Kentucky 2025 Regular Session

Kentucky House Bill HB245 Latest Draft

Bill / Introduced Version

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AN ACT relating to coverage for emergency ground ambulance services. 1 
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2 
SECTION 1.   A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 3 
IS CREATED TO READ AS FOLLOWS: 4 
(1) As used in this section: 5 
(a) "Adverse determination" has the same meaning as in KRS 304.17A-600, 6 
except for purposes of this section the term includes determinations 7 
regarding emergency ground ambulance services furnished or proposed to 8 
be furnished to a covered person; 9 
(b) "Clean claim" has the same meaning as in KRS 304.17A-700; 10 
(c) "Cost sharing" means any copayments, coinsurance, deductibles, and other 11 
out-of-pocket expense requirements imposed upon a covered person by a 12 
health benefit plan; 13 
(d) "Emergency ground ambulance services" means emergency ambulance 14 
services provided by a ground ambulance provider that are not air 15 
ambulance services; 16 
(e) "Ground ambulance provider" means a ground ambulance provider 17 
licensed in accordance with administrative regulations promulgated by the 18 
Kentucky Board of Emergency Medical Services; 19 
(f) "Local governing authority" means: 20 
1. Any city, county, charter county government, urban-county 21 
government, consolidated local government, unified local government, 22 
special district, or municipal corporation of this state; and 23 
2. Any agency, authority, board, bureau, department, commission, 24 
council, committee, instrumentality, joint venture, or other entity of an 25 
entity referenced in subparagraph 1. of this paragraph; 26 
(g) "Local emergency ground ambulance service rate" means either: 27  UNOFFICIAL COPY  	25 RS BR 872 
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1. The rate contracted between an out-of-network ground ambulance 1 
provider and a local governing authority for emergency ground 2 
ambulance services; or 3 
2. The rate for emergency ground ambulance services approved or 4 
established by a local governing authority, including by ordinance, 5 
regulation, or resolution; and 6 
(h) "Out-of-network ground ambulance provider" means a ground ambulance 7 
provider that has not entered into a contract to provide emergency ground 8 
ambulance services under the health benefit plan. 9 
(2) A health benefit plan shall: 10 
(a) Provide coverage for emergency ground ambulance services, which shall 11 
include coverage for emergency ground ambulance services provided by an 12 
out-of-network ground ambulance provider; 13 
(b) Consider emergency ground ambulance services requested by a first 14 
responder, any other health care practitioner, or through a 911 answering 15 
point to be: 16 
1. Medically necessary; and 17 
2. Not subject to an adverse determination; and 18 
(c) Not impose cost sharing for emergency ground ambulance services provided 19 
by an out-of-network ground ambulance provider that exceeds the cost 20 
sharing imposed by the plan for emergency ground ambulance services that 21 
are not provided by an out-of-network ground ambulance provider. 22 
(3) The minimum allowable reimbursement under any health benefit plan to an out-23 
of-network ground ambulance provider for emergency ground ambulance 24 
services shall be: 25 
(a) The local emergency ground ambulance service rate of the local governing 26 
authority in whose jurisdiction the emergency ground ambulance services 27  UNOFFICIAL COPY  	25 RS BR 872 
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originated; or 1 
(b) In the absence of an applicable local emergency ground ambulance service 2 
rate under paragraph (a) of this subsection, the lesser of the following: 3 
1. Four hundred percent (400%) of the reimbursement allowed to a 4 
ground ambulance provider providing the same services to a Medicare 5 
beneficiary; or 6 
2. The out-of-network ground ambulance provider's billed charges. 7 
(4) (a) Except as provided in paragraph (c) of this subsection, an insurer shall 8 
make a reimbursement to an out-of-network ground ambulance provider for 9 
a claim made for emergency ground ambulance services under a health 10 
benefit plan in accordance with subsection (3) of this section, less any cost 11 
sharing required to be paid for the services under the health benefit plan, 12 
within thirty (30) days of receipt of the claim from the provider. 13 
(b) The reimbursement required under this subsection shall: 14 
1. Be made directly to the out-of-network ground ambulance provider; 15 
and 16 
2. Not be made or sent to the covered person. 17 
(c) If the insurer determines that a claim made by an out-of-network ground 18 
ambulance provider for emergency ground ambulance services is not a 19 
clean claim, lacks required substantiating documentation, is not covered 20 
under the health benefit plan, or is subject in whole or in part to cost 21 
sharing, the insurer shall, within thirty (30) days of receipt of the claim, 22 
send a written notification to the out-of-network ground ambulance 23 
provider that: 24 
1. Acknowledges the date of receipt of the claim; and 25 
2. Provides one (1) of the following notifications: 26 
a. A notification that states: 27  UNOFFICIAL COPY  	25 RS BR 872 
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i. The insurer is declining to pay all or part of the claim; and 1 
ii. The specific reason or reasons for the declination; or 2 
b. A notification that states: 3 
i. Additional information is necessary to determine if all or 4 
part of the claim is payable; and 5 
ii. The specific additional information that is required to 6 
make the determination. 7 
(5) An out-of-network ground ambulance provider shall not seek reimbursement for 8 
emergency ground ambulance services from a covered person that is in excess of 9 
any cost sharing required to be paid for the services under the health benefit plan 10 
if the provider receives any of the following from the insurer: 11 
(a) Reimbursement in compliance with subsection (3) of this section; 12 
(b) A partial reimbursement and a notification that the remaining 13 
reimbursement, which together with the partial reimbursement is in 14 
compliance with subsection (3) of this section, is subject to cost sharing; or 15 
(c) A notification that reimbursement in compliance with subsection (3) of this 16 
section is subject in whole to cost sharing. 17 
(6) In the event of a conflict between this section and any other law, this section shall 18 
control. 19 
Section 2.   KRS 304.17A-099 is amended to read as follows: 20 
(1) As used in this section, "qualified health plan" has the same meaning as in 42 21 
U.S.C. sec. 18021(a)(1), as amended. 22 
(2) Notwithstanding any other provision of this chapter: 23 
(a) Except as provided in paragraph (b) of this subsection, if the application of a 24 
provision of this chapter results, or would result, in a determination that the 25 
state must make payments to defray the cost of the provision under 42 U.S.C. 26 
sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, then the provision 27  UNOFFICIAL COPY  	25 RS BR 872 
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shall not apply to a qualified health plan or any other health insurance policy, 1 
certificate, plan, or contract until the requirement to make cost defrayal 2 
payments is no longer applicable; and 3 
(b) This subsection shall not apply to any of the following: 4 
1. A provision of this chapter that became effective on or before January 1, 5 
2024; or 6 
2. Section 1 of this Act. 7 
(3) To the extent permitted by federal law, if the state is required under 42 U.S.C. sec. 8 
18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, to make payments to defray 9 
the cost of a provision of this chapter: 10 
(a) 1. Each qualified health plan issuer shall determine, and provide to the 11 
commissioner, the cost attributable to the provision for the qualified 12 
health plan. 13 
2. The cost attributable to a provision for a qualified health plan under 14 
subparagraph 1. of this paragraph shall be: 15 
a. Calculated in accordance with generally accepted actuarial 16 
principles and methodologies; 17 
b. Conducted by a member of the American Academy of Actuaries; 18 
and 19 
c. Reported by the qualified health plan issuer to: 20 
i. The commissioner; and 21 
ii. The Division of Health Benefit Exchange within the Office 22 
of Data Analytics; 23 
(b) The commissioner shall use the information obtained under paragraph (a) of 24 
this subsection to determine the statewide average of the cost attributable to 25 
the provision for all qualified health plan issuers to which the provision is 26 
applicable; and 27  UNOFFICIAL COPY  	25 RS BR 872 
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(c) The required payments shall be: 1 
1. Calculated based on the statewide average of the cost attributable to the 2 
provision as determined by the commissioner under paragraph (b) of this 3 
subsection; and 4 
2. Submitted directly to qualified health plan issuers by the department 5 
through a process established by the commissioner. 6 
(4) A qualified health plan issuer that receives a payment under subsection (3)(c)2. of 7 
this section shall: 8 
(a) Reduce the premium charged to an individual on whose behalf the issuer 9 
received the payment in an amount equal to the amount of the payment; or 10 
(b) Notwithstanding KRS 304.12-090, provide a premium rebate to an individual 11 
on whose behalf the issuer received the payment in an amount equal to the 12 
amount of the payment. 13 
(5) Any fines collected for violations of this section shall be: 14 
(a) Placed in a trust and agency account within the department, which shall not 15 
lapse; and 16 
(b) Used solely by the department to make payments in accordance with 17 
subsection (3)(c)2. of this section. 18 
(6) The commissioner shall promulgate any administrative regulations necessary to 19 
enforce and effectuate this section. 20 
Section 3.   KRS 18A.225 is amended to read as follows: 21 
(1) (a) The term "employee" for purposes of this section means: 22 
1. Any person, including an elected public official, who is regularly 23 
employed by any department, office, board, agency, or branch of state 24 
government; or by a public postsecondary educational institution; or by 25 
any city, urban-county, charter county, county, or consolidated local 26 
government, whose legislative body has opted to participate in the state-27  UNOFFICIAL COPY  	25 RS BR 872 
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sponsored health insurance program pursuant to KRS 79.080; and who 1 
is either a contributing member to any one (1) of the retirement systems 2 
administered by the state, including but not limited to the Kentucky 3 
Retirement Systems, County Employees Retirement System, Kentucky 4 
Teachers' Retirement System, the Legislators' Retirement Plan, or the 5 
Judicial Retirement Plan; or is receiving a contractual contribution from 6 
the state toward a retirement plan; or, in the case of a public 7 
postsecondary education institution, is an individual participating in an 8 
optional retirement plan authorized by KRS 161.567; or is eligible to 9 
participate in a retirement plan established by an employer who ceases 10 
participating in the Kentucky Employees Retirement System pursuant to 11 
KRS 61.522 whose employees participated in the health insurance plans 12 
administered by the Personnel Cabinet prior to the employer's effective 13 
cessation date in the Kentucky Employees Retirement System; 14 
2. Any certified or classified employee of a local board of education or a 15 
public charter school as defined in KRS 160.1590; 16 
3. Any elected member of a local board of education; 17 
4. Any person who is a present or future recipient of a retirement 18 
allowance from the Kentucky Retirement Systems, County Employees 19 
Retirement System, Kentucky Teachers' Retirement System, the 20 
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 21 
Kentucky Community and Technical College System's optional 22 
retirement plan authorized by KRS 161.567, except that a person who is 23 
receiving a retirement allowance and who is age sixty-five (65) or older 24 
shall not be included, with the exception of persons covered under KRS 25 
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 26 
employed pursuant to subparagraph 1. of this paragraph; and 27  UNOFFICIAL COPY  	25 RS BR 872 
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5. Any eligible dependents and beneficiaries of participating employees 1 
and retirees who are entitled to participate in the state-sponsored health 2 
insurance program; 3 
(b) The term "health benefit plan" for the purposes of this section means a health 4 
benefit plan as defined in KRS 304.17A-005; 5 
(c) The term "insurer" for the purposes of this section means an insurer as defined 6 
in KRS 304.17A-005; and 7 
(d) The term "managed care plan" for the purposes of this section means a 8 
managed care plan as defined in KRS 304.17A-500. 9 
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 10 
recommendation of the secretary of the Personnel Cabinet, shall procure, in 11 
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 12 
from one (1) or more insurers authorized to do business in this state, a group 13 
health benefit plan that may include but not be limited to health maintenance 14 
organization (HMO), preferred provider organization (PPO), point of service 15 
(POS), and exclusive provider organization (EPO) benefit plans 16 
encompassing all or any class or classes of employees. With the exception of 17 
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 18 
all employers of any class of employees or former employees shall enter into 19 
a contract with the Personnel Cabinet prior to including that group in the state 20 
health insurance group. The contracts shall include but not be limited to 21 
designating the entity responsible for filing any federal forms, adoption of 22 
policies required for proper plan administration, acceptance of the contractual 23 
provisions with health insurance carriers or third-party administrators, and 24 
adoption of the payment and reimbursement methods necessary for efficient 25 
administration of the health insurance program. Health insurance coverage 26 
provided to state employees under this section shall, at a minimum, contain 27  UNOFFICIAL COPY  	25 RS BR 872 
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the same benefits as provided under Kentucky Kare Standard as of January 1, 1 
1994, and shall include a mail-order drug option as provided in subsection 2 
(13) of this section. All employees and other persons for whom the health care 3 
coverage is provided or made available shall annually be given an option to 4 
elect health care coverage through a self-funded plan offered by the 5 
Commonwealth or, if a self-funded plan is not available, from a list of 6 
coverage options determined by the competitive bid process under the 7 
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 8 
during annual open enrollment. 9 
(b) The policy or policies shall be approved by the commissioner of insurance 10 
and may contain the provisions the commissioner of insurance approves, 11 
whether or not otherwise permitted by the insurance laws. 12 
(c) Any carrier bidding to offer health care coverage to employees shall agree to 13 
provide coverage to all members of the state group, including active 14 
employees and retirees and their eligible covered dependents and 15 
beneficiaries, within the county or counties specified in its bid. Except as 16 
provided in subsection (20) of this section, any carrier bidding to offer health 17 
care coverage to employees shall also agree to rate all employees as a single 18 
entity, except for those retirees whose former employers insure their active 19 
employees outside the state-sponsored health insurance program and as 20 
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 21 
(d) Any carrier bidding to offer health care coverage to employees shall agree to 22 
provide enrollment, claims, and utilization data to the Commonwealth in a 23 
format specified by the Personnel Cabinet with the understanding that the data 24 
shall be owned by the Commonwealth; to provide data in an electronic form 25 
and within a time frame specified by the Personnel Cabinet; and to be subject 26 
to penalties for noncompliance with data reporting requirements as specified 27  UNOFFICIAL COPY  	25 RS BR 872 
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by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 1 
to protect the confidentiality of each individual employee; however, 2 
confidentiality assertions shall not relieve a carrier from the requirement of 3 
providing stipulated data to the Commonwealth. 4 
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 5 
for timely analysis of data received from carriers and, to the extent possible, 6 
provide in the request-for-proposal specifics relating to data requirements, 7 
electronic reporting, and penalties for noncompliance. The Commonwealth 8 
shall own the enrollment, claims, and utilization data provided by each carrier 9 
and shall develop methods to protect the confidentiality of the individual. The 10 
Personnel Cabinet shall include in the October annual report submitted 11 
pursuant to the provisions of KRS 18A.226 to the Governor, the General 12 
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 13 
financial stability of the program, which shall include but not be limited to 14 
loss ratios, methods of risk adjustment, measurements of carrier quality of 15 
service, prescription coverage and cost management, and statutorily required 16 
mandates. If state self-insurance was available as a carrier option, the report 17 
also shall provide a detailed financial analysis of the self-insurance fund 18 
including but not limited to loss ratios, reserves, and reinsurance agreements. 19 
(f) If any agency participating in the state-sponsored employee health insurance 20 
program for its active employees terminates participation and there is a state 21 
appropriation for the employer's contribution for active employees' health 22 
insurance coverage, then neither the agency nor the employees shall receive 23 
the state-funded contribution after termination from the state-sponsored 24 
employee health insurance program. 25 
(g) Any funds in flexible spending accounts that remain after all reimbursements 26 
have been processed shall be transferred to the credit of the state-sponsored 27  UNOFFICIAL COPY  	25 RS BR 872 
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health insurance plan's appropriation account. 1 
(h) Each entity participating in the state-sponsored health insurance program shall 2 
provide an amount at least equal to the state contribution rate for the employer 3 
portion of the health insurance premium. For any participating entity that used 4 
the state payroll system, the employer contribution amount shall be equal to 5 
but not greater than the state contribution rate. 6 
(3) The premiums may be paid by the policyholder: 7 
(a) Wholly from funds contributed by the employee, by payroll deduction or 8 
otherwise; 9 
(b) Wholly from funds contributed by any department, board, agency, public 10 
postsecondary education institution, or branch of state, city, urban-county, 11 
charter county, county, or consolidated local government; or 12 
(c) Partly from each, except that any premium due for health care coverage or 13 
dental coverage, if any, in excess of the premium amount contributed by any 14 
department, board, agency, postsecondary education institution, or branch of 15 
state, city, urban-county, charter county, county, or consolidated local 16 
government for any other health care coverage shall be paid by the employee. 17 
(4) If an employee moves his or her place of residence or employment out of the 18 
service area of an insurer offering a managed health care plan, under which he or 19 
she has elected coverage, into either the service area of another managed health care 20 
plan or into an area of the Commonwealth not within a managed health care plan 21 
service area, the employee shall be given an option, at the time of the move or 22 
transfer, to change his or her coverage to another health benefit plan. 23 
(5) No payment of premium by any department, board, agency, public postsecondary 24 
educational institution, or branch of state, city, urban-county, charter county, 25 
county, or consolidated local government shall constitute compensation to an 26 
insured employee for the purposes of any statute fixing or limiting the 27  UNOFFICIAL COPY  	25 RS BR 872 
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compensation of such an employee. Any premium or other expense incurred by any 1 
department, board, agency, public postsecondary educational institution, or branch 2 
of state, city, urban-county, charter county, county, or consolidated local 3 
government shall be considered a proper cost of administration. 4 
(6) The policy or policies may contain the provisions with respect to the class or classes 5 
of employees covered, amounts of insurance or coverage for designated classes or 6 
groups of employees, policy options, terms of eligibility, and continuation of 7 
insurance or coverage after retirement. 8 
(7) Group rates under this section shall be made available to the disabled child of an 9 
employee regardless of the child's age if the entire premium for the disabled child's 10 
coverage is paid by the state employee. A child shall be considered disabled if he or 11 
she has been determined to be eligible for federal Social Security disability benefits. 12 
(8) The health care contract or contracts for employees shall be entered into for a 13 
period of not less than one (1) year. 14 
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 15 
State Health Insurance Subscribers to advise the secretary or the secretary's 16 
designee regarding the state-sponsored health insurance program for employees. 17 
The secretary shall appoint, from a list of names submitted by appointing 18 
authorities, members representing school districts from each of the seven (7) 19 
Supreme Court districts, members representing state government from each of the 20 
seven (7) Supreme Court districts, two (2) members representing retirees under age 21 
sixty-five (65), one (1) member representing local health departments, two (2) 22 
members representing the Kentucky Teachers' Retirement System, and three (3) 23 
members at large. The secretary shall also appoint two (2) members from a list of 24 
five (5) names submitted by the Kentucky Education Association, two (2) members 25 
from a list of five (5) names submitted by the largest state employee organization of 26 
nonschool state employees, two (2) members from a list of five (5) names submitted 27  UNOFFICIAL COPY  	25 RS BR 872 
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by the Kentucky Association of Counties, two (2) members from a list of five (5) 1 
names submitted by the Kentucky League of Cities, and two (2) members from a 2 
list of names consisting of five (5) names submitted by each state employee 3 
organization that has two thousand (2,000) or more members on state payroll 4 
deduction. The advisory committee shall be appointed in January of each year and 5 
shall meet quarterly. 6 
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 7 
provided to employees pursuant to this section shall not provide coverage for 8 
obtaining or performing an abortion, nor shall any state funds be used for the 9 
purpose of obtaining or performing an abortion on behalf of employees or their 10 
dependents. 11 
(11) Interruption of an established treatment regime with maintenance drugs shall be 12 
grounds for an insured to appeal a formulary change through the established appeal 13 
procedures approved by the Department of Insurance, if the physician supervising 14 
the treatment certifies that the change is not in the best interests of the patient. 15 
(12) Any employee who is eligible for and elects to participate in the state health 16 
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 17 
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 18 
state health insurance contribution toward health care coverage as a result of any 19 
other employment for which there is a public employer contribution. This does not 20 
preclude a retiree and an active employee spouse from using both contributions to 21 
the extent needed for purchase of one (1) state sponsored health insurance policy 22 
for that plan year. 23 
(13) (a) The policies of health insurance coverage procured under subsection (2) of 24 
this section shall include a mail-order drug option for maintenance drugs for 25 
state employees. Maintenance drugs may be dispensed by mail order in 26 
accordance with Kentucky law. 27  UNOFFICIAL COPY  	25 RS BR 872 
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(b) A health insurer shall not discriminate against any retail pharmacy located 1 
within the geographic coverage area of the health benefit plan and that meets 2 
the terms and conditions for participation established by the insurer, including 3 
price, dispensing fee, and copay requirements of a mail-order option. The 4 
retail pharmacy shall not be required to dispense by mail. 5 
(c) The mail-order option shall not permit the dispensing of a controlled 6 
substance classified in Schedule II. 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, subject 10 
to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months 11 
pursuant to KRS 304.17A-132. 12 
(15) Any policy provided to state employees or their dependents pursuant to this section 13 
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 14 
consistent with KRS 304.17A-142. 15 
(16) Any policy provided to state employees or their dependents pursuant to this section 16 
shall provide coverage for obtaining amino acid-based elemental formula pursuant 17 
to KRS 304.17A-258. 18 
(17) If a state employee's residence and place of employment are in the same county, 19 
and if the hospital located within that county does not offer surgical services, 20 
intensive care services, obstetrical services, level II neonatal services, diagnostic 21 
cardiac catheterization services, and magnetic resonance imaging services, the 22 
employee may select a plan available in a contiguous county that does provide 23 
those services, and the state contribution for the plan shall be the amount available 24 
in the county where the plan selected is located. 25 
(18) If a state employee's residence and place of employment are each located in 26 
counties in which the hospitals do not offer surgical services, intensive care 27  UNOFFICIAL COPY  	25 RS BR 872 
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services, obstetrical services, level II neonatal services, diagnostic cardiac 1 
catheterization services, and magnetic resonance imaging services, the employee 2 
may select a plan available in a county contiguous to the county of residence that 3 
does provide those services, and the state contribution for the plan shall be the 4 
amount available in the county where the plan selected is located. 5 
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 6 
in the best interests of the state group to allow any carrier bidding to offer health 7 
care coverage under this section to submit bids that may vary county by county or 8 
by larger geographic areas. 9 
(20) Notwithstanding any other provision of this section, the bid for proposals for health 10 
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 11 
the statewide rating structure provided in calendar year 2003 and a bid scenario that 12 
allows for a regional rating structure that allows carriers to submit bids that may 13 
vary by region for a given product offering as described in this subsection: 14 
(a) The regional rating bid scenario shall not include a request for bid on a 15 
statewide option; 16 
(b) The Personnel Cabinet shall divide the state into geographical regions which 17 
shall be the same as the partnership regions designated by the Department for 18 
Medicaid Services for purposes of the Kentucky Health Care Partnership 19 
Program established pursuant to 907 KAR 1:705; 20 
(c) The request for proposal shall require a carrier's bid to include every county 21 
within the region or regions for which the bid is submitted and include but not 22 
be restricted to a preferred provider organization (PPO) option; 23 
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 24 
carrier all of the counties included in its bid within the region. If the Personnel 25 
Cabinet deems the bids submitted in accordance with this subsection to be in 26 
the best interests of state employees in a region, the cabinet may award the 27  UNOFFICIAL COPY  	25 RS BR 872 
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contract for that region to no more than two (2) carriers; and 1 
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 2 
other requirements or criteria in the request for proposal. 3 
(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 4 
after July 12, 2006, to public employees pursuant to this section which provides 5 
coverage for services rendered by a physician or osteopath duly licensed under KRS 6 
Chapter 311 that are within the scope of practice of an optometrist duly licensed 7 
under the provisions of KRS Chapter 320 shall provide the same payment of 8 
coverage to optometrists as allowed for those services rendered by physicians or 9 
osteopaths. 10 
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to 11 
public employees pursuant to this section shall comply with: 12 
(a) KRS 304.12-237; 13 
(b) KRS 304.17A-270 and 304.17A-525; 14 
(c) KRS 304.17A-600 to 304.17A-633; 15 
(d) KRS 205.593; 16 
(e) KRS 304.17A-700 to 304.17A-730; 17 
(f) KRS 304.14-135; 18 
(g) KRS 304.17A-580 and 304.17A-641; 19 
(h) KRS 304.99-123; 20 
(i) KRS 304.17A-138; 21 
(j) KRS 304.17A-148; 22 
(k) KRS 304.17A-163 and 304.17A-1631; 23 
(l) KRS 304.17A-265; 24 
(m) KRS 304.17A-261; 25 
(n) KRS 304.17A-262; 26 
(o) KRS 304.17A-145; 27  UNOFFICIAL COPY  	25 RS BR 872 
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(p) KRS 304.17A-129; 1 
(q) KRS 304.17A-133; 2 
(r) KRS 304.17A-264;[ and] 3 
(s) Section 1 of this Act; and 4 
(t) Administrative regulations promulgated pursuant to statutes listed in this 5 
subsection. 6 
(23) (a) Any fully insured health benefit plan or self-insured plan issued or renewed to 7 
public employees pursuant to this section shall provide a special enrollment 8 
period to pregnant women who are eligible for coverage in accordance with 9 
the requirements set forth in KRS 304.17-182. 10 
(b) The Department of Employee Insurance shall, at or before the time a public 11 
employee is initially offered the opportunity to enroll in the plan or coverage, 12 
provide the employee a notice of the special enrollment rights under this 13 
subsection. 14 
Section 4.   This Act applies to health benefit plans issued or renewed on or after 15 
January 1, 2026. 16 
Section 5.   This Act takes effect on January 1, 2026. 17