Substitute House Bill No. 6430

Public Act No. 01-137

AN ACT CONCERNING BENEFITS AND ELIGIBILITY UNDER THE HUSKY PLAN.

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

Section 1. Subsection (m) of section 17b-292 of the general statutes is repealed and the following is substituted in lieu thereof:

(m) The commissioner shall adopt regulations, in accordance with chapter 54, to establish residency requirements and income eligibility for participation in the HUSKY Plan, Part B and procedures for a simplified mail-in application process. Notwithstanding the provisions of section 17b-257b, such regulations shall provide that any child adopted from another country by an individual who is a citizen of the United States and a resident of this state shall be eligible for benefits under the HUSKY Plan, Part B upon arrival in this state.

Sec. 2. Subdivision (22) of section 17b-290 of the general statutes is repealed and the following is substituted in lieu thereof:

(22) "Qualified entity" means any entity: (A) Eligible for payments under a state plan approved under Medicaid and which provides medical services under the HUSKY Plan, Part A, or [is authorized to determine eligibility of (i) a child to participate in a Head Start program under the Head Start Act, (ii) a child to receive child care services for which financial assistance is provided under the Child Care and Development Block Grant Act of 1990, or (iii) a child to receive assistance under WIC; and (B) that is determined by the commissioner to be capable of making the determinations specified in subparagraph (A) of this subdivision] (B) is a qualified entity, as defined in 42 USC 1396r-1a, as amended by Section 708 of Public Law 106-554 and that is determined by the commissioner to be capable of making the determination of eligibility. The commissioner shall provide qualified entities with such forms as are necessary for an application to be made on behalf of a child under the HUSKY Plan, Part A and information on how to assist parents, guardians and other persons in completing and filing such forms.

Sec. 3. Subsection (h) of section 17b-292 of the general statutes is repealed and the following is substituted in lieu thereof:

(h) The commissioner shall enter into a contract with an entity to be a single point of entry servicer for applicants and enrollees under the HUSKY Plan, Part A and Part B. The servicer shall jointly market both Part A and Part B together as the HUSKY Plan. Such servicer shall develop and implement public information and outreach activities with community programs. Such servicer shall electronically transmit data with respect to enrollment and disenrollment in the HUSKY Plan, Part B to the commissioner who may transmit such data to the Children's Health Council.

Sec. 4. Subsection (k) of section 17b-292 of the general statutes is repealed and the following is substituted in lieu thereof:

(k) Not more than twelve months after the determination of eligibility for benefits under the HUSKY Plan, Part A and Part B and annually thereafter, the commissioner or the servicer, as the case may be, shall determine if the child continues to be eligible for the plan. The commissioner or the servicer shall mail [a] an application form to each participant in the plan for the purposes of obtaining information to make a determination on eligibility. To the extent permitted by federal law, in determining eligibility for benefits under the HUSKY Plan, Part A and Part B with respect to family income, the commissioner or the servicer shall rely upon information provided in such form by the participant unless the commissioner or the servicer has reason to believe that such information is inaccurate or incomplete. The determination of eligibility shall be coordinated with health plan open enrollment periods.

Sec. 5. Subsections (b) and (c) of section 17b-299 of the general statutes are repealed and the following is substituted in lieu thereof:

(b) An application may be disapproved if it is determined that a child to be covered under the HUSKY Plan, Part B was covered by an employer-sponsored insurance within the last [six] two months. If the commissioner determines that the time period specified in this subsection is insufficient to effectively deter applicants or employers of applicants from discontinuing employer-sponsored dependent coverage for the purpose of participation in the HUSKY Plan, Part B, the commissioner may extend such period for a maximum of an additional [six] two months.

(c) An application may be approved in cases where prior employer-sponsored coverage ended less than [six] two months prior to the determination of eligibility for reasons unrelated to the availability of the HUSKY Plan, Part B, including, but not limited to:

(1) Loss of employment due to factors other than voluntary termination;

(2) Death of a parent;

(3) Change to a new employer that does not provide an option for dependent coverage;

(4) Change of address so that no employer-sponsored coverage is available;

(5) Discontinuation of health benefits to all employees of the applicant's employer;

(6) Expiration of the coverage periods established by the Consolidated Omnibus Budget Reconciliation Act of 1985, (P.L. 99-272) as amended from time to time, (COBRA);

(7) Self-employment;

(8) Termination of health benefits due to a long-term disability;

(9) Termination of dependent coverage due to an extreme economic hardship on the part of either the employee or the employer, as determined by the commissioner; or

(10) Substantial reduction in either lifetime medical benefits or benefit category available to an employee and dependents under an employer's health care plan.

Sec. 6. (NEW) The Commissioner of Social Services may seek a waiver, if required, under Title XXI of the Social Security Act to authorize the use of funds received under said title to promote the enrollment of children in the HUSKY Plan who are eligible for benefits under other income-based assistance programs including, but not limited to, free or reduced school lunch programs.

Sec. 7. (NEW) (a) To the extent permitted by federal law, the Commissioners of Social Services and Education shall jointly establish procedures for the sharing of information contained in applications for free and reduced price meals under the National School Lunch Program for the purpose of determining whether children participating in such program are eligible for coverage under the HUSKY Plan, Part A and Part B. The Commissioner of Social Services shall take all actions necessary to ensure that children identified as eligible for the HUSKY Plan are able to enroll in such plan.

(b) The Commissioner of Education shall establish procedures whereby an individual may apply for the HUSKY Plan, Part A or Part B, at the same time such individual applies for the National School Lunch Program.

Sec. 8. (NEW) The Commissioner of Social Services, in determining if an individual continues to be eligible for the HUSKY Plan, Part A or Part B, shall determine whether such individual is a recipient of a child care subsidy under section 17b-749 of the general statutes, food stamps under the food stamp program pursuant to the Food Stamp Act of 1977 or benefits under any other program administered by the Department of Social Services for the purpose of ascertaining whether the department has information necessary for the redetermination of eligibility under the HUSKY Plan. In the event such information is available, the commissioner shall use such information in such redetermination.

Sec. 9. This act shall take effect from its passage, except that sections 2 to 8, inclusive, shall take effect July 1, 2001.

Approved June 28, 2001