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AN ACT relating to state employee health insurance. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 18A.225 (Effective until January 1, 2025) is amended to read as 3
follows: 4
(1) (a) The term "employee" for purposes of this section means: 5
1. Any person, including an elected public official, who is regularly 6
employed by any department, office, board, agency, or branch of state 7
government; or by a public postsecondary educational institution; or by 8
any city, urban-county, charter county, county, or consolidated local 9
government, whose legislative body has opted to participate in the state-10
sponsored health insurance program pursuant to KRS 79.080; and who 11
is either a contributing member to any one (1) of the retirement systems 12
administered by the state, including but not limited to the Kentucky 13
Retirement Systems, County Employees Retirement System, Kentucky 14
Teachers' Retirement System, the Legislators' Retirement Plan, or the 15
Judicial Retirement Plan; or is receiving a contractual contribution from 16
the state toward a retirement plan; or, in the case of a public 17
postsecondary education institution, is an individual participating in an 18
optional retirement plan authorized by KRS 161.567; or is eligible to 19
participate in a retirement plan established by an employer who ceases 20
participating in the Kentucky Employees Retirement System pursuant to 21
KRS 61.522 whose employees participated in the health insurance plans 22
administered by the Personnel Cabinet prior to the employer's effective 23
cessation date in the Kentucky Employees Retirement System, except 24
that no employer who ceases participation in the state health 25
insurance plan shall be eligible to participate in the state health 26
insurance plan again in the future; 27 UNOFFICIAL COPY 24 RS SB 261/GA
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2. Any certified or classified employee of a local board of education or a 1
public charter school as defined in KRS 160.1590; 2
3. Any elected member of a local board of education; 3
4. Any person who is a present or future recipient of a retirement 4
allowance from the Kentucky Retirement Systems, County Employees 5
Retirement System, Kentucky Teachers' Retirement System, the 6
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 7
Kentucky Community and Technical College System's optional 8
retirement plan authorized by KRS 161.567, except that a person who is 9
receiving a retirement allowance and who is age sixty-five (65) or older 10
shall not be included, with the exception of persons covered under KRS 11
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 12
employed pursuant to subparagraph 1. of this paragraph; and 13
5. Any eligible dependents and beneficiaries of participating employees 14
and retirees who are entitled to participate in the state-sponsored health 15
insurance program; 16
(b) The term "health benefit plan" for the purposes of this section means a health 17
benefit plan as defined in KRS 304.17A-005; 18
(c) The term "insurer" for the purposes of this section means an insurer as defined 19
in KRS 304.17A-005; and 20
(d) The term "managed care plan" for the purposes of this section means a 21
managed care plan as defined in KRS 304.17A-500. 22
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 23
recommendation of the secretary of the Personnel Cabinet, shall procure, in 24
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 25
from one (1) or more insurers authorized to do business in this state, a group 26
health benefit plan that may include but not be limited to health maintenance 27 UNOFFICIAL COPY 24 RS SB 261/GA
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organization (HMO), preferred provider organization (PPO), point of service 1
(POS), and exclusive provider organization (EPO) benefit plans 2
encompassing all or any class or classes of employees. With the exception of 3
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 4
all employers of any class of employees or former employees shall enter into 5
a contract with the Personnel Cabinet prior to including that group in the state 6
health insurance group. The contracts shall include but not be limited to 7
designating the entity responsible for filing any federal forms, adoption of 8
policies required for proper plan administration, acceptance of the contractual 9
provisions with health insurance carriers or third-party administrators, 10
requiring minimal participation duration, requiring participation in all 11
employee benefits administered by the Personnel Cabinet pursuant to KRS 12
18A.205 to 18A.2287, and adoption of the payment and reimbursement 13
methods necessary for efficient administration of the health insurance 14
program. Health insurance coverage provided to state employees under this 15
section shall: 16
1. Provide minimum value in that the plan shall pay at least sixty percent 17
(60%) of the total cost of in-network medical services for employees; 18
2. Provide minimum essential coverage as defined in 26 U.S.C. sec. 19
5000A(f); 20
3. Not discriminate in favor of highly compensated individuals as 21
prohibited by 26 U.S.C. sec. 105(h); and 22
4. [, at a minimum, contain the same benefits as provided under Kentucky 23
Kare Standard as of January 1, 1994, and shall ]Include a mail-order 24
drug option as provided in subsection (12)[(13)] of this section. 25
All employees and other persons for whom the health care coverage is 26
provided or made available shall annually be given an option to elect health 27 UNOFFICIAL COPY 24 RS SB 261/GA
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care coverage through a self-funded plan offered by the Commonwealth or, if 1
a self-funded plan is not available, from a list of coverage options determined 2
by the competitive bid process under the provisions of KRS 45A.080, 3
45A.085, and 45A.090 and made available during annual open enrollment. 4
(b) The policy or policies shall be approved by the commissioner of insurance 5
and may contain the provisions the commissioner of insurance approves, 6
whether or not otherwise permitted by the insurance laws. 7
(c) Any carrier bidding to offer health care coverage to employees shall agree to 8
provide coverage to all members of the state group, including active 9
employees and retirees and their eligible covered dependents and 10
beneficiaries, within the county or counties specified in its bid. Any[Except as 11
provided in subsection (20) of this section, any] carrier bidding to offer health 12
care coverage to employees shall also agree to rate all employees as a single 13
entity, except for those retirees whose former employers insure their active 14
employees outside the state-sponsored health insurance program and as 15
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 16
(d) Any carrier bidding to offer health care coverage to employees shall agree to 17
provide enrollment, claims, and utilization data to the Commonwealth in a 18
format specified by the Personnel Cabinet with the understanding that the data 19
shall be owned by the Commonwealth; to provide data in an electronic form 20
and within a time frame specified by the Personnel Cabinet; and to be subject 21
to penalties for noncompliance with data reporting requirements as specified 22
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 23
to protect the confidentiality of each individual employee; however, 24
confidentiality assertions shall not relieve a carrier from the requirement of 25
providing stipulated data to the Commonwealth. 26
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 27 UNOFFICIAL COPY 24 RS SB 261/GA
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for timely analysis of data received from carriers and, to the extent possible, 1
provide in the request-for-proposal specifics relating to data requirements, 2
electronic reporting, and penalties for noncompliance. The Commonwealth 3
shall own the enrollment, claims, and utilization data provided by each carrier 4
and shall develop methods to protect the confidentiality of the individual. The 5
Personnel Cabinet shall include in the October annual report submitted 6
pursuant to the provisions of KRS 18A.226 to the Governor, the General 7
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 8
financial stability of the program, which shall include but not be limited to 9
loss ratios, methods of risk adjustment, measurements of carrier quality of 10
service, prescription coverage and cost management, and statutorily required 11
mandates. If state self-insurance was available as a carrier option, the report 12
also shall provide a detailed financial analysis of the self-insurance fund 13
including but not limited to loss ratios, reserves, and reinsurance agreements. 14
(f) If any agency participating in the state-sponsored employee health insurance 15
program for its active employees terminates participation and there is a state 16
appropriation for the employer's contribution for active employees' health 17
insurance coverage, then neither the agency nor the employees shall receive 18
the state-funded contribution after termination from the state-sponsored 19
employee health insurance program. 20
(g) Any funds in flexible spending accounts that remain after all reimbursements 21
have been processed shall be transferred to the credit of the state-sponsored 22
health insurance plan's appropriation account. 23
(h) Each entity participating in the state-sponsored health insurance program shall 24
provide an amount at least equal to the state contribution rate for the employer 25
portion of the health insurance premium. For any participating entity that used 26
the state payroll system, the employer contribution amount shall be equal to 27 UNOFFICIAL COPY 24 RS SB 261/GA
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but not greater than the state contribution rate. 1
(3) The premiums may be paid by the policyholder: 2
(a) Wholly from funds contributed by the employee, by payroll deduction or 3
otherwise; 4
(b) Wholly from funds contributed by any department, board, agency, public 5
postsecondary education institution, or branch of state, city, urban-county, 6
charter county, county, or consolidated local government; or 7
(c) Partly from each, except that any premium due for health care coverage, 8
vision coverage, or dental coverage, if any, in excess of the premium amount 9
contributed by any department, board, agency, postsecondary education 10
institution, or branch of state, city, urban-county, charter county, county, or 11
consolidated local government for any other health care coverage shall be 12
paid by the employee. 13
(4) If an employee moves his or her place of residence or employment out of the 14
service area of an insurer offering a managed health care plan, under which he or 15
she has elected coverage, into either the service area of another managed health care 16
plan or into an area of the Commonwealth not within a managed health care plan 17
service area, the employee shall be given an option, at the time of the move or 18
transfer, to change his or her coverage to another health benefit plan. 19
(5) No payment of premium by any department, board, agency, public postsecondary 20
educational institution, or branch of state, city, urban-county, charter county, 21
county, or consolidated local government shall constitute compensation to an 22
insured employee for the purposes of any statute fixing or limiting the 23
compensation of such an employee. Any premium or other expense incurred by any 24
department, board, agency, public postsecondary educational institution, or branch 25
of state, city, urban-county, charter county, county, or consolidated local 26
government shall be considered a proper cost of administration. 27 UNOFFICIAL COPY 24 RS SB 261/GA
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(6) The policy or policies may contain the provisions with respect to the class or classes 1
of employees covered, amounts of insurance or coverage for designated classes or 2
groups of employees, policy options, terms of eligibility, and continuation of 3
insurance or coverage after retirement. 4
(7) Group rates under this section shall be made available to the disabled child of an 5
employee regardless of the child's age if the entire premium for the disabled child's 6
coverage is paid by the state employee. A child shall be considered disabled if he or 7
she has been determined to be eligible for federal Social Security disability benefits. 8
(8) The health care contract or contracts for employees shall be entered into for a 9
period of not less than one (1) year. 10
(9) [The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 11
State Health Insurance Subscribers to advise the secretary or the secretary's 12
designee regarding the state-sponsored health insurance program for employees. 13
The secretary shall appoint, from a list of names submitted by appointing 14
authorities, members representing school districts from each of the seven (7) 15
Supreme Court districts, members representing state government from each of the 16
seven (7) Supreme Court districts, two (2) members representing retirees under age 17
sixty-five (65), one (1) member representing local health departments, two (2) 18
members representing the Kentucky Teachers' Retirement System, and three (3) 19
members at large. The secretary shall also appoint two (2) members from a list of 20
five (5) names submitted by the Kentucky Education Association, two (2) members 21
from a list of five (5) names submitted by the largest state employee organization of 22
nonschool state employees, two (2) members from a list of five (5) names submitted 23
by the Kentucky Association of Counties, two (2) members from a list of five (5) 24
names submitted by the Kentucky League of Cities, and two (2) members from a 25
list of names consisting of five (5) names submitted by each state employee 26
organization that has two thousand (2,000) or more members on state payroll 27 UNOFFICIAL COPY 24 RS SB 261/GA
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deduction. The advisory committee shall be appointed in January of each year and 1
shall meet quarterly. 2
(10) ]Notwithstanding any other provision of law to the contrary, the policy or policies 3
provided to employees pursuant to this section shall not provide coverage for 4
obtaining or performing an abortion, nor shall any state funds be used for the 5
purpose of obtaining or performing an abortion on behalf of employees or their 6
dependents. 7
(10)[(11)] Interruption of an established treatment regime with maintenance drugs shall 8
be grounds for an insured to appeal a formulary change through the established 9
appeal procedures approved by the Department of Insurance, if the physician 10
supervising the treatment certifies that the change is not in the best interests of the 11
patient. 12
(11)[(12)] Any employee who is eligible for and elects to participate in the state health 13
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 14
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 15
state health insurance contribution toward health care coverage as a result of any 16
other employment for which there is a public employer contribution. This does not 17
preclude a retiree and an active employee spouse from using both contributions to 18
the extent needed for purchase of one (1) state sponsored health insurance policy 19
for that plan year. 20
(12)[(13)] (a) The policies of health insurance coverage procured under subsection (2) 21
of this section shall include a mail-order drug option for maintenance drugs 22
for state employees. Maintenance drugs may be dispensed by mail order in 23
accordance with Kentucky law. 24
(b) A health insurer shall not discriminate against any retail pharmacy located 25
within the geographic coverage area of the health benefit plan and that meets 26
the terms and conditions for participation established by the insurer, including 27 UNOFFICIAL COPY 24 RS SB 261/GA
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price, dispensing fee, and copay requirements of a mail-order option. The 1
retail pharmacy shall not be required to dispense by mail. 2
(c) The mail-order option shall not permit the dispensing of a controlled 3
substance classified in Schedule II. 4
(13) Except as authorized under this section and Section 3 of this Act, no provision of 5
KRS Chapter 304 shall apply to the public employee health insurance program 6
for public employees established under subsection (1) of Section 3 of this Act. 7
(14) The policy or policies provided to state employees or their dependents pursuant to 8
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 9
aid-related services for insured individuals[ under eighteen (18) years of age,] 10
subject to a limit[cap] of one (1) hearing aid per each hearing impaired 11
ear[thousand four hundred dollars ($1,400)] every thirty-six (36) months pursuant 12
to KRS 304.17A-132. 13
(15) Any policy provided to state employees or their dependents pursuant to this section 14
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 15
consistent with KRS 304.17A-142. 16
(16) Any policy provided to state employees or their dependents pursuant to this section 17
shall provide coverage for obtaining amino acid-based elemental formula pursuant 18
to KRS 304.17A-258. 19
(17) [If a state employee's residence and place of employment are in the same county, 20
and if the hospital located within that county does not offer surgical services, 21
intensive care services, obstetrical services, level II neonatal services, diagnostic 22
cardiac catheterization services, and magnetic resonance imaging services, the 23
employee may select a plan available in a contiguous county that does provide 24
those services, and the state contribution for the plan shall be the amount available 25
in the county where the plan selected is located. 26
(18) If a state employee's residence and place of employment are each located in 27 UNOFFICIAL COPY 24 RS SB 261/GA
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counties in which the hospitals do not offer surgical services, intensive care 1
services, obstetrical services, level II neonatal services, diagnostic cardiac 2
catheterization services, and magnetic resonance imaging services, the employee 3
may select a plan available in a county contiguous to the county of residence that 4
does provide those services, and the state contribution for the plan shall be the 5
amount available in the county where the plan selected is located. 6
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 7
in the best interests of the state group to allow any carrier bidding to offer health 8
care coverage under this section to submit bids that may vary county by county or 9
by larger geographic areas. 10
(20) Notwithstanding any other provision of this section, the bid for proposals for health 11
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 12
the statewide rating structure provided in calendar year 2003 and a bid scenario that 13
allows for a regional rating structure that allows carriers to submit bids that may 14
vary by region for a given product offering as described in this subsection: 15
(a) The regional rating bid scenario shall not include a request for bid on a 16
statewide option; 17
(b) The Personnel Cabinet shall divide the state into geographical regions which 18
shall be the same as the partnership regions designated by the Department for 19
Medicaid Services for purposes of the Kentucky Health Care Partnership 20
Program established pursuant to 907 KAR 1:705; 21
(c) The request for proposal shall require a carrier's bid to include every county 22
within the region or regions for which the bid is submitted and include but not 23
be restricted to a preferred provider organization (PPO) option; 24
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 25
carrier all of the counties included in its bid within the region. If the Personnel 26
Cabinet deems the bids submitted in accordance with this subsection to be in 27 UNOFFICIAL COPY 24 RS SB 261/GA
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the best interests of state employees in a region, the cabinet may award the 1
contract for that region to no more than two (2) carriers; and 2
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 3
other requirements or criteria in the request for proposal. 4
(21) ]Any fully insured health benefit plan or self-insured plan issued or renewed on or 5
after July 12, 2006, to public employees pursuant to this section which provides 6
coverage for services rendered by a physician or osteopath duly licensed under KRS 7
Chapter 311 that are within the scope of practice of an optometrist duly licensed 8
under the provisions of KRS Chapter 320 shall provide the same payment of 9
coverage to optometrists as allowed for those services rendered by physicians or 10
osteopaths. 11
(18)[(22)] Any fully insured health benefit plan or self-insured plan issued or renewed to 12
public employees pursuant to this section shall comply with: 13
(a) KRS 304.12-237; 14
(b) KRS 304.17A-270 and 304.17A-525; 15
(c) KRS 304.17A-600 to 304.17A-633; 16
(d) KRS 205.593; 17
(e) KRS 304.17A-700 to 304.17A-730; 18
(f) KRS 304.14-135; 19
(g) KRS 304.17A-580 and 304.17A-641; 20
(h) KRS 304.99-123; 21
(i) KRS 304.17A-138; 22
(j) KRS 304.17A-148; 23
(k) KRS 304.17A-163 and 304.17A-1631; 24
(l) KRS 304.17A-265; and 25
(m) Administrative regulations promulgated pursuant to statutes listed in this 26
subsection. 27 UNOFFICIAL COPY 24 RS SB 261/GA
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Section 2. KRS 18A.225 (Effective January 1, 2025) is amended to read as 1
follows: 2
(1) (a) The term "employee" for purposes of this section means: 3
1. Any person, including an elected public official, who is regularly 4
employed by any department, office, board, agency, or branch of state 5
government; or by a public postsecondary educational institution; or by 6
any city, urban-county, charter county, county, or consolidated local 7
government, whose legislative body has opted to participate in the state-8
sponsored health insurance program pursuant to KRS 79.080; and who 9
is either a contributing member to any one (1) of the retirement systems 10
administered by the state, including but not limited to the Kentucky 11
Retirement Systems, County Employees Retirement System, Kentucky 12
Teachers' Retirement System, the Legislators' Retirement Plan, or the 13
Judicial Retirement Plan; or is receiving a contractual contribution from 14
the state toward a retirement plan; or, in the case of a public 15
postsecondary education institution, is an individual participating in an 16
optional retirement plan authorized by KRS 161.567; or is eligible to 17
participate in a retirement plan established by an employer who ceases 18
participating in the Kentucky Employees Retirement System pursuant to 19
KRS 61.522 whose employees participated in the health insurance plans 20
administered by the Personnel Cabinet prior to the employer's effective 21
cessation date in the Kentucky Employees Retirement System, except 22
that no employer who ceases participation in the state health 23
insurance plan shall be eligible to participate in the state health 24
insurance plan again in the future; 25
2. Any certified or classified employee of a local board of education or a 26
public charter school as defined in KRS 160.1590; 27 UNOFFICIAL COPY 24 RS SB 261/GA
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3. Any elected member of a local board of education; 1
4. Any person who is a present or future recipient of a retirement 2
allowance from the Kentucky Retirement Systems, County Employees 3
Retirement System, Kentucky Teachers' Retirement System, the 4
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 5
Kentucky Community and Technical College System's optional 6
retirement plan authorized by KRS 161.567, except that a person who is 7
receiving a retirement allowance and who is age sixty-five (65) or older 8
shall not be included, with the exception of persons covered under KRS 9
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 10
employed pursuant to subparagraph 1. of this paragraph; and 11
5. Any eligible dependents and beneficiaries of participating employees 12
and retirees who are entitled to participate in the state-sponsored health 13
insurance program; 14
(b) The term "health benefit plan" for the purposes of this section means a health 15
benefit plan as defined in KRS 304.17A-005; 16
(c) The term "insurer" for the purposes of this section means an insurer as defined 17
in KRS 304.17A-005; and 18
(d) The term "managed care plan" for the purposes of this section means a 19
managed care plan as defined in KRS 304.17A-500. 20
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 21
recommendation of the secretary of the Personnel Cabinet, shall procure, in 22
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 23
from one (1) or more insurers authorized to do business in this state, a group 24
health benefit plan that may include but not be limited to health maintenance 25
organization (HMO), preferred provider organization (PPO), point of service 26
(POS), and exclusive provider organization (EPO) benefit plans 27 UNOFFICIAL COPY 24 RS SB 261/GA
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encompassing all or any class or classes of employees. With the exception of 1
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 2
all employers of any class of employees or former employees shall enter into 3
a contract with the Personnel Cabinet prior to including that group in the state 4
health insurance group. The contracts shall include but not be limited to 5
designating the entity responsible for filing any federal forms, adoption of 6
policies required for proper plan administration, acceptance of the contractual 7
provisions with health insurance carriers or third-party administrators, 8
requiring minimal participation duration, requiring participation in all 9
employee benefits administered by the Personnel Cabinet pursuant to KRS 10
18A.205 to 18A.2287, and adoption of the payment and reimbursement 11
methods necessary for efficient administration of the health insurance 12
program. Health insurance coverage provided to state employees under this 13
section shall: 14
1. Provide minimum value in that the plan shall pay at least sixty percent 15
(60%) of the total cost of in-network medical services for employees; 16
2. Provide minimum essential coverage as defined in 26 U.S.C. sec. 17
5000A(f); 18
3. Not discriminate in favor of highly compensated individuals as 19
prohibited by 26 U.S.C. sec. 105(h); and 20
4. [, at a minimum, contain the same benefits as provided under Kentucky 21
Kare Standard as of January 1, 1994, and shall ]Include a mail-order 22
drug option as provided in subsection (12)[(13)] of this section. 23
All employees and other persons for whom the health care coverage is 24
provided or made available shall annually be given an option to elect health 25
care coverage through a self-funded plan offered by the Commonwealth or, if 26
a self-funded plan is not available, from a list of coverage options determined 27 UNOFFICIAL COPY 24 RS SB 261/GA
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by the competitive bid process under the provisions of KRS 45A.080, 1
45A.085, and 45A.090 and made available during annual open enrollment. 2
(b) The policy or policies shall be approved by the commissioner of insurance 3
and may contain the provisions the commissioner of insurance approves, 4
whether or not otherwise permitted by the insurance laws. 5
(c) Any carrier bidding to offer health care coverage to employees shall agree to 6
provide coverage to all members of the state group, including active 7
employees and retirees and their eligible covered dependents and 8
beneficiaries, within the county or counties specified in its bid.[ Except as 9
provided in subsection (20) of this section,] Any carrier bidding to offer 10
health care coverage to employees shall also agree to rate all employees as a 11
single entity, except for those retirees whose former employers insure their 12
active employees outside the state-sponsored health insurance program and as 13
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 14
(d) Any carrier bidding to offer health care coverage to employees shall agree to 15
provide enrollment, claims, and utilization data to the Commonwealth in a 16
format specified by the Personnel Cabinet with the understanding that the data 17
shall be owned by the Commonwealth; to provide data in an electronic form 18
and within a time frame specified by the Personnel Cabinet; and to be subject 19
to penalties for noncompliance with data reporting requirements as specified 20
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 21
to protect the confidentiality of each individual employee; however, 22
confidentiality assertions shall not relieve a carrier from the requirement of 23
providing stipulated data to the Commonwealth. 24
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 25
for timely analysis of data received from carriers and, to the extent possible, 26
provide in the request-for-proposal specifics relating to data requirements, 27 UNOFFICIAL COPY 24 RS SB 261/GA
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electronic reporting, and penalties for noncompliance. The Commonwealth 1
shall own the enrollment, claims, and utilization data provided by each carrier 2
and shall develop methods to protect the confidentiality of the individual. The 3
Personnel Cabinet shall include in the October annual report submitted 4
pursuant to the provisions of KRS 18A.226 to the Governor, the General 5
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 6
financial stability of the program, which shall include but not be limited to 7
loss ratios, methods of risk adjustment, measurements of carrier quality of 8
service, prescription coverage and cost management, and statutorily required 9
mandates. If state self-insurance was available as a carrier option, the report 10
also shall provide a detailed financial analysis of the self-insurance fund 11
including but not limited to loss ratios, reserves, and reinsurance agreements. 12
(f) If any agency participating in the state-sponsored employee health insurance 13
program for its active employees terminates participation and there is a state 14
appropriation for the employer's contribution for active employees' health 15
insurance coverage, then neither the agency nor the employees shall receive 16
the state-funded contribution after termination from the state-sponsored 17
employee health insurance program. 18
(g) Any funds in flexible spending accounts that remain after all reimbursements 19
have been processed shall be transferred to the credit of the state-sponsored 20
health insurance plan's appropriation account. 21
(h) Each entity participating in the state-sponsored health insurance program shall 22
provide an amount at least equal to the state contribution rate for the employer 23
portion of the health insurance premium. For any participating entity that used 24
the state payroll system, the employer contribution amount shall be equal to 25
but not greater than the state contribution rate. 26
(3) The premiums may be paid by the policyholder: 27 UNOFFICIAL COPY 24 RS SB 261/GA
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(a) Wholly from funds contributed by the employee, by payroll deduction or 1
otherwise; 2
(b) Wholly from funds contributed by any department, board, agency, public 3
postsecondary education institution, or branch of state, city, urban-county, 4
charter county, county, or consolidated local government; or 5
(c) Partly from each, except that any premium due for health care coverage, 6
vision coverage, or dental coverage, if any, in excess of the premium amount 7
contributed by any department, board, agency, postsecondary education 8
institution, or branch of state, city, urban-county, charter county, county, or 9
consolidated local government for any other health care coverage shall be 10
paid by the employee. 11
(4) If an employee moves his or her place of residence or employment out of the 12
service area of an insurer offering a managed health care plan, under which he or 13
she has elected coverage, into either the service area of another managed health care 14
plan or into an area of the Commonwealth not within a managed health care plan 15
service area, the employee shall be given an option, at the time of the move or 16
transfer, to change his or her coverage to another health benefit plan. 17
(5) No payment of premium by any department, board, agency, public postsecondary 18
educational institution, or branch of state, city, urban-county, charter county, 19
county, or consolidated local government shall constitute compensation to an 20
insured employee for the purposes of any statute fixing or limiting the 21
compensation of such an employee. Any premium or other expense incurred by any 22
department, board, agency, public postsecondary educational institution, or branch 23
of state, city, urban-county, charter county, county, or consolidated local 24
government shall be considered a proper cost of administration. 25
(6) The policy or policies may contain the provisions with respect to the class or classes 26
of employees covered, amounts of insurance or coverage for designated classes or 27 UNOFFICIAL COPY 24 RS SB 261/GA
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groups of employees, policy options, terms of eligibility, and continuation of 1
insurance or coverage after retirement. 2
(7) Group rates under this section shall be made available to the disabled child of an 3
employee regardless of the child's age if the entire premium for the disabled child's 4
coverage is paid by the state employee. A child shall be considered disabled if he or 5
she has been determined to be eligible for federal Social Security disability benefits. 6
(8) The health care contract or contracts for employees shall be entered into for a 7
period of not less than one (1) year. 8
(9) [The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 9
State Health Insurance Subscribers to advise the secretary or the secretary's 10
designee regarding the state-sponsored health insurance program for employees. 11
The secretary shall appoint, from a list of names submitted by appointing 12
authorities, members representing school districts from each of the seven (7) 13
Supreme Court districts, members representing state government from each of the 14
seven (7) Supreme Court districts, two (2) members representing retirees under age 15
sixty-five (65), one (1) member representing local health departments, two (2) 16
members representing the Kentucky Teachers' Retirement System, and three (3) 17
members at large. The secretary shall also appoint two (2) members from a list of 18
five (5) names submitted by the Kentucky Education Association, two (2) members 19
from a list of five (5) names submitted by the largest state employee organization of 20
nonschool state employees, two (2) members from a list of five (5) names submitted 21
by the Kentucky Association of Counties, two (2) members from a list of five (5) 22
names submitted by the Kentucky League of Cities, and two (2) members from a 23
list of names consisting of five (5) names submitted by each state employee 24
organization that has two thousand (2,000) or more members on state payroll 25
deduction. The advisory committee shall be appointed in January of each year and 26
shall meet quarterly. 27 UNOFFICIAL COPY 24 RS SB 261/GA
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(10) ]Notwithstanding any other provision of law to the contrary, the policy or policies 1
provided to employees pursuant to this section shall not provide coverage for 2
obtaining or performing an abortion, nor shall any state funds be used for the 3
purpose of obtaining or performing an abortion on behalf of employees or their 4
dependents. 5
(10)[(11)] Interruption of an established treatment regime with maintenance drugs shall 6
be grounds for an insured to appeal a formulary change through the established 7
appeal procedures approved by the Department of Insurance, if the physician 8
supervising the treatment certifies that the change is not in the best interests of the 9
patient. 10
(11)[(12)] Any employee who is eligible for and elects to participate in the state health 11
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 12
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 13
state health insurance contribution toward health care coverage as a result of any 14
other employment for which there is a public employer contribution. This does not 15
preclude a retiree and an active employee spouse from using both contributions to 16
the extent needed for purchase of one (1) state sponsored health insurance policy 17
for that plan year. 18
(12)[(13)] (a) The policies of health insurance coverage procured under subsection (2) 19
of this section shall include a mail-order drug option for maintenance drugs 20
for state employees. Maintenance drugs may be dispensed by mail order in 21
accordance with Kentucky law. 22
(b) A health insurer shall not discriminate against any retail pharmacy located 23
within the geographic coverage area of the health benefit plan and that meets 24
the terms and conditions for participation established by the insurer, including 25
price, dispensing fee, and copay requirements of a mail-order option. The 26
retail pharmacy shall not be required to dispense by mail. 27 UNOFFICIAL COPY 24 RS SB 261/GA
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(c) The mail-order option shall not permit the dispensing of a controlled 1
substance classified in Schedule II. 2
(13) Except as authorized under this section and Section 3 of this Act, no provision of 3
KRS Chapter 304 shall apply to the public employee health insurance program 4
for public employees established under subsection (1) of Section 3 of this Act. 5
(14) The policy or policies provided to state employees or their dependents pursuant to 6
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 7
aid-related services for insured individuals[ under eighteen (18) years of age,] 8
subject to a limit[cap] of one (1) hearing aid per each hearing impaired 9
ear[thousand four hundred dollars ($1,400)] every thirty-six (36) months pursuant 10
to KRS 304.17A-132. 11
(15) Any policy provided to state employees or their dependents pursuant to this section 12
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 13
consistent with KRS 304.17A-142. 14
(16) Any policy provided to state employees or their dependents pursuant to this section 15
shall provide coverage for obtaining amino acid-based elemental formula pursuant 16
to KRS 304.17A-258. 17
(17) [If a state employee's residence and place of employment are in the same county, 18
and if the hospital located within that county does not offer surgical services, 19
intensive care services, obstetrical services, level II neonatal services, diagnostic 20
cardiac catheterization services, and magnetic resonance imaging services, the 21
employee may select a plan available in a contiguous county that does provide 22
those services, and the state contribution for the plan shall be the amount available 23
in the county where the plan selected is located. 24
(18) If a state employee's residence and place of employment are each located in 25
counties in which the hospitals do not offer surgical services, intensive care 26
services, obstetrical services, level II neonatal services, diagnostic cardiac 27 UNOFFICIAL COPY 24 RS SB 261/GA
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catheterization services, and magnetic resonance imaging services, the employee 1
may select a plan available in a county contiguous to the county of residence that 2
does provide those services, and the state contribution for the plan shall be the 3
amount available in the county where the plan selected is located. 4
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 5
in the best interests of the state group to allow any carrier bidding to offer health 6
care coverage under this section to submit bids that may vary county by county or 7
by larger geographic areas. 8
(20) Notwithstanding any other provision of this section, the bid for proposals for health 9
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 10
the statewide rating structure provided in calendar year 2003 and a bid scenario that 11
allows for a regional rating structure that allows carriers to submit bids that may 12
vary by region for a given product offering as described in this subsection: 13
(a) The regional rating bid scenario shall not include a request for bid on a 14
statewide option; 15
(b) The Personnel Cabinet shall divide the state into geographical regions which 16
shall be the same as the partnership regions designated by the Department for 17
Medicaid Services for purposes of the Kentucky Health Care Partnership 18
Program established pursuant to 907 KAR 1:705; 19
(c) The request for proposal shall require a carrier's bid to include every county 20
within the region or regions for which the bid is submitted and include but not 21
be restricted to a preferred provider organization (PPO) option; 22
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 23
carrier all of the counties included in its bid within the region. If the Personnel 24
Cabinet deems the bids submitted in accordance with this subsection to be in 25
the best interests of state employees in a region, the cabinet may award the 26
contract for that region to no more than two (2) carriers; and 27 UNOFFICIAL COPY 24 RS SB 261/GA
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(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 1
other requirements or criteria in the request for proposal. 2
(21) ]Any fully insured health benefit plan or self-insured plan issued or renewed on or 3
after July 12, 2006, to public employees pursuant to this section which provides 4
coverage for services rendered by a physician or osteopath duly licensed under KRS 5
Chapter 311 that are within the scope of practice of an optometrist duly licensed 6
under the provisions of KRS Chapter 320 shall provide the same payment of 7
coverage to optometrists as allowed for those services rendered by physicians or 8
osteopaths. 9
(18)[(22)] Any fully insured health benefit plan or self-insured plan issued or renewed to 10
public employees pursuant to this section shall comply with: 11
(a) KRS 304.12-237; 12
(b) KRS 304.17A-270 and 304.17A-525; 13
(c) KRS 304.17A-600 to 304.17A-633; 14
(d) KRS 205.593; 15
(e) KRS 304.17A-700 to 304.17A-730; 16
(f) KRS 304.14-135; 17
(g) KRS 304.17A-580 and 304.17A-641; 18
(h) KRS 304.99-123; 19
(i) KRS 304.17A-138; 20
(j) KRS 304.17A-148; 21
(k) KRS 304.17A-163 and 304.17A-1631; 22
(l) KRS 304.17A-265; 23
(m) KRS 304.17A-261; 24
(n) KRS 304.17A-262; and 25
(o) Administrative regulations promulgated pursuant to statutes listed in this 26
subsection. 27 UNOFFICIAL COPY 24 RS SB 261/GA
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Section 3. KRS 18A.2254 is amended to read as follows: 1
(1) Based on the recommendation of the secretary of the Personnel Cabinet, the 2
secretary of the Finance and Administration Cabinet, in lieu of contracting with one 3
(1) or more insurers licensed to do business in this state, shall procure, in 4
compliance with KRS 45A.080, 45A.085, and 45A.090, and reviewed by the 5
Government Contract Review Committee pursuant to KRS 45A.705, a contract 6
with one (1) or more third-party administrators licensed to do business in the 7
Commonwealth pursuant to KRS 304.9-052 to administer a self-insured plan 8
offered to the Public Employee Health Insurance Program for public employees. 9
The requirements for the self-insured plan shall be as follows: 10
(a) 1. The secretary of the Personnel Cabinet shall incorporate by reference in 11
an administrative regulation, pursuant to KRS 13A.2251, the plan year 12
handbook distributed by the Department of Employee Insurance in the 13
Personnel Cabinet to public employees covered under the self-insured 14
plan. The plan year handbook shall contain, at a minimum, the 15
premiums, employee contributions, employer contributions, and a 16
summary of benefits, copays, coinsurance, and deductibles for each plan 17
provided to public employees covered under the self-insured plan; 18
2. Notwithstanding any other provision of KRS Chapter 18A to the 19
contrary, the administrative regulation shall not be subject to review by 20
the Personnel Board prior to filing the administrative regulation with the 21
Legislative Research Commission; and 22
3. The secretary of the Personnel Cabinet shall file the administrative 23
regulation for the self-insured plan with the Legislative Research 24
Commission on or before September 15 of the year before each new 25
plan year begins; 26
(b) The self-insured plan offered by the program shall cover hospice care at least 27 UNOFFICIAL COPY 24 RS SB 261/GA
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equal to the Medicare benefit; 1
(c) The Personnel Cabinet shall provide written notice of any formulary change 2
to employees covered under the self-insured plan who are directly impacted 3
by the formulary change and to the Kentucky Group Health Insurance Board 4
fifteen (15) days before implementation of any formulary change. If, after 5
consulting with his or her physician, the employee still disagrees with the 6
formulary change, the employee shall have the right to appeal the change. The 7
employee shall have sixty (60) days from the date of the notice of the 8
formulary change to file an appeal with the Personnel Cabinet. The cabinet 9
shall render a decision within thirty (30) days from the receipt of the request 10
for an appeal. After a final decision is rendered by the Personnel Cabinet, the 11
employee shall have a right to file an appeal pursuant to the utilization review 12
statutes in KRS 304.17A-600 to 304.17A-633. During the appeal process, the 13
employee shall have the right to continue to take any drug prescribed by his or 14
her physician that is the subject of the formulary changes; 15
(d) The Personnel Cabinet shall develop the necessary capabilities to ensure that 16
an independent review of each formulary change is conducted and includes 17
but is not limited to an evaluation of the fiscal impact and therapeutic benefit 18
of the formulary change. The independent review shall be conducted by 19
knowledgeable medical professionals and the results of the independent 20
review shall be posted on the website[Web sites] of the Personnel Cabinet[ 21
and the Cabinet for Health and Family Services] and made available to the 22
public upon request within thirty (30) days of the notice from the Personnel 23
Cabinet required in paragraph (c) of this subsection; 24
(e) If the self-insured plan restricts pharmacy benefits to a drug formulary, the 25
plan shall comply with and have an exceptions policy in accordance with KRS 26
304.17A-535; 27 UNOFFICIAL COPY 24 RS SB 261/GA
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(f) Premiums for all plans offered by the Public Employee Health Insurance 1
Program to employees shall be based on the experience of the entire group; 2
and 3
(g) The plan year for the Public Employee Health Insurance Program, whether for 4
fully insured or self-insured benefits, shall be on a calendar year basis. 5
(2) (a) 1. In addition to any fully insured health benefit plans or self-insured 6
plans, beginning January 1, 2015, the Personnel Cabinet shall offer a 7
health reimbursement account or health flexible spending account for 8
public employees insured under the Public Employee Health Insurance 9
Program. 10
2. The Personnel Cabinet may offer a health savings account in 11
conjunction with a high deductible health plan option as defined by 26 12
U.S.C. sec. 223(c)(2) or as an optional account to which the Personnel 13
Cabinet may deposit funds of an employee who waives coverage in 14
accordance with paragraph (b) of this subsection, provided the employee 15
who waives coverage is eligible to contribute to a health savings 16
account. 17
(b) If a public employee waives coverage provided by his or her employer under 18
the Public Employee Health Insurance Program, the employer shall forward a 19
monthly amount to be determined by the secretary of the Personnel Cabinet 20
for that employee as an employer contribution to an employee's[the] health 21
reimbursement account, health savings account, or health flexible spending 22
account, but not less than one hundred seventy-five dollars ($175) per month, 23
subject to any conditions or limitations imposed by the secretary to comply 24
with applicable federal law. The type of account available for waiver funding 25
during a plan year shall be at the discretion of the Personnel Cabinet. 26
(c) The administrative fees associated with the employee's health savings 27 UNOFFICIAL COPY 24 RS SB 261/GA
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SB026110.100 - 1722 - XXXX 3/14/2024 3:22 PM GA
account, health reimbursement account, or health flexible spending account 1
shall be an authorized expense to be charged to the public employee health 2
insurance trust fund. 3
(3) (a) The public employee health insurance trust fund is established in the 4
Personnel Cabinet. The purpose of the public employee health insurance trust 5
fund is to provide funds to pay medical claims and other costs associated with 6
the administration of the Public Employee Health Insurance Program self-7
insured plan under a competitively bid contract as provided by KRS Chapter 8
45A and reviewed by the Government Contract Review Committee pursuant 9
to KRS 45A.705. Unless authorized by the General Assembly, the trust fund 10
shall not utilize funds for any other purpose and the trust fund receipts from 11
prior plan years shall not be used to pay claims and expenses for current or 12
subsequent plan years, except as provided by paragraph (b) of this subsection. 13
(b) In the event of a projected deficit in the trust fund balance of a prior plan year, 14
the secretary of the Finance and Administration Cabinet may declare an 15
emergency and transfer up to twenty-five percent (25%) of another prior plan 16
year's balance to that plan year, provided the Governor, all members of the 17
General Assembly, and Legislative Research Commission are notified at least 18
thirty (30) days prior to the transfer. The Legislative Research Commission 19
shall refer the notice to appropriate committees of jurisdiction for their 20
review. 21
(c) The following moneys shall be directly deposited into the trust fund: 22
1. Employer and employee premiums collected under the self-insured plan; 23
2. Interest and investment returns earned by the self-insured plan; 24
3. Rebates and refunds attributed to the self-insured plan; and 25
4. All other receipts attributed to the self-insured plan. 26
(d) Any balance remaining in the public employee health insurance trust fund at 27 UNOFFICIAL COPY 24 RS SB 261/GA
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the end of a fiscal year shall not lapse. Any balance remaining at the end of a 1
fiscal year shall be carried forward to the next fiscal year and be used solely 2
for the purpose established in paragraphs (a) and (b) of this subsection. The 3
balance of funds in the public employee health insurance trust fund shall be 4
invested by the Office of Financial Management consistent with the 5
provisions of KRS Chapter 42, and interest income shall be credited to the 6
trust fund. Any balance for a specific plan year and any subsequent interest 7
income for that specific plan year shall be accounted for separately. 8
(e) The Auditor of Public Accounts shall be responsible for a financial audit of 9
the books and records of the trust fund. The audit shall be conducted in 10
accordance with generally accepted accounting principles and shall be 11
completed within ninety (90) days of the close of the fiscal year. All audit 12
reports shall be filed with the Governor, the President of the Senate, the 13
Speaker of the House of Representatives, and the secretary of the Personnel 14
Cabinet. 15
(f) The secretary of the Personnel Cabinet shall, upon request, send[ file] a 16
quarterly report on the status of the trust fund to[with] the Governor, the 17
Interim Joint Committee on Appropriations and Revenue, or the Kentucky 18
Group Health Insurance Board[, and the Advisory Committee of State Health 19
Insurance Subscribers]. The quarterly reports shall be available[first status 20
report shall be submitted no later than July 30, 2006, and subsequent reports 21
shall be submitted] no later than sixty (60) days following the end of each 22
calendar quarter. The report shall include the following: 23
1. The current balance of the trust fund and the amount of the balance 24
associated with each plan year; 25
2. A detailed description of all income to the trust fund since the last 26
report; 27 UNOFFICIAL COPY 24 RS SB 261/GA
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3. A detailed description of any receipts due to the trust fund; 1
4. A total amount of payments made for medical and pharmacy claims 2
from the trust fund by plan year; 3
5. A detailed description of all payments made to the third-party 4
administrator of the self-insured plan by the trust fund; 5
6. Current enrollment data, including monthly enrollment since the last 6
report, of the Public Employee Health Insurance Program self-insured 7
plan; 8
7. Any other information the secretary may include; 9
8. Any other information requested by the Interim Joint Committee on 10
Appropriations and Revenue concerning the operation of the Public 11
Employee Health Insurance Program self-funded plan or the trust fund; 12
and 13
9. In addition to the information required under subparagraphs 1. to 8. of 14
this paragraph, the quarterly report for quarters ending June 30 and 15
December 31[filed in July and January] shall also include the following: 16
a. A projection of the medical claims incurred but not yet reported 17
that are considered liabilities to the trust fund; 18
b. A statement of any other trust fund liabilities; 19
c. A detailed calculation outlining proposed premium rates for the 20
next plan year, including base claims, trend assumptions, 21
administrative fees, and any proposed plan or benefit changes; 22
d. A detailed description of the current in-state and out-of-state 23
networks provided under the plan, any changes to the networks 24
since the last report, and any proposed changes to the in-state or 25
out-of-state networks during the next six (6) months; and 26
e. Specific data regarding the third-party administrator's performance 27 UNOFFICIAL COPY 24 RS SB 261/GA
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under the contract. The data shall include the following: 1
i. Any results or outcomes of disease management and 2
wellness programs; 3
ii. Results of case management audits and educational and 4
communication efforts; and 5
iii. Comparison of actual measurable results to contract 6
performance guarantees. 7
Section 4. KRS 18A.226 is amended to read as follows: 8
(1) To provide quality, affordable health insurance coverage so that the Commonwealth 9
can attract and retain able and dedicated public employees, and to facilitate the need 10
for comprehensive and efficient planning, implementation, and administration of a 11
state employee health insurance program in order to meet this goal, the Kentucky 12
Group Health Insurance Board is created. The board shall be attached to the 13
Personnel Cabinet for administrative purposes only. The board shall consist of 14
fourteen (14)[thirteen (13)] members as follows: 15
(a) The secretary of the Finance and Administration Cabinet; 16
(b) The secretary of the Personnel Cabinet; 17
(c) The state budget director; 18
(d) The commissioner of education; 19
(e) [The chair of the Advisory Committee of State Health Insurance Subscribers; 20
(f) ]The commissioner of insurance, ex officio; 21
(f)[(g)] The Auditor of Public Accounts, ex officio; 22
(g)[(h)] The Director of the Administrative Office of the Courts, or his or her 23
designee; 24
(h)[(i)] One (1) retired state employee appointed by the Kentucky Public 25
Pensions Authority, and one (1) employee of the Kentucky Public Pensions 26
Authority[Retirement Systems], who shall each serve a term of two (2) 27 UNOFFICIAL COPY 24 RS SB 261/GA
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years[an initial term of one (1) year]; 1
(i)[(j)] One (1) retired teacher appointed by the Teachers' Retirement System 2
and one (1) employee of the Teachers' Retirement System, who shall serve 3
an initial term of two (2) years; 4
(j)[(k)] One (1) active teacher appointed by the organization with the largest 5
number of teacher members on payroll deduction, who shall serve a[an initial] 6
term of one (1) year; 7
(k)[(l)] One (1) active state employee appointed by the organization with the 8
largest number of state employee members on payroll deduction, who shall 9
serve an initial term of two (2) years; and 10
(l)[(m)] One (1) active classified education support employee appointed by the 11
organization with the largest number of classified education support employee 12
members on payroll deduction, who shall serve an initial term of one (1) year. 13
As each appointed member's term expires, the vacancy created shall be filled by the 14
appointing authority for that position for a term applicable to each representative 15
agency provided in paragraphs (h) to (l) of this subsection[of two (2) years]. An 16
appointment to fill an unexpired term of an appointed member shall be made by the 17
designated appointing authority for the remainder of the term. Appointed terms 18
shall begin effective January[October] 1. 19
(2) The members of the board shall elect from among its members a chair and a vice 20
chair. 21
(3) Regular meetings of the board shall be held at least once every month at a place, 22
day, and time determined by the board. Special meetings of the board shall be held 23
when needed as determined by the chair. If eight (8)[seven (7)] or more members of 24
the board request in writing that the chair call a special meeting, the chair shall call 25
a special meeting. The meetings shall operate in accordance with the provisions of 26
the Open Meetings Law under KRS 61.805 to 61.850. 27 UNOFFICIAL COPY 24 RS SB 261/GA
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(4) Members of the board shall receive reimbursement for necessary expenses for 1
attendance at official board meetings or public hearings. 2
(5) The Kentucky Group Health Insurance Board shall: 3
(a) Engage in analyses and research to identify the factors and parameters that 4
affect the state group health insurance program; 5
(b) Upon request, transmit[Develop and transmit, by October 1 of each year 6
beginning October 1, 2001,] to the Governor, the General Assembly, or[and] 7
the Chief Justice of the Supreme Court the annual report, which shall be 8
available by January 31 of each year and shall contain, at a minimum, the 9
following information:[, ] 10
1. Policy recommendations regarding benefit options and management of 11
the state group health insurance program;[ and 12
(c) Provide in the first report, due by October 1, 2001, the following:] 13
2.[1.] Analysis and discussion of methods used by all other states to provide 14
health insurance benefits to their state group;[ and] 15
3.[2.] Analysis and discussion of the cost, enrollment, claims, and utilization 16
data[ for calendar year 2000 on the Kentucky state group]; and 17
4.[3.] Recommendations including but not limited to appropriate structures for 18
the state contribution rate which shall include recommendations on 19
increasing the state contribution to provide support for dependent 20
coverage, possible methods to mitigate adverse selection, competitive 21
plan designs by type and benefit options, the feasibility of a state self-22
insurance plan, and strategies for evaluating third-party administrators 23
and vendors. 24
Section 5. The following KRS section is repealed: 25
18A.2255 Health benefit plans and other information to be submitted to Advisory 26
Committee of State Health Insurers -- Approval or recommendations for changes -- 27 UNOFFICIAL COPY 24 RS SB 261/GA
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Committee to advise on options, bids, administration, and drug formulary -- Written 1
report or testimony. 2