ARTICLE 2:  INSURANCE PLANS

9-3-201.  Group prepaid plans authorized; agreements with insurance companies authorized; limitation on authorized plans and companies; payroll deductions; self-insurance programs.

            (a)  The state of Wyoming and its political subdivisions and school districts may obtain group prepaid plans or insurance for life, health, accident or hospitalization for their employees and for elected officials, except for members of the legislature, and enter into agreements with prepaid plans or insurance companies to provide this coverage.

            (b)  Prepaid plans or insurance shall be procured only from prepaid plans authorized to do business in the state of Wyoming or from insurance companies authorized to do business in the state of Wyoming and under the full jurisdiction of the Wyoming insurance commissioner.

            (c)  Upon a request in writing from any employee of the state of Wyoming, the state treasurer or the proper officer in any political subdivision or school district may deduct from the wages of the employee the amount of the premium which the employee has agreed to pay for the prepaid plans or insurance, and to pay or remit the payment directly to the prepaid plan or insurance company issuing the group plan or insurance.

            (d)  The state and any political subdivision are authorized to utilize a self-insurance program, provided that a defined plan with proper funding is first adopted and the cost of the plan is included in the annual budget and provided the self-insurance program includes any coverage mandated by Wyoming insurance law. Any self-insurance program, including the Wyoming state employees' and officials' group insurance plan, adopted pursuant to this section shall be within the jurisdiction of the insurance commissioner under  the provisions of title 26, Wyoming statutes.

9-3-202.  Short title.

This act shall be known and may be cited as the "State Employees and Officials Group Insurance Act".

  9-3-203.  Definitions.

            (a)  As used in this act:

                        (i)  "Board" means the Wyoming state employees' and officials' group insurance board of administration;

                        (ii)  "Carrier" means a private insurance company or health maintenance organization, as defined in W.S. 26-34-102(a)(vii) [26-34-102(a)(xvi)], holding a valid outstanding certificate of authority from the state insurance commissioner, or a nonprofit hospital service plan or a nonprofit medical service plan incorporated as a nonprofit corporation, either of which has had successful experience in the group health insurance field as determined by the commissioner of insurance;

                        (iii)  "Dependent" means an employee's spouse, each unmarried child under the age of eighteen (18), including adopted children, stepchildren and foster children, and each unmarried child between the age of eighteen (18) and twenty-three (23) years who is a full-time student in an accredited educational or vocational institution, and for whom the employee is the major source of financial support;

                        (iv)  "Employee" means any official or employee of the state of Wyoming whose salary is paid by state funds, including employees and faculty members of the University of Wyoming and various community colleges in the state, except persons employed on intermittent, irregular, or less than halftime basis and any at-will contract employee who does not meet the requirements established under W.S. 9-2-1022(a)(xi)(F)(III) or (IV). Until July 1, 2004, "employee" shall not include employees of the agricultural extension service of the University of Wyoming who hold federal civil service appointments, are required to participate in federal civil service retirement and who elect to participate in the federal employees' health benefit program as authorized in W.S. 9-3-210(d);

                        (v)  "Group insurance plan" means the health and life insurance plans defined in this section, the flexible benefits plan or any other group insurance coverages contracted for by the board, including disability insurance, as defined in W.S. 26-5-103(a);

                        (vi)  "Health insurance plan" means a group insurance policy or contract or a medical or hospital service agreement or other health care delivery system provided by a carrier or carriers for the purpose of paying for or reimbursing the cost of hospital and medical care;

                        (vii)  "Hospital and medical benefits" means hospital room and board, other hospital services, certain outpatient benefits, maternity benefits, surgical benefits, including obstetrical care, in-hospital medical care, diagnostic X-ray and laboratory benefits, physician's services provided by house and office calls, prescription drugs, outpatient psychiatric services and other benefits determined by the board. Benefits may be provided on a coinsurance basis, the insured to pay a proportion of the cost of benefits;

                        (viii)  "Life insurance plan" means a group insurance policy or contract provided by a carrier for the purpose of providing life insurance;

                        (ix)  "Official" means any elected or appointed state official who receives compensation other than expense reimbursement from state funds, except officials serving on an intermittent, irregular or less than halftime basis;

                        (x)  "Supplemental health insurance plan" or "supplemental plan" means a group insurance contract or a medical or hospital service agreement provided by a carrier for the purpose of paying for or reimbursing the cost of hospital and medical care in excess of or supplemental to medicare or medicaid, or both, which employees or officials and their dependents may be eligible to receive.  Supplemental coverage may consist of one (1), a combination of, or alternative plans in the discretion of the board;

                        (xi)  "This act" means W.S. 9-3-202 through 9-3-213;

                        (xii)  "Flexible benefits plan" means a plan of benefits established by board rules and regulations and adopted pursuant to the Internal Revenue Code of 1986, Title 26 of the United States code and qualified under § 125 of the Internal Revenue Code of 1986.  The plan may include benefits authorized by the Internal Revenue Code of 1986 and related federal regulations which are consistent with Wyoming law.

  9-3-204.  Creation of state employees' and officials' group health insurance board of administration; members; meetings; quorum; officers; compensation.

            (a)  The state employees' and officials' group health insurance board of administration is created, consisting of seven (7) members. One (1) member of the board shall be the state treasurer who shall not send a designee.  Three (3) members shall represent the employees of the state of Wyoming. One (1) member shall be a retired employee of the state of Wyoming, one (1) member shall be a person with a background in health insurance and one (1) member shall be the administrator of the human resources division of the department of administration and information. The attorney general shall serve as legal advisor to the board, attend all board meetings but have no vote. The insurance commissioner shall serve as insurance advisor to the board and attend all board meetings, but have no vote.

            (b)  The board members representing the employees shall be elected for terms of two (2) years, but not more than two (2) employees shall be elected from the same agency. The procedure for the election shall be established by the two (2) state officials designated as board members in subsection (a) of this section. Elections shall be held between May 1 and May 31 in odd-numbered years. At elections, all employees who are enrolled in the health insurance plan at the time of the election are entitled to vote. The vacancy of an elected employee board member shall be filled by the employee receiving the highest number of votes at the preceding election who is not employed by an agency which already has

two (2) employees on the board. The board member who is a retired employee and the board member with a background in health insurance shall be appointed by the governor for a term of two (2) years and may be reappointed.

            (c)  The board shall meet within thirty (30) days after each biennial election of the representatives of the state employees, and at the meeting, the board shall select a chairman and vice-chairman  from among its members who shall serve until their successors are selected.

            (d)  A majority of the members of the board constitutes a quorum for the transaction of official business. The board shall meet upon call of the chairman as often as necessary to carry out its responsibilities under this act.

            (e)  The board shall employ a director, who shall also serve as secretary of the board. The board shall employ personnel as provided in W.S. 9-2-1005(b)(iv) and 9-2-1022.

            (f)  State employee members of the board shall suffer no loss of wages for the time devoted to the duties of the board.  All members who are state employees and employees of the board shall be reimbursed for their expenses incurred through service on the board at the same rate provided under W.S. 9-3-102 and 9-3-103. Each board member not employed by the state shall while engaged in official board duties, receive salary and per diem allowance in the same amounts provided for members of the legislature under W.S. 28-5-101 and transportation reimbursement provided state employees under W.S. 9-3-103.

  9-3-205.  Administration and management of group insurance program; powers and duties; adoption of rules and regulations.

            (a)  The board shall administer and manage the state employees' and officials' group insurance program and, subject to the provisions of this act:

                        (i)  Shall prepare specifications for the health insurance plan and a supplemental plan, the life insurance plan and any other group insurance plan contracted for by the board;

                        (ii)  Shall contract with carriers to underwrite group or supplemental insurance plans;

                        (iii)  Shall determine the methods of claims administration under group insurance or supplemental plans, whether by the state or carrier or both;

                        (iv)  Shall determine the eligibility of employees, officials and their dependents to participate in  group insurance and supplemental plans;

                        (v)  Shall determine the amount of employee payroll deductions;

                        (vi)  Shall establish a procedure by which the board shall hear complaints by insured employees concerning the allowance and payment of claims, eligibility for coverage and other matters. Unless otherwise provided in the group insurance or supplemental plan or plans, any decision of the board upon complaints is not binding upon either the employee or carrier and the provisions of the Wyoming Administrative Procedure Act shall not apply to the proceedings. The group insurance or supplemental plan or plans may provide that the decision of the board shall be binding upon both the employee and the carrier as to certain disputes and in such event the procedure adopted by the board shall conform to the provisions of the Wyoming Administrative Procedure Act;

                        (vii)  Shall administer state group insurance reserve monies; and

                        (viii)  Shall continuously study the operation of the group insurance plan including such matters as gross and net costs, administrative costs, benefits, utilization of benefits and claims administration;

                        (ix)  May enter into a contract with a carrier to underwrite a supplemental plan and negotiate and enter into amendments to existing health insurance contracts to provide a supplemental plan and determine an effective date;

                        (x)  May determine that employees, officials and their dependents who are eligible for medicare or medicaid, or both, shall be eligible for a supplemental plan and, upon the effective date of the supplemental plan as to employees, officials and their dependents presently covered by the health insurance plan, may transfer them from the health insurance plan to the supplemental plan;

                        (xi)  May negotiate and enter into amendments to existing contracts providing group insurance and supplemental plans to provide appropriate coverage for employees and officials who may become eligible for coverage after the effective date of those contracts and to provide for their enrollment;

                        (xii)  May contract with carriers to underwrite optional group insurance plans which may be additions to or supplemental to those plans contracted under this act and which are paid for entirely by state employees and officials, entirely by the state, or by both.  The contracts shall be designed to provide the fullest benefits at the lowest cost, and the board may contract with the same carriers for the optional group insurance plans as for the other plans contracted for under this act;

                        (xiii)  May contract with any person for the furnishing of actuarial services, the preparation of specifications for group insurance plans and other specialized services which cannot be performed by the board or by state employees.  Contracts for these services shall be awarded through responsible competitive bidding at intervals as the board determines, and shall be reviewed annually by the board;

                        (xiv)  May develop, implement and administer a flexible benefits  plan and may contract with carriers, third-party administrators or other professionals to develop, administer and implement a flexible benefits plan;

                        (xv)  May delegate to its executive director any administrative duties as are necessary to the daily functioning of the board including the ability to authorize payments from the trust and agency fund as set forth in W.S. 9-3-213(b).

            (b)  The board shall adopt rules and regulations consistent with the provisions of this act as necessary to carry out its statutory duties and responsibilities.

            (c)  For the purposes of determining financial condition, ability to fulfill and the manner of fulfillment of its statutory duties, the nature of its operations and compliance with law, the insurance commissioner shall examine the affairs, accounts, records and assets of the Wyoming state employees' and officials' group insurance plan, as often as he deems advisable but not less frequently than every three (3) years.

  9-3-206.  Specifications for insurance plan; submission of bids; change of carriers; notice of rate changes or intent of carrier not to renew; premium tax exemption.

            (a)  The specifications drawn by the board for the health insurance plan shall include hospital and medical  benefits, and comparable benefits for employees who rely solely on spiritual means for healing. The specification drawn by the board for the life insurance plan and any other group insurance plan shall include benefits as determined by the board. Bids shall be submitted to the board within time limits established by the board and, in addition to the carrier's cost proposal, shall include an explanation of the method of claims administration proposed by the carrier and the cost thereof, the amount of total premiums to be retained by the carrier, the purpose for which these retained funds would be allocated, and other information requested by the board.

            (b)  The board may:

                        (i)  Call for bids and change carriers at its discretion;

                        (ii)  Terminate an existing contract at any time upon sixty (60) days notice in the event of unsatisfactory performance or noncompliance with the terms of the contract by the carrier.

            (c)  Any carrier under contract with the board shall give the board sixty (60) days notice of any proposed rate change in the contract specifications or intent not to renew the contract. If the board and the carrier agree during the sixty (60) day period to any rate change in the specifications, the board may renew the contract, as changed, without reopening to bids.

            (d)  If the board decides to change carriers or to reopen bids on the underwriting of any aspect of the group insurance plan, it shall follow the same procedures in the selection of a subsequent carrier as it did in awarding the initial contract.

            (e)  Any carrier underwriting any portion of the state's group insurance plan is exempt from paying premium taxes under W.S. 26-4-103 on that portion of its business representing premiums collected from the group insurance plan.

  9-3-207.  Eligibility for membership in plan; state employees; 31 day period to elect enrollment; new employees; later enrollment.

            (a)  Any state employee eligible for membership in the group insurance plan at the time the plan becomes effective shall have thirty-one (31) days to either elect to be enrolled or not be enrolled in the plan. The board shall establish the procedure by which eligible employees shall notify the board of their decision within the prescribed thirty-one (31) day period.

            (b)  An eligible state employee who enters state service has thirty-one (31) days from the initial date of employment to elect to be enrolled or not be enrolled in the group insurance plan.

            (c)  Employees who elect not to be enrolled within the time prescribed in subsections (a) and (b) of this section may be enrolled at a later date upon conditions the board may impose, such as a physical examination or the exclusion of preexisting conditions from coverage.

  9-3-208.  State officials; 31 day period to elect enrollment; newly appointed or elected officials; later enrollment.

            (a)  State officials eligible for membership in the group insurance plan at the time the plan becomes effective shall have thirty-one (31) days to either elect to become enrolled or not become enrolled in the plan. The election shall be made according to procedures established by the board.

            (b)  Eligible state officials appointed or elected after the effective date of the group insurance plan have thirty-one (31) days after the date they officially take office to elect to become enrolled or not become enrolled in the plan.

            (c)  Eligible state officials who elect not to become enrolled within the time prescribed in subsections (a) and (b) of this section may be enrolled at a later date upon conditions the board may impose, such as a physical examination or the exclusion of preexisting conditions from coverage.

  9-3-209.  Dependents; election of coverage; later election; change in number of dependents.

            (a)  Any eligible employee or official may elect to have his dependents covered by the group  insurance plan. The election shall be made at the time the employee or official becomes enrolled in the

plan, under procedures the board may establish. If dependent coverage is not elected at the time that an employee or official becomes enrolled in the plan, dependent coverage may be elected at a later date under conditions the board may impose, such as physical examination or the exclusion of preexisting conditions from coverage.

            (b)  Any employee or official who has elected to have his dependents covered as provided in subsection (a) of this section, and who subsequently has a change in the number of his dependents, may at the time of the change increase or decrease the number of his dependents covered by the group insurance plan under procedures established by the board.

            (c)  Any employee or official who has no eligible dependents at the time he becomes enrolled in the group insurance plan, and who later has an eligible dependent may, at the time his dependency status changes, elect coverage for the dependent under procedures established by the board.

9-3-210.       Amount of state's contribution; estimates submitted to state budget officer; specified employees participation in federal program.

(a)  The state shall contribute monthly the amount established and appropriated by the legislature for each employee and official enrolled in the plan in accordance with subsections (b) and (c) of this section.

          (b)  Any state agency, department or institution, including the University of Wyoming and the community colleges in the state, shall pay monthly to the board the amount established and appropriated by the legislature for each eligible employee or official electing to become covered by any portion of the group insurance plan as the contribution of the state to that plan during the period the employee or official is enrolled in the plan. If the monthly premium for coverage of the employee or official is less than the amount established and appropriated by the legislature, the balance may be applied to the premium for coverage of dependents, or to the premium for any optional group insurance coverage made available by the board, if so elected.

          (c)  Each state agency, department or institution, including the University of Wyoming and the community colleges in the state shall estimate the amount required for its participation in the group insurance plan for the next biennium and shall submit the estimate to the state budget officer at the time the state budget officer makes the request.

          (d)  Until July 1, 2004, notwithstanding any other provision contained in W.S. 9-3-201 or the State Employees' and Officials' Group Insurance Act, employees of the agricultural extension service of the University of Wyoming who hold federal civil service appointments and are required to participate in federal civil service retirement may elect to participate in the federal employees' health insurance program. For eligible employees participating in the federal employees' health insurance program the state shall contribute monthly an amount toward the federal employees health insurance program costs which is in excess of the federal contribution thereto but which does not exceed the

amount which would otherwise be paid under subsection (a) of this section if the employee were enrolled in the state group insurance plan.

  9-3-211.  Deductions from salaries of monthly contributions by employees and officials; establishment of procedure.

The amount of monthly contribution to be made by eligible employees and officials enrolled in the group insurance plan for themselves and their dependents shall be deducted from the monthly salaries of the employees and officials by the various agencies and remitted to the board. The procedure for deductions and remittances shall be established by the board. If a flexible benefits plan is chosen, the employees' and officials' contribution shall be applied to the chosen benefits in an amount determined by the employee or official.

  9-3-212.  Repealed by Laws 1987, ch. 194, § 3.

  9-3-213.  Treasurer of monies; bond; deposit in trust and agency fund of premium cost payments, dividend payments and return of premiums; expenditures; investment of excess portions.

          (a)  The state treasurer shall be the treasurer of monies under this act, and his general bond to the state of Wyoming shall cover all liabilities for his acts as treasurer. The board shall remit to the treasurer for deposit in the trust and agency fund all payments received by the board for the group insurance premium costs from employees and officials, and the state agencies, departments and institutions. The board shall also remit to the treasurer for deposit in the trust and agency fund any dividend payments and return of premium received by the board from any carrier underwriting the group insurance plan. All remittances shall be made as soon as possible after they are received.

          (b)  Expenditures shall be made from the trust and agency fund, upon certification of the board to the office of the state auditor, only for the following purposes:

                      (i)  The payment of premiums to any carrier underwriting the group insurance or supplemental plan or plans; and

                      (ii)  The state's cost of administering group insurance and supplemental plans, subject to annual appropriation by the legislature based on the submission by the board of a budget request containing detailed information on current and projected administrative costs.

          (c)  The board shall certify in writing to the state treasurer for investment portions of the monies which in its judgment will not be needed for the payment of premiums to the carriers underwriting the group insurance or supplemental plans.

    9-3-214.  Repealed by Laws 1987, ch. 194, § 2.

    9-3-215.  Repealed by Laws 1987, ch. 194, § 2.

    9-3-216.  Repealed by Laws 1987, ch. 194, § 2.

9-2-2008    Department of administration and information created; director appointed; structure.

(d)  The Wyoming state employees' and officials' group insurance board of administration is assigned to the department as follows:

                        (i)  The department shall provide budget, fiscal, administrative and clerical services to the Wyoming state employees' and officials' group insurance board of administration, if it requests these services, but shall not affect its authority.  The positions, personnel, property, appropriated funds of the board and any funds the board administers under W.S. 9-3-202 through 9-3-213 shall not be transferred to the department.  If the board requests any of the services described in this paragraph it shall compensate the department for them at a reasonable rate established by the department.  In addition to offering the optional services specified in this paragraph, the department shall:

                                    (A)  Provide administrative oversight of the board's procedures to assure that it is in compliance with existing statutes that created it and that govern its functions;

                                    (B)  Provide guidance to the board in matters pertaining to budget preparation, administration, personnel and other procedural functions;

                                    (C)  Function as a liaison between the board and other agencies within state government;

                                                (D)  Review the current practices of the board and make recommendations to it which might improve its efficiency.