
the best interests of state employees in a region, the cabinet may award the 16
contract for that region to no more than two (2) carriers; and 17
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 18
other requirements or criteria in the request for proposal. 19
(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 20
after July 12, 2006, to public employees pursuant to this section which provides 21
coverage for services rendered by a physician or osteopath duly licensed under KRS 22
Chapter 311 that are within the scope of practice of an optometrist duly licensed 23
under the provisions of KRS Chapter 320 shall provide the same payment of 24
coverage to optometrists as allowed for those services rendered by physicians or 25
osteopaths. 26
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to 27 UNOFFICIAL COPY 24 RS BR 1495
Page 17 of 19
XXXX 1/30/2024 9:48 AM Jacketed
public employees pursuant to this section shall comply with: 1
(a) KRS 304.12-237; 2
(b) KRS 304.17A-270 and 304.17A-525; 3
(c) KRS 304.17A-600 to 304.17A-633; 4
(d) KRS 205.593; 5
(e) KRS 304.17A-700 to 304.17A-730; 6
(f) KRS 304.14-135; 7
(g) KRS 304.17A-580 and 304.17A-641; 8
(h) KRS 304.99-123; 9
(i) KRS 304.17A-138; 10
(j) KRS 304.17A-148; 11
(k) KRS 304.17A-163 and 304.17A-1631; 12
(l) KRS 304.17A-265; 13
(m) KRS 304.17A-261; 14
(n) KRS 304.17A-262;[ and] 15
(o) Subsection (2) of Section 1 of this Act; and 16
(p) Administrative regulations promulgated pursuant to statutes listed in this 17
subsection. 18
Section 6. KRS 164.2871 (Effective January 1, 2025) is amended to read as 19
follows: 20
(1) The governing board of each state postsecondary educational institution is 21
authorized to purchase liability insurance for the protection of the individual 22
members of the governing board, faculty, and staff of such institutions from liability 23
for acts and omissions committed in the course and scope of the individual's 24
employment or service. Each institution may purchase the type and amount of 25
liability coverage deemed to best serve the interest of such institution. 26
(2) All retirement annuity allowances accrued or accruing to any employee of a state 27 UNOFFICIAL COPY 24 RS BR 1495
Page 18 of 19
XXXX 1/30/2024 9:48 AM Jacketed
postsecondary educational institution through a retirement program sponsored by 1
the state postsecondary educational institution are hereby exempt from any state, 2
county, or municipal tax, and shall not be subject to execution, attachment, 3
garnishment, or any other process whatsoever, nor shall any assignment thereof be 4
enforceable in any court. Except retirement benefits accrued or accruing to any 5
employee of a state postsecondary educational institution through a retirement 6
program sponsored by the state postsecondary educational institution on or after 7
January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent 8
provided in KRS 141.010 and 141.0215. 9
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 10
members of governing boards, faculty and staff of institutions of higher education 11
in this state shall not be construed to be a waiver of sovereign immunity or any 12
other immunity or privilege. 13
(4) The governing board of each state postsecondary education institution is authorized 14
to provide a self-insured employer group health plan to its employees, which plan 15
shall: 16
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and 17
(b) Except as provided in subsection (5) of this section, be exempt from 18
conformity with Subtitle 17A of KRS Chapter 304. 19
(5) A self-insured employer group health plan provided by the governing board of a 20
state postsecondary education institution to its employees shall comply with: 21
(a) KRS 304.17A-163 and 304.17A-1631; 22
(b) KRS 304.17A-265; 23
(c) KRS 304.17A-261;[ and] 24
(d) KRS 304.17A-262; and 25
(e) Subsection (2) of Section 1 of this Act. 26
Section 7. The following KRS section is repealed: 27 UNOFFICIAL COPY 24 RS BR 1495
Page 19 of 19
XXXX 1/30/2024 9:48 AM Jacketed
304.38A-120 Compliance with KRS 304.17A-265. 1
Section 8. This Act applies to health plans issued or renewed on or after 2
January 1, 2025. 3
Section 9. This Act takes effect January 1, 2025. 4