Substitute House Bill No. 6712

Public Act No. 01-30

AN ACT CONCERNING COVERAGE FOR NONPROFIT PROVIDERS AND MUNICIPAL EMPLOYEES UNDER THE STATE EMPLOYEE HEALTH PLAN.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsection (i) of section 5-259 of the general statutes is repealed and the following is substituted in lieu thereof:

(i) The Comptroller may provide for coverage of municipal employees or employees of nonprofit corporations under the plan or plans procured under subsection (a) of this section, provided: (1) Participation by each municipal employer or nonprofit corporation shall be on a voluntary basis; (2) where an employee organization represents employees in a municipality or nonprofit corporation, participation in a plan or plans to be procured under subsection (a) of this section shall be by mutual agreement of the municipal employer and the employee organization only and neither party may submit the issue of participation to binding arbitration except by mutual agreement; (3) no group of employees shall be refused entry into the plan by reason of past or future health care costs or claim experience; (4) rates paid by the state for its employees under subsection (a) of this section are not adversely affected by this subsection; (5) administrative costs to the plan or plans provided under this subsection shall be paid by the participating municipality or nonprofit corporation at no additional cost to the state; and (6) participation in the plan or plans in an amount determined by the state shall be for the duration of the period of the plan or plans, or for such other period as mutually agreed by the municipality or nonprofit corporation and the Comptroller. The Comptroller, with the approval of the Secretary of the Office of Policy and Management, may arrange and procure for the employees under this subsection health benefit plans that vary from the plan or plans procured under subsection (a) of this section. Such alternate plans may be offered to municipal employees on a fully underwritten basis only. Notwithstanding any provision of law, such alternate plan may be offered to employees of nonprofit corporations on either a fully underwritten or risk-pooled basis at the discretion of the Comptroller. For the purposes of this subsection, (A) "municipality" means any town, city, borough, school district, taxing district, fire district, district department of health, probate district, housing authority, regional work force development board established under section 31-3k, flood commission or authority established by special act, regional planning agency, transit district formed under chapter 103a, or the Children's Center established by number 571 of the public acts of 1969; and (B) "nonprofit corporation" means a nonprofit corporation organized under 26 USC 501(c)(3) that has a contract with the state.

Sec. 2. Subdivision (4) of section 38a-564 of the general statutes is repealed and the following is substituted in lieu thereof:

(4) "Small employer" means any person, firm, corporation, limited liability company, partnership or association actively engaged in business or self-employed for at least three consecutive months who, on at least fifty per cent of its working days during the preceding twelve months, employed no more than fifty eligible employees, the majority of whom were employed within the state of Connecticut. "Small employer" includes a self-employed individual. In determining the number of eligible employees, companies which are affiliated companies, as defined in section 33-840, or which are eligible to file a combined tax return for purposes of taxation under chapter 208 shall be considered one employer. Eligible employees shall not include employees covered through the employer by 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. Except as otherwise specifically provided, provisions of sections 12-201, 12-211, 12-212a and 38a-564 to 38a-572, inclusive, which apply to a small employer shall continue to apply until the plan anniversary following the date the employer no longer meets the requirements of this definition. "Small employer" does not include (A) a municipality procuring health insurance pursuant to section 5-259, as amended by this act, [or] (B) a private school in this state procuring health insurance through a health insurance plan or an insurance arrangement sponsored by an association of such private schools, or (C) a nonprofit organization procuring health insurance pursuant to section 5-259, as amended by this act, unless the Secretary of the Office of Policy and Management and the State Comptroller make a request in writing to the Insurance Commissioner that such nonprofit organization be deemed a small employer for the purposes of this chapter.

Sec. 3. Subsection (b) of section 12-202a of the general statutes is repealed and the following is substituted in lieu thereof:

(b) Notwithstanding the provisions of subsection (a) of this section, the tax shall not apply to: (1) Any new or renewal contract or policy entered into with the state on or after July 1, 1997, to provide health care coverage to state employees, retirees and their dependents; (2) any subscriber charges received from the federal government to provide coverage for Medicare patients; (3) any subscriber charges received under a contract or policy entered into with the state to provide health care coverage to Medicaid recipients under the Medicaid managed care program established pursuant to section 17b-28, which charges are attributable to a period on or after January 1, 1998; (4) any new or renewal contract or policy entered into with the state on or after April 1, 1998, to provide health care coverage to eligible beneficiaries under the HUSKY Medicaid Plan Part A, HUSKY Part B, or the HUSKY Plus programs, each as defined in section 17b-290; (5) any new or renewal contract or policy entered into with the state on or after April 1, 1998, to provide health care coverage to recipients of state-administered general assistance pursuant to section 17b-257; [or] (6) any new or renewal contract or policy entered into with the state on or after February 1, 2000, to provide health care coverage to retired teachers, spouses or surviving spouses covered by plans offered by the state teachers' retirement system; (7) any new or renewal contract or policy entered into on or after July 1, 2001, to provide health care coverage to employees of a municipality under a plan procured pursuant to section 5-259, as amended by this act; or (8) any new or renewal contract or policy entered into on or after July 1, 2001, to provide health care coverage to employees of nonprofit organizations and their dependents under a plan procured pursuant to section 5-259, as amended by this act.

Sec. 4. This act shall take effect July 1, 2001.

Approved May 25, 2001