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H.J.R. 21 Enrolled

             1     

JOINT RESOLUTION ON STATE HEALTH INSURANCE

             2     
2012 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Brad L. Dee

             5     
Senate Sponsor: Scott K. Jenkins

             6     
             7      LONG TITLE
             8      General Description:
             9          This resolution directs the Public Employees' Benefit and Insurance Program (PEHP)
             10      regarding the medical and dental coverage premium share between employer and
             11      employee and other cost issues related to medical and dental plans for state employees.
             12      Highlighted Provisions:
             13          This resolution:
             14          .    directs PEHP to:
             15              .    maintain for FY 2012-13 the same combined employer/employee premiums for
             16      health benefit plan medical coverage from FY 2011-12; and
             17              .    fund trend increases for FY 2012-13 using excess reserves in the state's medical
             18      risk pool;
             19          .    directs PEHP and the Department of Human Resource Management to:
             20              .    maintain the state's contribution for health maintenance organization medical
             21      coverage based on a 90% employer and 10% employee premium share; and
             22              .    change the state's contribution for dental coverage to be based on a 90%
             23      employer and 10% employee premium share;
             24          .    directs PEHP to take additional action to adjust costs to stay within existing
             25      revenues;
             26          .    directs PEHP to establish 80% as the standard coinsurance level for medical
             27      benefits under the health maintenance organization medical coverage (traditional
             28      plan) and the high deductable medical coverage (STAR plan);
             29          .    directs PEHP to establish a second federally qualified high deductible health plan


             30      with a 70% coinsurance level for medical benefits; and
             31          .    directs PEHP to develop a program for differentiating premiums, benefits, or both
             32      on the basis of health and wellness outcomes.
             33      Special Clauses:
             34          None
             35     
             36      Be it resolved by the Legislature of the state of Utah:
             37          WHEREAS, in accordance with Utah Code Section 49-20-201 , the state participates in
             38      the Public Employees' Benefit and Insurance Program;
             39          WHEREAS, Utah Code Subsection 49-20-401 (1)(g) provides that the program must
             40      "consult with the covered employers to evaluate employee benefit plans and develop
             41      recommendations for benefit changes";
             42          WHEREAS, Utah Code Subsection 49-20-401 (1)(h) provides that the program
             43      "annually submit a budget and audited financial statements to the governor and Legislature
             44      which includes total projected benefit costs and administrative costs";
             45          WHEREAS, Utah Code Subsection 49-20-401 (1)(i) provides that the program
             46      "maintain reserves sufficient to liquidate the unrevealed claims liability and other liabilities of
             47      the employee benefit plans as certified by the program's consulting actuary";
             48          WHEREAS, Utah Code Subsection 49-20-401 (1)(j) provides that the program "submit,
             49      in advance, its recommended benefit adjustments for state employees to . . . the Legislature;
             50      and . . . the executive director of the state Department of Human Resource Management";
             51          WHEREAS, Utah Code Subsection 49-20-401 (1)(k) provides that the program
             52      "determine benefits and rates, upon approval of the board, for multi-employer risk pools,
             53      retiree coverage, and conversion coverage";
             54          WHEREAS, Utah Code Subsection 49-20-401 (1)(l) provides that the program
             55      "determine benefits and rates based on the total estimated costs and the employee premium
             56      share established by the Legislature, upon approval of the board, for state employees"; and
             57          WHEREAS, PEHP's medical risk pool for the state of Utah contains more than $23


             58      million in excess reserves;
             59          NOW, THEREFORE, BE IT RESOLVED that the Legislature directs PEHP to:
             60          (1) maintain for FY 2012-13 the same overall combined employer/employee premiums
             61      for health benefit plan medical coverage from FY 2011-12; and
             62          (2) fund trend increases for FY 2012-13 using excess reserves in the state's medical
             63      risk pool.
             64          BE IT FURTHER RESOLVED that the Legislature directs PEHP and the Department
             65      of Human Resource Management to:
             66          (1) maintain the state's contribution for health maintenance organization medical
             67      coverage based on a 90% employer and 10% employee premium share; and
             68          (2) change the state's contribution for dental coverage to be based on a 90% employer
             69      and 10% employee premium share to be in line with the employer/employee premium share for
             70      health maintenance organization medical coverage.
             71          BE IT FURTHER RESOLVED that the Legislature directs PEHP to take additional
             72      action to adjust costs to come within existing revenues.
             73          BE IT FURTHER RESOLVED that the Legislature directs PEHP to establish 80% as
             74      the standard coinsurance level for medical benefits under the health maintenance organization
             75      medical coverage (traditional plan) and the high deductable medical coverage (STAR plan).
             76          BE IT FURTHER RESOLVED that the Legislature directs PEHP to establish a second
             77      federally qualified high deductible health plan with a 70% coinsurance level for medical
             78      benefits.
             79          BE IT FURTHER RESOLVED that the Legislature directs PEHP to develop a program
             80      for differentiating premiums, benefits, or both on the basis of health and wellness outcomes
             81      that could be implemented no later than FY 2013-14.


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