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First Substitute S.B. 138

Senator Todd Weiler proposes the following substitute bill:


             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:
             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      ENACTS:
             34          53A-3-431, Utah Code Annotated 1953
             35          53B-1-101.8, Utah Code Annotated 1953
             36     
             37      Be it enacted by the Legislature of the state of Utah:
             38          Section 1. Section 31A-22-605.5 is amended to read:
             39           31A-22-605.5. Application.
             40          (1) For purposes of this section "insurance mandate":
             41          (a) means a mandatory obligation with respect to coverage, benefits, or the number or
             42      types of providers imposed on policies of accident and health insurance; and
             43          (b) does not mean:
             44          (i) an administrative rule imposing a mandatory obligation with respect to coverage,
             45      benefits, or providers unless that mandatory obligation was specifically imposed on policies of
             46      accident and health insurance by statute[.]; or
             47          (ii) an insurance mandate in an essential health benefits package imposed pursuant to
             48      the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the Health Care
             49      Education Reconciliation Act of 2010, Pub. L. No. 111-152, and federal rules related to their
             50      implementation.
             51          (2) (a) Notwithstanding the provisions of Subsection 31A-1-103 (3)(f), the following
             52      shall apply to health coverage offered to the state employees' risk pool under Subsection
             53      49-20-202 (1)(a):
             54          (i) any law [imposed] enacted under this title that becomes effective after January 1,
             55      2002, which provides for an insurance mandate for policies of accident and health insurance;
             56      and


             57          (ii) in accordance with Section 31A-22-613.5 , disclosure requirements for coverage
             58      limitations.
             59          (b) Notwithstanding the provisions of Subsection 31A-1-103 (3)(f), a health insurance
             60      mandate enacted under this title after January 1, 2012, shall apply to:
             61          (i) health coverage offered to the state employees' risk pool under Subsection
             62      49-20-202 (1)(a); and
             63          (ii) health coverage offered to public school districts, charter schools, and institutions
             64      of higher education under Subsection 49-20-201 (1)(b).
             65          [(b)] (c) If health coverage offered to the state employees' risk pool under [Subsection]
             66      Subsections 49-20-201 (1)(b) and 49-20-202 (1)(a) offers coverage in the same manner and to
             67      the same extent as the coverage required by [the] an insurance mandate [imposed] enacted
             68      under this title or coverage that is greater than the insurance mandate [imposed] enacted under
             69      this title, the coverage offered to state employees under [Subsection] Subsections
             70      49-20-201 (1)(b) and 49-20-202 (1)(a) will be considered in compliance with the insurance
             71      mandate.
             72          [(c)] (d) The [program] programs regulated under [Subsection] Subsections
             73      49-20-201 (1)(b) and 49-20-202 (1)(a) shall report to the Retirement and Independent Entities
             74      Committee created under Section 63E-1-201 by November 30 of each year in which a mandate
             75      is [imposed] enacted under the provisions of this section. The report shall include the costs and
             76      benefits of the particular mandatory obligation.
             77          (3) (a) An insurance mandate for policies of accident and health insurance enacted
             78      under this title after January 1, 2012, shall apply to policies of accident and health insurance
             79      offered by a public school district, a charter school, or a state funded institution of higher
             80      education that is not insured through the Public Employees' Benefit and Insurance Program.
             81          (b) If an insurance mandate for policies of accident and health insurance is enacted
             82      under this title after January 1, 2012, the state shall determine whether each entity described in
             83      Subsections (2) and (3)(a) offers coverage in the same manner and to the same extent, or
             84      greater than the insurance coverage required in the mandate enacted after January 1, 2012.
             85          (c) Before enacting an insurance mandate, the state shall, for each entity that does not
             86      offer coverage in accordance with Subsection (3)(b):
             87          (i) determine the cost to the entity of implementing the insurance mandate; and


             88          (ii) appropriate money necessary to fund the full cost to the entity of implementing the
             89      insurance mandate.
             90          Section 2. Section 49-20-407 is amended to read:
             91           49-20-407. Insurance mandates.
             92          Notwithstanding the provisions of Subsection 31A-1-103 (3)(f)[,]:
             93          (1) health coverage offered to the state employee risk pool under Subsection
             94      49-20-202 (1)(a) shall comply with the provisions of Sections 31A-8-501 and 31A-22-605.5 ;
             95      and
             96          (2) health coverage offered to public school districts, charter schools, and institutions
             97      of higher education under Subsection 49-20-201 (1)(b) shall comply with the provisions of
             98      Section 31A-22-605.5 .
             99          Section 3. Section 53A-3-431 is enacted to read:
             100          53A-3-431. Health Insurance Mandates.
             101          A local school board and the governing body of a charter school shall include in an
             102      accident and health insurance policy it offers to school district employees, or charter school
             103      employees insurance mandates in accordance with Section 31A-22-605.5 .
             104          Section 4. Section 53B-1-101.8 is enacted to read:
             105          53B-1-101.8. Health Insurance Mandates.
             106          An institution of higher education shall include in an accident and health insurance
             107      policy it offers to its employees insurance mandates in accordance with Section 31A-22-605.5
             108          Section 5. Effective date.
             109          If approved by two-thirds of all the members elected to each house, this bill takes effect
             110      upon approval by the governor, or the day following the constitutional time limit of Utah
             111      Constitution Article VII, Section 8, without the governor's signature, or in the case of a veto,
             112      the date of veto override.


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