Public Act 19-117 Budget Implementer Bill. Signed into Law.

Sec. 377. Section 3-123rrr of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2019):

As used in this section and sections 3-123sss to 3-123vvv, inclusive, and section 382 of this act:

(1)”Health Care Cost Containment Committee” means the committee established in accordance with the ratified agreement between the state and the State Employees Bargaining Agent Coalition pursuant to subsection (f) of section 5-278.

(2)”Nonstate public employee” means any employee or elected officer of a nonstate public employer.

(3)”Nonstate public employer” means a municipality or other political subdivision of the state, including a board of education, quasi-public agency or public library. A municipality and a board of education may be considered separate employers.

(4)”State employee plan” means the group hospitalization, medical, pharmacy and surgical insurance plan offered to state employees and retirees pursuant to section 5-259.

(5) “Health enhancement program” means the program established in accordance with the provisions of the Revised State Employees Bargaining Agent Coalition agreement, approved by the General Assembly on August 22, 2011, for state employees, as may be amended by stipulated agreements.

(6) “Value-based insurance design” means health benefit designs that lower or remove financial barriers to essential, high-value clinical services.

(7) “Health care coverage type” means the type of health care coverage offered by nonstate public employers, including, but not limited to, coverage for a nonstate public employee, nonstate public employee plus spouse and nonstate public employee plus family.

Sec. 378. Section 3-123sss of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2019):

(a) (1) Notwithstanding any provision of title 38a, the Comptroller shall offer to nonstate public employers and their nonstate public employees, and their retirees, if applicable, coverage under the state employee plan or another group hospitalization, medical, pharmacy and surgical insurance plan developed by the Comptroller to provide coverage for nonstate public employees and their retirees, if applicable. Such nonstate public employees, or retirees, if applicable, shall be pooled with the state employee plan, provided the Comptroller receives an application from a nonstate public employer and the application is approved in accordance with this section or section 3-123ttt. Premium payments for such coverage shall be remitted by the nonstate public employer to the Comptroller and shall be the same as those paid by the state inclusive of any premiums paid by state employees, except that premium payments shall be adjusted pursuant to subdivision (2) of this subsection for nonstate public employers enrolled in coverage on and after July 1, 2019, to reflect the cost of health care in the county in which the majority of such nonstate public employer’s employees work, differences from the benefits and networks provided to state employees or as otherwise provided in this section or section 3-123uuu. The Comptroller may charge each nonstate public employer participating in the state employee plan an administrative fee calculated on a per member, per month basis.

(2) During the two-year period beginning July 1, 2020, the Comptroller shall phase in the adjustment for premium payments to reflect the cost of health care in the county in which the majority of a nonstate public employer’s employees work, as described in subdivision (1) of this subsection. In no year shall the adjustment for premium payments be greater than one-half of the total adjustment.

(b) Any group hospitalization, medical, pharmacy and surgical insurance plan developed by the Comptroller pursuant to subsection (a) of this section shall (1) include the health enhancement program, (2) be consistent with value-based insurance design principles, and (3) be approved by the Health Care Cost Containment Committee prior to being offered to nonstate public employers. The Comptroller shall, prior to the approval of the Health Care Cost Containment Committee, and offering any such plan, and annually thereafter, (A) cause the premium payments associated with such plan to be reviewed by an independent actuarial firm to determine the adequacy of such premiums relative to experience and total costs, and (B) provide a report concerning such review to the Health Care Cost Containment Committee, the Office of Policy and Management and the joint standing committee of the General Assembly having cognizance of matters relating to appropriations, in accordance with the provisions of section 11-4a.

[(b)] (c) (1)The Comptroller shall offer participation in such plan for not less than three-year intervals. A nonstate public employer may apply for renewal prior to the expiration of each interval.

(2)The Comptroller shall develop procedures by which nonstate public employers receiving coverage for nonstate public employees pursuant to the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section may (A) apply for renewal, or (B) withdraw from such coverage, including, but not limited to, the terms and conditions under which such nonstate public employers may withdraw prior to the expiration of the interval. [and the procedure by which any premium payments such nonstate public employers may be entitled to or premium equivalent payments made in excess of incurred claims shall be refunded to such nonstate public employer.] Any such procedures shall provide that nonstate public employees covered by collective bargaining shall withdraw from such coverage in accordance with chapters 68, 113 and 166.

[(c)] (d) Nothing in sections 3-123rrr to 3-123vvv, inclusive, shall (1) require the Comptroller to offer coverage to every nonstate public employer seeking coverage under the state employee plan [,] or a plan developed by the Comptroller pursuant to subsection (a) of this section, (2) prevent the Comptroller from procuring coverage for nonstate public employees from vendors other than those providing coverage to state employees, or (3) prevent the Comptroller from offering plans other than the plans offered to state employees on July 1, 2019, provided no such plan shall be offered if such plan qualifies as a high deductible health plan, as defined in Section 220(c)(2) or Section 223(c)(2) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time, and is used to establish a medical savings account or an Archer MSA pursuant to said Section 220 or a health savings account pursuant to said section 223.

[(d)] (e) The Comptroller shall create applications for coverage under and for renewal of the state employee plan and any other plan developed by the Comptroller pursuant to subsection (a) of this section. Such applications shall require a nonstate public employer to disclose whether such nonstate public employer shall offer any other health care benefits plan to the nonstate public employees who are offered the state employee plan.

[(e)] (f) No nonstate public employee shall be enrolled in the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section if such nonstate public employee is covered through a nonstate public employer’s health insurance plans or insurance arrangements issued to or in accordance with a trust established pursuant to collective bargaining subject to the federal Labor Management Relations Act.

[(f)] (g) (1)A nonstate public employer may submit an application to the Comptroller to provide coverage under the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section for nonstate public employees employed by such nonstate public employer.

(2)If a nonstate public employer submits an application for coverage of all of its nonstate public employees, the Comptroller shall provide such coverage not later than the first day of the third calendar month following such application.

(3)(A)Except as provided in subsection [(g)] (h) of this section, if a nonstate public employer submits an application for coverage for fewer than all of its nonstate public employees, or indicates in the application that the nonstate public employer shall offer other health plans to nonstate public employees who are offered the state health plan, the Comptroller shall forward such application to the Health Care Cost Containment Committee not later than five business days after receiving such application. Said committee may, not later than thirty days after receiving such application, certify to the Comptroller that the application will shift a significantly disproportional part of a nonstate public employer’s medical risks to the state employee plan.

(B)If the Health Care Cost Containment Committee certifies to the Comptroller that the application will shift a significantly disproportional part of a nonstate public employer’s medical risks to the state employee plan, the Comptroller shall not provide coverage to such nonstate public employer. If the Health Care Cost Containment Committee does not certify to the Comptroller that the application will shift a significantly disproportional part of a nonstate public employer’s medical risks to the state employee plan, the Comptroller shall provide coverage not later than the first day of the third calendar month following the deadline for receiving the certification.

(4)Notwithstanding any provisions of the general statutes, initial and continuing participation in the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section by a nonstate public employer shall be a mandatory subject of collective bargaining and shall be subject to binding interest arbitration in accordance with the same procedures and standards that apply to any other mandatory subject of bargaining pursuant to chapters 68, 113 and 166.

[(g)] (h) If a nonstate public employer included fewer than all of its nonstate public employees in its application for coverage because of (1) the decision by individual nonstate public employees to decline such coverage for themselves or their dependents, or (2) the nonstate public employer’s decision to not offer coverage to temporary, part-time or durational employees, the Comptroller shall not forward such nonstate public employer’s application to the Health Care Cost Containment Committee pursuant to subdivision (3) of subsection [(f)] (g) of this section.

[(h)] (i) Notwithstanding any provision of the general statutes, neither the state employee plan nor any plan developed by the Comptroller pursuant to subsection (a) of this section shall [not] be deemed (1) an unauthorized insurer, or (2) a multiple employer welfare arrangement. Any licensed insurer in this state may conduct business with the state employee plan or any plan developed by the Comptroller pursuant to subsection (a) of this section.

(j) Nothing in this section shall require a nonstate public employer enrolled in the state employee plan to enroll in another plan developed by the Comptroller pursuant to this section.

Sec. 379. Section 3-123ttt of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2019):

(a) Any nonstate public employer that is eligible to seek coverage under the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of section 3-123sss for its nonstate public employees may seek such coverage for such nonstate public employer’s retirees in accordance with this section. Premium payments for such coverage shall be remitted by the nonstate public employer to the Comptroller and shall be the same as those paid by the state, inclusive of any premiums paid by retired state employees.

(b)(1)If a nonstate public employer seeks coverage for all of its retirees in accordance with this section and all of the nonstate public employees employed by such nonstate public employer in accordance with section 3-123sss, the Comptroller shall accept such application upon the terms and conditions applicable to the state employee plan or plan developed by the Comptroller pursuant to subsection (a) of section 3-123sss and shall provide coverage not later than the first day of the third calendar month following such application.

(2)If a nonstate public employer seeks coverage for fewer than all of its retirees, regardless of whether such nonstate public employer is seeking coverage for all of the nonstate public employees employed by such nonstate public employer, the Comptroller shall forward such application to the Health Care Cost Containment Committee not later than five business days after receiving such application. Said committee may, not later than thirty days after receiving such application, certify to the Comptroller that, with respect to such retirees, the application will shift a significantly disproportional part of such nonstate public employer’s medical risks to the state employee plan.

(3)If the Health Care Cost Containment Committee certifies to the Comptroller that the application will shift a significantly disproportional part of a nonstate public employer’s medical risks to the state employee plan, the Comptroller shall not provide coverage to such nonstate public employer’s retirees. If the Health Care Cost Containment Committee does not certify to the Comptroller that the application will shift a significantly disproportional part of a nonstate public employer’s medical risks to the state employee plan, the Comptroller shall provide coverage not later than the first day of the third calendar month following the deadline for receiving the certification.

(c)Nothing in sections 3-123rrr to 3-123vvv, inclusive, shall diminish any right to retiree health insurance pursuant to a collective bargaining agreement or to any other provision of the general statutes.

Sec. 380. Section 3-123uuu of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2019):

[(a) There is established an account to be known as the “state employee plan premium account”, which shall be a separate, nonlapsing account within the General Fund. All premiums paid by nonstate public employers and nonstate public employees pursuant to participation in the state employee plan shall be deposited into said account. The account shall be administered by the Comptroller, with the advice of the Health Care Cost Containment Committee, for payment of claims and administrative fees to entities providing coverage or services under the state employee plan.]

[(b)] (a) Each nonstate public employer shall pay monthly the amount determined by the Comptroller for coverage of its nonstate public employees or its nonstate public employees and retirees, as appropriate, under the state employee plan. A nonstate public employer may require each nonstate public employee to contribute a portion of the cost of his or her coverage under the plan, subject to any collective bargaining obligation applicable to such nonstate public employer.

(b) The Comptroller shall establish accounting procedures to track claims and premium payments paid by nonstate public employers.

(c)If any payment due by a nonstate public employer under this [subsection] section is not paid after the date such payment is due, interest to be paid by such nonstate public employer shall be added, retroactive to the date such payment was due, at the prevailing rate of interest as determined by the Comptroller.

(d)If a nonstate public employer fails to make premium payments, the Comptroller may direct the State Treasurer, or any other officer of the state who is the custodian of any moneys made available by grant, allocation or appropriation payable to such nonstate public employer at any time subsequent to such failure, to withhold the payment of such moneys until the amount of the premium or interest due has been paid to the Comptroller, or until the State Treasurer or such custodial officer determines that arrangements have been made, to the satisfaction of the State Treasurer, for the payment of such premium and interest. Such moneys shall not be withheld if such withholding will adversely affect the receipt of any federal grant or aid in connection with such moneys.

Sec. 381. Section 3-123vvv of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2019):

The Comptroller shall not offer coverage under the state employee plan pursuant to sections 3-123rrr to 3-123uuu, inclusive, or section 378 of this act, until the State Employees’ Bargaining Agent Coalition has provided its consent to the clerks of both houses of the General Assembly to incorporate the terms of sections 3-123rrr to 3-123uuu, inclusive, and section 378 of this act, into its collective bargaining agreement.

Sec. 382. (NEW) (Effective from passage) Not later than October 1, 2019, and annually thereafter, each nonstate public employer shall submit a report to the Comptroller, Office of Policy and Management and Office of Fiscal Analysis, in a form and manner prescribed by the Comptroller. Such report shall contain (1) the total number of employees covered under a health care plan sponsored by such employer, (2) the coverage type selected by each covered employee, (3) the total premium for each coverage type, inclusive of employee and employer shares and medical and pharmacy coverage, (4) the amount of any contributions by such employer to health savings or health reimbursement accounts, (5) the number of participants in such health care plans, including employee dependents, (6) a summary of benefits and coverage for each health care plan offered by such employer and the number of employees enrolled in each such plan, and (7) information concerning retirement plans and benefits offered or provided by such employer and the total costs to such employer associated with the provision of such plans and benefits in the preceding year.

Sec. 383. (NEW) (Effective from passage) Not later than January 1, 2021, and annually thereafter, the Comptroller shall submit a report to the Health Care Cost Containment Committee, Office of Policy and Management and joint standing committee of the General Assembly having cognizance of matters relating to appropriations, in accordance with the provisions of section 11-4a of the general statutes, concerning municipal group hospitalization, medical, pharmacy and surgical insurance plans developed by the Comptroller pursuant to subsection (a) of section 3-923sss of the general statutes. Such report shall include, but need not be limited to, the total number of contracts, members, plan costs and premium payments and other revenues associated with such plans and the corresponding profit loss ratio for the previous calendar year. Such report shall distinguish municipal health care plans from the state employee plan and demonstrate cost neutrality by individual municipal insurance plan and in total across all municipal insurance plans. If the profit loss ratio demonstrates inadequacy in premium payments, such report shall include a plan to ensure the fiscal adequacy of the premium rate structure for such individual municipal insurance plans and the associated benefit design to eliminate any prior year financial loss and prevent financial loss in the upcoming plan year.