SF0112 - State employees group insurance reorganization.
|
2001 |
State of Wyoming |
01LSO-0346 |
SENATE FILE NO. SF0112
State employees group insurance reorganization.
Sponsored by: Management Audit Committee
A BILL
for
1 AN ACT relating to state
employees and officials;
2
transferring the state employees' and officials' group
3 insurance
program to the department of administration and
4
information; assigning all duties and functions of the
5
state employees' and officials' group insurance board of
6
administration to the department; specifying additional
7
related duties of the department; transferring personnel,
8
appropriations and property to the department as specified;
9
terminating the state employees' and officials' group
10 insurance board of administration; extending
terms of
11 current board members until transfer is
effective;
12 providing for an advisory panel; and
providing for
13 effective dates.
14
15 Be It Enacted by the Legislature of the State of Wyoming:
16
17 Section 1. W.S. 9-3-217 is created to read:
Page 1
1
2 9-3-217. Advisory panel; composition; compensation.
3
4 (a) The
director of the department shall establish an
5
advisory panel consisting of active plan participants
6
employed by the state, the University of Wyoming and
7
Wyoming community colleges and of retired employees who are
8
plan participants. The panel shall consist of no more than
9 ten
(10) members and, insofar as possible, shall
10 proportionally represent the specified
employee groups
11 participating in the group health insurance
plan. The
12 advisory panel shall be consulted regarding
plan benefits
13 and costs.
14
15 (b) State,
university and community college employee
16 members of the panel shall suffer no loss of
wages for the
17 time devoted to attending meetings of the
panel called by
18 the department. All members shall be provided per diem and
19 travel expenses incurred for attending such
meetings at the
20 rates provided under W.S. 9-3-102 and 9-3-103.
21
22 Section
2. W.S. 9-2-1003 by creating a new subsection
23 (e), 9-3-203(a)(v), (vii), (x), by
creating a new paragraph
24 (xi), (xii) and by amending and
renumbering (xi) as (xiii)
Page 2
1 and (xii), 9-3-205(a)(intro),
(i), (vi), (viii), (xii),
2
(xiii), (b) and by creating a new subsection (d),
3
9-3-206(a), (b)(intro), (c) and (d), 9-3-207(a) and (c),
4
9-3-208(a) and (c), 9-3-209, 9-3-210(b), 9-3-211 and
5
9-3-213(a), (b)(intro), (ii) and (c) are amended to read:
6
7 9-2-1003. Director and division administrators;
8 appointment; removal;
powers of director.
9
10 (e) The director shall administer through his office
11 or
through a division of the department, the duties of the
12 department
under the State Employees' and Officials' Group
13 Insurance
Act.
14
15 9-3-203. Definitions.
16
17 (a) As used in this act:
18
19 (v) "Group insurance plan"
means the health and
20 life insurance plans defined in this
section, the flexible
21 benefits plan or any other group insurance
coverages
22 contracted for by the board department,
including
23 disability insurance, as defined in W.S. 26-5-103(a);
24
Page 3
1 (vii) "Hospital and medical
benefits" means
2
hospital room and board, other hospital services, certain
3
outpatient benefits, maternity benefits, surgical benefits,
4
including obstetrical care, in-hospital medical care,
5
diagnostic X-ray and laboratory benefits, physician's
6
services provided by house and office calls, prescription
7
drugs, outpatient psychiatric services and other benefits
8
determined by the board department. Benefits may be
9
provided on a coinsurance basis, the insured to pay a
10 proportion of the cost of benefits;
11
12 (x) "Supplemental
health insurance plan" or
13 "supplemental plan" means a group
insurance contract or a
14 medical or hospital service agreement
provided by a carrier
15 for the purpose of paying for or reimbursing
the cost of
16 hospital and medical care in excess of or
supplemental to
17 medicare or medicaid, or both, which
employees or officials
18 and their dependents may be eligible to
receive.
19 Supplemental coverage may consist of one
(1), a combination
20 of, or alternative plans in the discretion
of the board
21
22
23 (xi) "Department" means the department
of
24 administration and information;
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1
2 (xii) "Flexible benefits
plan" means a plan of
3
benefits established by board department rules and
4
regulations and adopted pursuant to the Internal Revenue
5
Code of 1986, Title 26 of the United States code and
6
qualified under §125 of the Internal Revenue Code of 1986.
7 The
plan may include benefits authorized by the Internal
8
Revenue Code of 1986 and related federal regulations which
9 are
consistent with Wyoming law;.
10
11 (xi)(xiii)"This
act" means W.S. 9-3-202 through
12 9-3-213; 9-3-217.
13
14
9-3-205. Administration
and management of group
15 insurance program; powers and duties; adoption of rules and
16 regulations.
17
18 (a) The
board department
shall administer and manage
19 the state employees' and officials' group
insurance program
20 and, subject to the provisions of this act:
21
22 (i) Shall prepare specifications for
the health
23 insurance plan and a supplemental plan, the
life insurance
Page 5
1
plan and any other group insurance plan contracted for by
2 the
board department;
3
4 (vi) Shall establish a procedure by
which the
5 board department
shall hear complaints by insured employees
6
concerning the allowance and payment of claims, eligibility
7 for
coverage and other matters. Unless otherwise provided
8 in
the group insurance or supplemental plan or plans, any
9
decision of the board department upon complaints is not
10 binding upon either the employee or carrier
and the
11 provisions of the Wyoming Administrative
Procedure Act
12 shall not apply to the proceedings. The
group insurance or
13 supplemental plan or plans may provide that
the decision of
14 the board department shall be binding upon both the
15 employee and the carrier as to certain
disputes and in such
16 event the procedure adopted by the board department
shall
17 conform to the provisions of the Wyoming
Administrative
18 Procedure Act;
19
20 (viii) Shall continuously study the
operation of
21 the group insurance plan including such matters as gross
and
net costs, administrative costs, benefits, utilization
of
benefits and claims administration; analysis
of:
24
Page 6
1 (A) Gross and net
costs, including
2 administrative costs;
3
4 (B) Claims administration;
5
6 (C) Comprehensive
health claims utilization
7 information to determine the causes of
plan health care
8 cost increases and strategies to
control those costs;
9
10 (D) Factors in the plan's design that may
11 adversely
affect participation;
12
13 (E) The effect of benefit changes;
14
15 (F) Contribution levels and recommendations
16 to
attract a broad mix of participants to the plan;
17
18 (G) Demographic information about existing
19 and
eligible participants;
20
21 (H) Trends in costs and benefits of the
22 plan
relative to other plans.
23
Page 7
1 (xii) May contract with carriers to
underwrite
2 optional
group insurance plans which may be additions to or
3
supplemental to those plans contracted under this act and
4
which are paid for entirely by state employees and
5
officials, entirely by the state, or by both. The
6
contracts shall be designed to provide the fullest benefits
7 at
the lowest cost, and the board department may contract
8
with the same carriers for the optional group insurance
9
plans as for the other plans contracted for under this act;
10
11 (xiii) May contract with any person for
the
12 furnishing of actuarial services, the
preparation of
13 specifications for group insurance plans and
other
14 specialized services which cannot be
performed by the board
16 services shall be awarded through
responsible competitive
17 bidding at intervals as the board department
determines,
18 and shall be reviewed annually by the board department;
19
20 (b) The
board department
shall adopt rules and
21 regulations consistent with the provisions
of this act as
22 necessary to carry out its statutory duties
and
23 responsibilities under this act.
24
Page 8
1 (d) The department
shall report the results of the
2 analysis conducted pursuant to
paragraph (a)(viii) of this
3 section and suggested activities to
manage the plan by
4 December 1 of each year to a committee
of the legislature
5 designated by the management council.
6
7 9-3-206. Specifications for insurance plan;
8 submission of bids;
change of carriers; notice of rate
9 changes or intent of
carrier not to renew; premium tax
10 exemption.
11
12 (a) The
specifications drawn by the board department
13 for the health insurance plan shall include
hospital and
14 medical benefits, and comparable benefits
for employees who
15 rely solely on spiritual means for healing.
The
16 specification drawn by the board department
for the life
17 insurance plan and any other group insurance
plan shall
18 include benefits as determined by the board department.
19 Bids shall be submitted to the board department
within time
20 limits established by the board department
and, in addition
21 to the carrier's cost proposal, shall
include an
22 explanation of the method of claims
administration proposed
23 by the carrier and the cost thereof, the
amount of total
24 premiums to be retained by the carrier, the
purpose for
Page 9
1
which these retained funds would be allocated, and other
2
information requested by the board department.
3
4 (b) The board department
may:
5
6 (c) Any carrier under contract with
the board
board department sixty (60)
days
8 notice of any proposed rate change in the contract
9 specifications or intent not to renew the contract. If the
10 board department and the
carrier agree during the sixty
11 (60) day period to
any rate change in the specifications,
12 the board department may renew the contract, as changed,
13 without reopening
to bids.
14
15 (d) If
the board department
decides to change
16 carriers or to reopen bids on the
underwriting of any
17 aspect of the group insurance plan, it shall
follow the
18 same procedures in the selection of a
subsequent carrier as
19 it did in awarding the initial contract.
20
21
9-3-207. Eligibility for
membership in plan; state
22 employees; 31 day period to elect enrollment; new
23 employees; later enrollment.
24
Page 10
1 (a) Any state employee eligible for
membership in the
2
group insurance plan at the time the plan becomes effective
3
shall have thirty-one (31) days to either elect to be
4
enrolled or not be enrolled in the plan. The board
6 employees shall notify the board department of their
7 decision within the prescribed thirty-one (31) day period.
8
9 (c) Employees who elect not to be
enrolled within the
10 time prescribed in subsections (a) and (b)
of this section
11 may be enrolled at a later date upon
conditions the board
13 the exclusion of
preexisting conditions from coverage.
14
15
9-3-208. State officials;
31 day period to elect
16 enrollment; newly appointed or elected officials; later
17 enrollment.
18
19 (a) State
officials eligible for membership in the
20 group insurance plan at the time the plan
becomes effective
21 shall have thirty-one (31) days to either
elect to become
22 enrolled or not become enrolled in the plan.
The election
23 shall be made according to procedures
established by the
board
department.
Page 11
1
2 (c) Eligible state officials who
elect not to become
3 enrolled
within the time prescribed in subsections (a) and
4 (b)
of this section may be enrolled at a later date upon
5
conditions the board department may impose, such as a
6
physical examination or the exclusion of preexisting
7
conditions from coverage.
8
9 9-3-209. Dependents; election of coverage; later
10 election; change in number of dependents.
11
12 (a) Any
eligible employee or official may elect to
13 have his dependents covered by the
group insurance plan.
14 The election shall be made at the time the
employee or
15 official becomes enrolled in the plan, under
procedures the
16 board department may establish. If dependent
coverage is
17 not elected at the time that an employee or
official
18 becomes enrolled in the plan, dependent
coverage may be
19 elected at a later date under conditions the
board
21 exclusion of
preexisting conditions from coverage.
22
23 (b) Any
employee or official who has elected to have
24 his dependents covered as provided in
subsection (a) of
Page 12
1
this section, and who subsequently has a change in the
2
number of his dependents, may at the time of the change
3 increase
or decrease the number of his dependents covered
4 by
the group insurance plan under procedures established by
5 the board department.
6
7 (c) Any employee or official who has
no eligible
8
dependents at the time he becomes enrolled in the group
9
insurance plan, and who later has an eligible dependent
10 may, at the time his dependency status
changes, elect
11 coverage for the dependent under procedures
established by
12 the board
department.
13
14
9-3-210. Amount of state's
contribution; estimates
15 submitted to state budget officer; specified employees
16 participation in federal program.
17
18 (b) Any
state agency, department or institution,
19 including the University of Wyoming and the
community
20 colleges in the state, shall pay monthly to
the board
22 legislature for each eligible employee or
official electing
23 to become covered by any portion of the
group insurance
24 plan as the contribution of the state to
that plan during
Page 13
1 the
period the employee or official is enrolled in the
2
plan. If the monthly premium for coverage of the employee
3 or
official is less than the amount established and
4
appropriated by the legislature, the balance may be applied
5 to
the premium for coverage of dependents, or to the
6
premium for any optional group insurance coverage made
7
available by the board
department, if so elected.
8
9 9-3-211. Deductions from salaries of monthly
10 contributions by employees and officials; establishment of
11 procedure.
12
13 The amount of monthly contribution to be
made by eligible
14 employees and officials enrolled in the
group insurance
15 plan for themselves and their dependents
shall be deducted
16 from the monthly salaries of the employees
and officials by
17 the various agencies and remitted to the board department.
18 The procedure for deductions and remittances
shall be
19 established by the board department. If a flexible benefits
20 plan is chosen, the employees' and
officials' contribution
21 shall be applied to the chosen benefits in
an amount
22 determined by the employee or official.
23
Page 14
1 9-3-213. Treasurer of monies; bond; deposit in trust
2 and agency fund of
premium cost payments, dividend payments
3 and return of
premiums; expenditures; investment of excess
4 portions.
5
6 (a) The state treasurer shall be the
treasurer of
7
monies under this act, and his general bond to the state of
8
Wyoming shall cover all liabilities for his acts as
9
treasurer. The board department shall remit to the
10 treasurer for deposit in the trust and
agency fund all
11 payments received by the board department
for the group
12 insurance premium costs from employees and
officials, and
13 the state agencies, departments and
institutions. The board
15 the trust and
agency fund any dividend payments and return
16
of premium
received by the board department from any
17 carrier
underwriting the group insurance plan. All
18 remittances shall
be made as soon as possible after they
19 are received.
20
21 (b) Expenditures
shall be made from the trust and
22 agency fund, upon certification of the board department
to
23 the office of the state auditor, only for
the following
24 purposes:
Page 15
1
2 (ii) The state's cost of administering
group
3
insurance and supplemental plans, subject to annual
4
appropriation by the legislature based on the submission by
5 the
board department
of a budget request containing
6
detailed information on current and projected
7
administrative costs.
8
9 (c) The board department
shall certify in writing to
10 the state treasurer for investment portions
of the monies
11 which in its judgment will not be needed for
the payment of
12 premiums to the carriers underwriting the
group insurance
13 or supplemental plans.
14
15 Section 3. W.S.
9-2-1022(a)(xiv), 9-2-2008(d),
16 9-3-203(a)(i), 9-3-204 and 9-3-205(a)(xv)
are repealed.
17
19
20 (a) All
positions, personnel, appropriations,
21 property, equipment and authority in the
state employees'
22 and officials' group insurance board of
administration are
23 transferred to the department of
administration and
24 information by this act. All payments for
group insurance
Page 16
1
premium costs, all dividend payments or return of premium
2
previously received by the board and all such payments
3
received by the department in carrying out its duties under
4 the
State Employees' and Officials' Group Insurance Act
5
shall be remitted to the state treasurer and accounted for
6 in
accordance with the provisions of W.S. 9-3-213. The
7
state's cost of administering the State Employees' and
8
Officials' Group Insurance Act shall be paid in accordance
9
with the provisions of W.S. 9-3-213. The validity of rules,
10 regulations, contracts, agreements or other
obligations of
11 the board are not affected by this act.
12
13 (b) Expenditures
may be made from the trust and
14 agency fund pursuant to W.S. 9-3-213(b), as
required by the
15 director of the department of administration
and
16 information in taking necessary transitional
actions to
17 implement the provisions of this act. Until
July 1,2001,
18 the expenditures shall be made upon request
of the director
19 and certification of the board to the office
of the state
20 auditor. The department shall promulgate all
necessary
21 rules and regulations to carry out the
provisions of this
22 act as soon as feasible after the effective
date of this
23 subsection.
24
Page 17
1 Section 5. Notwithstanding the provisions of
W.S.
2 9-3-204,
no further elections shall be held for the state
3
employees' and officials' group insurance board of
4
administration and the terms of all members serving on the
5
board on the effective date of this section shall terminate
6
July 1, 2001.
7
9
10 (a) Sections
4(b) and 5 of this act are effective
11 immediately upon completion of all acts
necessary for a
12 bill to become law as provided by Article 4,
Section 8 of
13 the Wyoming Constitution.
14
15 (b) The
balance of this act is effective July 1,
16 2001.
17
18 (END)
Page 18