Connecticut General Statutes|Sec. 3-123sss. Enrollment procedures and requirements.

                                                
Sec. 3-123sss. Enrollment procedures and requirements. (a)(1) Notwithstanding any provision of title 38a, the Comptroller shall offer to nonstate public employers and their nonstate public employees, and their retirees, if applicable, coverage under the state employee plan or another group hospitalization, medical, pharmacy and surgical insurance plan developed by the Comptroller to provide coverage for nonstate public employees and their retirees, if applicable. Such nonstate public employees, or retirees, if applicable, shall be pooled with the state employee plan, provided the Comptroller receives an application from a nonstate public employer and the application is approved in accordance with this section or section 3-123ttt. Premium payments for such coverage shall be remitted by the nonstate public employer to the Comptroller and shall be the same as those paid by the state inclusive of any premiums paid by state employees, except that premium payments shall be adjusted pursuant to subdivision (2) of this subsection for nonstate public employers enrolled in coverage on and after July 1, 2019, to reflect the cost of health care in the county in which the majority of such nonstate public employer's employees work, differences from the benefits and networks provided to state employees or as otherwise provided in this section or section 3-123uuu. The Comptroller may charge each nonstate public employer participating in the state employee plan an administrative fee calculated on a per member, per month basis.

(2) During the two-year period beginning July 1, 2020, the Comptroller shall phase in the adjustment for premium payments to reflect the cost of health care in the county in which the majority of a nonstate public employer's employees work, as described in subdivision (1) of this subsection. In no year shall the adjustment for premium payments be greater than one-half of the total adjustment.

(b) Any group hospitalization, medical, pharmacy and surgical insurance plan developed by the Comptroller pursuant to subsection (a) of this section shall (1) include the health enhancement program, (2) be consistent with value-based insurance design principles, and (3) be approved by the Health Care Cost Containment Committee prior to being offered to nonstate public employers. The Comptroller shall, prior to the approval of the Health Care Cost Containment Committee, and offering any such plan, and annually thereafter, (A) cause the premium payments associated with such plan to be reviewed by an independent actuarial firm to determine the adequacy of such premiums relative to experience and total costs, and (B) provide a report concerning such review to the Health Care Cost Containment Committee, the Office of Policy and Management and the joint standing committee of the General Assembly having cognizance of matters relating to appropriations, in accordance with the provisions of section 11-4a.

(c) (1) The Comptroller shall offer participation in such plan for not less than three-year intervals. A nonstate public employer may apply for renewal prior to the expiration of each interval.

(2) The Comptroller shall develop procedures by which nonstate public employers receiving coverage for nonstate public employees pursuant to the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section may (A) apply for renewal, or (B) withdraw from such coverage, including, but not limited to, the terms and conditions under which such nonstate public employers may withdraw prior to the expiration of the interval. Any such procedures shall provide that nonstate public employees covered by collective bargaining shall withdraw from such coverage in accordance with chapters 68, 113 and 166.

(d) Nothing in sections 3-123rrr to 3-123vvv, inclusive, shall (1) require the Comptroller to offer coverage to every nonstate public employer seeking coverage under the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section, (2) prevent the Comptroller from procuring coverage for nonstate public employees from vendors other than those providing coverage to state employees, or (3) prevent the Comptroller from offering plans other than the plans offered to state employees on July 1, 2019, provided no such plan shall be offered if such plan qualifies as a high deductible health plan, as defined in Section 220(c)(2) or Section 223(c)(2) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time, and is used to establish a medical savings account or an Archer MSA pursuant to said Section 220 or a health savings account pursuant to said Section 223.

(e) The Comptroller shall create applications for coverage under and for renewal of the state employee plan and any other plan developed by the Comptroller pursuant to subsection (a) of this section. Such applications shall require a nonstate public employer to disclose whether such nonstate public employer shall offer any other health care benefits plan to the nonstate public employees who are offered the state employee plan.

(f) No nonstate public employee shall be enrolled in the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section if such nonstate public employee is covered through a nonstate public employer's health insurance plans or insurance arrangements issued to or in accordance with a trust established pursuant to collective bargaining subject to the federal Labor Management Relations Act.

(g) (1) A nonstate public employer may submit an application to the Comptroller to provide coverage under the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section for nonstate public employees employed by such nonstate public employer.

(2) If a nonstate public employer submits an application for coverage of all of its nonstate public employees, the Comptroller shall provide such coverage not later than the first day of the third calendar month following such application.

(3) (A) Except as provided in subsection (h) of this section, if a nonstate public employer submits an application for coverage for fewer than all of its nonstate public employees, or indicates in the application that the nonstate public employer shall offer other health plans to nonstate public employees who are offered the state health plan, the Comptroller shall forward such application to the Health Care Cost Containment Committee not later than five business days after receiving such application. Said committee may, not later than thirty days after receiving such application, certify to the Comptroller that the application will shift a significantly disproportional part of a nonstate public employer's medical risks to the state employee plan.

(B) If the Health Care Cost Containment Committee certifies to the Comptroller that the application will shift a significantly disproportional part of a nonstate public employer's medical risks to the state employee plan, the Comptroller shall not provide coverage to such nonstate public employer. If the Health Care Cost Containment Committee does not certify to the Comptroller that the application will shift a significantly disproportional part of a nonstate public employer's medical risks to the state employee plan, the Comptroller shall provide coverage not later than the first day of the third calendar month following the deadline for receiving the certification.

(4) Notwithstanding any provisions of the general statutes, initial and continuing participation in the state employee plan or a plan developed by the Comptroller pursuant to subsection (a) of this section by a nonstate public employer shall be a mandatory subject of collective bargaining and shall be subject to binding interest arbitration in accordance with the same procedures and standards that apply to any other mandatory subject of bargaining pursuant to chapters 68, 113 and 166.

(h) If a nonstate public employer included fewer than all of its nonstate public employees in its application for coverage because of (1) the decision by individual nonstate public employees to decline such coverage for themselves or their dependents, or (2) the nonstate public employer's decision to not offer coverage to temporary, part-time or durational employees, the Comptroller shall not forward such nonstate public employer's application to the Health Care Cost Containment Committee pursuant to subdivision (3) of subsection (g) of this section.

(i) Notwithstanding any provision of the general statutes, neither the state employee plan nor any plan developed by the Comptroller pursuant to subsection (a) of this section shall be deemed (1) an unauthorized insurer, or (2) a multiple employer welfare arrangement. Any licensed insurer in this state may conduct business with the state employee plan or any plan developed by the Comptroller pursuant to subsection (a) of this section.

(j) Nothing in this section shall require a nonstate public employer enrolled in the state employee plan to enroll in another plan developed by the Comptroller pursuant to this section.

(P.A. 15-93, S. 2; P.A. 19-117, S. 378.)