Second Substitute H.B. 364

This document includes House Floor Amendments incorporated into the bill on Tue, Feb 26, 2008 at 12:21 PM by ddonat. --> This document includes Senate 2nd Reading Floor Amendments incorporated into the bill on Wed, Mar 5, 2008 at 10:19 AM by rday. -->

Representative Kory M. Holdaway proposes the following substitute bill:

1 PROMOTION OF HEALTH CARE COVERAGE
2 2008 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: Kory M. Holdaway
5 Senate Sponsor: Peter C. Knudson
6
7 LONG TITLE
8 General Description:
9 This bill amends the Medical Assistance Act and the Individual, Small Employer, and
10 Group Health Insurance Act.
11 Highlighted Provisions:
12 This bill:
13 . requires the Department of Workforce Services, the State Board of Education, and
14 the department to:
15 . collaborate with one another to develop a process to H. [ identify ] promote .H the
15a health
16 insurance H. [ status of certain ] awareness and coverage of .H children in H. [ public ] .H
16a schools;
17 . report to the Legislature on the development of the process; and
18 . implement the process no later than the 2009-10 school year;
19 . requires the Department of Workforce Services to promote and facilitate the
20 enrollment of the children identified in public schools without health insurance in
21 the Utah Children's Health Insurance Program or the Medicaid program; and
22 . provides that under certain conditions an individual who qualifies for premium
23 assistance under the Utah's Premium Partnership for Health Insurance Program, or
24 the individual's dependents, may enroll in an employer health benefit plan outside
25 an open enrollment period.

26 Monies Appropriated in this Bill:
27 This bill appropriates:
28 . as an ongoing appropriation subject to future budget constraints, S. [ $100,000 ] $60,000 .S
28a from the
29 General Fund for fiscal year 2008-09 to the Division of Health Care Financing
30 within the Department of Health to promote awareness of and facilitate enrollment
31 in the Utah's Premium Partnership for Health Insurance Program.
32 Other Special Clauses:
33 None
34 Utah Code Sections Affected:
35 ENACTS:
36 26-18-12, Utah Code Annotated 1953
37 31A-22-610.6, Utah Code Annotated 1953
38
39 Be it enacted by the Legislature of the state of Utah:
40 Section 1. Section 26-18-12 is enacted to read:
41 26-18-12. Process to H. [ identify ] promote .H health insurance H. [ status of certain ]
41a coverage for .H children --
42 H. [ Promoting enrollment of children ] .H .
43 (1) The Department of Workforce Services, the State Board of Education, and the
44 department shall:
45 (a) collaborate with one another to develop a process to H. [ identify the ] promote .H
45a health insurance
46 H. [ status of a ] coverage for a .H child in H. [ a public ] .H school H. [ at the time ]
46a when .H :
47 (i) the child applies for free or reduced price school lunch; H. [ or ] .H
48 (ii) a H. [ certificate of immunization required under Title 53A, Chapter 11, Part 3,
49 Immunization of Students, is submitted on behalf of the child ] child enrolls in or registers in school;
49a and
49b (iii) other appropriate school related opportunities .H ;
50 (b) report to the Legislature on the development of the process under Subsection (1)(a)
51 no later than November 19, 2008; and
52 (c) implement the process developed under Subsection (1)(a) no later than the 2009-10
53 school year.
54 (2) The Department of Workforce Services shall promote and facilitate the enrollment
55 of children identified under Subsection (1)(a) without health insurance in the Utah Children's
56 Health Insurance Program H. [ or ] , .H the Medicaid program H. , or the Utah Premium
56a Partnership for Health Insurance Program .H .

57 Section 2. Section 31A-22-610.6 is enacted to read:
58 31A-22-610.6. Special enrollment for individuals receiving premium assistance.
59 (1) As used in this section:
60 (a) "Premium assistance" means assistance under Title 26, Chapter 18, Medical
61 Assistance Act, in the payment of premium.
62 (b) "Qualified beneficiary" means an individual who is approved to receive premium
63 assistance.
64 (2) Subject to the other provisions in this section, an individual may enroll under this
65 section at a time outside of an employer health benefit plan open enrollment period, regardless
66 of previously waiving coverage, if the individual is:
67 (a) a qualified beneficiary who is eligible for coverage as an employee under the
68 employer health benefit plan; or
69 (b) a dependent of the qualified beneficiary who is eligible for coverage under the
70 employer health benefit plan.
71 (3) To be eligible to enroll outside of an open enrollment period, an individual
72 described in Subsection (2) shall enroll in the employer health benefit plan by no later than 30
73 days from the day on which the qualified beneficiary receives written notification that the
74 qualified beneficiary is eligible to receive premium assistance.
75 (4) An individual described in Subsection (2) may enroll under this section only in an
76 employer's health benefit plan that is available at the time of enrollment to similarly situated
77 eligible employees or dependents of eligible employees.
78 (5) Coverage under an employer health benefit plan for an individual described in
79 Subsection (2) may begin as soon as the first day of the month immediately following
80 enrollment of the individual in accordance with this section.
81 (6) This section does not modify any requirement related to premiums that applies
82 under an employer health benefit plan to a similarly situated eligible employee or dependent of
83 an eligible employee under the employer health benefit plan.
84 (7) An employer health benefit plan may require an individual described in Subsection
85 (2) to satisfy a preexisting condition waiting period that:
86 (a) is allowed under the Health Insurance Portability and Accountability Act of 1996,
87 Pub. L. 104-191, 110 Stat. 1936; and

88 (b) is not longer than 12 months.
89 Section 3. Appropriation.
90 As an ongoing appropriation subject to future budget constraints, there is appropriated
91 from the General Fund for fiscal year 2008-09, S. [ $100,000 ] 60,000 .S to the Division of Health Care
92 Financing within the Department of Health to promote awareness of and facilitate enrollment
93 in the Utah's Premium Partnership for Health Insurance Program.