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S.B. 138

This document includes Senate Committee Amendments incorporated into the bill on Fri, Jan 27, 2012 at 9:09 AM by kcallred. --> This document includes Senate Committee Amendments incorporated into the bill on Fri, Jan 27, 2012 at 9:16 AM by khelgesen. -->              1     

HEALTH INSURANCE MANDATE ACCOUNTABILITY

             2     
AMENDMENTS

             3     
2012 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: Todd Weiler

             6     
House Sponsor: Evan J. Vickers

             7     

             8      LONG TITLE
             9      General Description:
             10          This bill amends the Accident and Health Insurance Policy chapter of the Insurance
             11      Code.
             12      Highlighted Provisions:
             13          This bill:
             14          .     applies a health insurance mandate that is enacted by the state after January 1,
             15      2012, to a public school district, charter school, or a state funded institution of
             16      higher education;
             17          .    requires the state to evaluate the cost of an insurance mandate enacted after January
             18      1, 2012, for the state employees' risk pool, a public school district, a charter school,
             19      and state funded institutions of higher education;
             20          .    requires the state to appropriate the cost of implementing a health insurance
             21      mandate enacted after January 1, 2012, to the participating employers in the state
             22      employees' risk pools, public school districts, charter schools, and state funded
             23      institutions of higher education; and
             24          .    makes technical amendments.
             25      Money Appropriated in this Bill:
             26          None
             27      Other Special Clauses:



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             28
         This bill provides an immediate effective date.
             29      Utah Code Sections Affected:
             30      AMENDS:
             31          31A-22-605.5, as last amended by Laws of Utah 2008, Chapters 241 and 250
             32          49-20-407, as last amended by Laws of Utah 2004, Chapter 229
             33     

             34      Be it enacted by the Legislature of the state of Utah:
             35          Section 1. Section 31A-22-605.5 is amended to read:
             36           31A-22-605.5. Application.
             37          (1) For purposes of this section "insurance mandate":
             38          (a) means a mandatory obligation with respect to coverage, benefits, or the number or
             39      types of providers imposed on policies of accident and health insurance; and
             40          (b) does not mean:
             41          (i) an administrative rule imposing a mandatory obligation with respect to coverage,
             42      benefits, or providers unless that mandatory obligation was specifically imposed on policies of
             43      accident and health insurance by statute[.]; or
             44          (ii) an insurance mandate in an essential health benefits package imposed pursuant to
             45      the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the Health Care
             46      Education Reconciliation Act of 2010, Pub. L. No. 111-152, and federal rules related to their
             47      implementation.
             48          (2) (a) Notwithstanding the provisions of Subsection 31A-1-103 (3)(f), the following
             49      shall apply to health coverage offered to the state employees' risk pool under Subsection
             50      49-20-202 (1)(a):
             51          (i) any law [imposed] enacted under this title that becomes effective after January 1,
             52      2002, which provides for an insurance mandate for policies of accident and health insurance;
             53      and
             54          (ii) in accordance with Section 31A-22-613.5 , disclosure requirements for coverage
             55      limitations.
             56          (b) Notwithstanding the provisions of Subsection 31A-1-103 (3)(f), a health insurance
             57      mandate enacted under this title after January 1, 2012, shall apply to:
             58          (i) health coverage offered to the state employees' risk pool under Subsection



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             59
     49-20-202 (1)(a); and
             60          (ii) health coverage offered to public school districts, charter schools, and institutions
             61      of higher education under Subsection 49-20-201 (1)(b).
             62          [(b)] (c) If health coverage offered to the state employees' risk pool under [Subsection]
             63      Subsections 49-20-201 (1)(b) and 49-20-202 (1)(a) offers coverage in the same manner and to
             64      the same extent as the coverage required by [the] an insurance mandate [imposed] enacted
             65      under this title or coverage that is greater than the insurance mandate [imposed] enacted under
             66      this title, the coverage offered to state employees under [Subsection] Subsections
             67      49-20-201 (1)(b) and 49-20-202 (1)(a) will be considered in compliance with the insurance
             68      mandate.
             69          [(c)] (d) The [program] programs regulated under [Subsection] Subsections
             70      49-20-201 (1)(b) and 49-20-202 (1)(a) shall report to the Retirement and Independent Entities
             71      Committee created under Section 63E-1-201 by November 30 of each year in which a mandate
             72      is [imposed] enacted under the provisions of this section. The report shall include the costs and
             73      benefits of the particular mandatory obligation.
             74          (3) (a) An insurance mandate for policies of accident and health insurance enacted
             75      under this title after January 1, 2012, shall apply to policies of accident and health insurance
             76      offered by a public school district, a charter school, or a state funded institution of higher
             77      education that is not insured through the Public Employees' Benefit and Insurance Program.
             78          (b) If an insurance mandate for policies of accident and health insurance is enacted
             79      under this title after January 1, 2012, the state shall determine whether each entity described in
             80      Subsections (2) and (3)(a) offers coverage in the same manner and to the same extent, or
             81      greater than the insurance coverage required in the mandate enacted after January 1, 2012.
             82          (c) Before enacting an insurance mandate, the state shall, for each entity that does not
             83      offer coverage in accordance with Subsection (3)(b):
             84          (i) determine the cost to the entity of implementing the insurance mandate; and
             85          (ii) appropriate money necessary to fund the full cost to the entity of implementing the
             86      insurance mandate.
             87          Section 2. Section 49-20-407 is amended to read:
             88           49-20-407. Insurance mandates.
             89          Notwithstanding the provisions of Subsection 31A-1-103 (3)(f)[,]:



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Senate Committee Amendments 1-27-2012 kc/cjd
             90
         (1) health coverage offered to the state employee risk pool under Subsection
             91      49-20-202 (1)(a) shall comply with the provisions of Sections 31A-8-501 and 31A-22-605.5 ;
             92      and
             93          (2) health coverage offered to public school districts, charter schools, and institutions
             94      of higher education under Subsection 49-20- S. [ 301 ] 201 .S (1)(b) shall comply with the
             94a      provisions of
             95      Section 31A-22-605.5 .
             96          Section 3. Effective date.
             97          If approved by two-thirds of all the members elected to each house, this bill takes effect
             98      upon approval by the governor, or the day following the constitutional time limit of Utah
             99      Constitution Article VII, Section 8, without the governor's signature, or in the case of a veto,
             100      the date of veto override.





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