OLR Bill Analysis
AN ACT EXPANDING ELIGIBILITY FOR PARTICIPATION IN THE MUNICIPAL EMPLOYEES' HEALTH INSURANCE PLAN
This bill authorizes the comptroller to provide health insurance coverage for personal care assistant associations (PCAA) under the existing Municipal Employees' Health Insurance Plan (MEHIP). It defines "association for personal care assistants" as an organization of personal care attendants employed by recipients of specific programs for (1) the elderly, (2) people with mental or physical disabilities, or (3) people suffering from brain injuries. Consumer-directed personal care assistant service is an alternative to nursing homes or agency-sponsored home care assistance in that it allows the client to hire his own care attendant with program financial support.
Under current law, MEHIP is available to municipal employees and employees of nonprofit corporations that have a contract with the state.
The bill applies a number of parallel requirements for PCAA participation that already apply to municipalities and nonprofits, including that (1) PCAA plan members pay all plan administrative costs at no additional cost to the state and (2) no employees be refused entry to the plan because of past or future health care costs or claim experience.
The bill exempts PCAA health insurance contracts from the tax on health care organization subscriber charges. The health plan may be, at the comptroller's discretion, fully underwritten or a risk pooled.
It also specifies that a PCAA procuring health insurance through MEHIP cannot also be designated a "small employer" under existing health care insurance statutes.
EFFECTIVE DATE: July 1, 2003
MEHIP REQUIREMENTS
The bill applies a number of requirements on the PCAA provision that already apply to municipalities and nonprofits, including that:
1. participation be voluntary,
2. plan administrative costs be paid by PCAA members at no cost to the state,
3. rates paid by the state for state employee health insurance coverage for not be affected by the new plan, and
4. no group of employees be refused entry to the plan by reason of past or future health care costs or claim experience.
The bill does not require that PCAA participation be for the duration of the plan or for another period mutually agreed to by the PCAA and the comptroller. Existing law imposes this requirement on municipalities and nonprofits.
The bill allows the comptroller to offer PCAAs health insurance that is either fully underwritten or on a risk-pool basis. Under existing law, the comptroller has the same discretion with plans for nonprofit corporation employees. The law requires MEHIP plans for municipal employees to be fully underwritten.
PROGRAMS INCLUDED IN THE BILL
The bill specifically defines a PCAA as an organization made up of personal care attendants who are employed by recipients of any of the following: Connecticut Home Care Program for the Elderly, personal care assistance program (for people with physical disabilities), independent living centers (for people with mental or physical disabilities), or the acquired brain injury program. These programs provide services to individuals in their homes and account for more than 500 personal care attendants.
BACKGROUND
Personal Care Attendants
Personal care attendant service is an alternative to nursing homes or home care through an agency. In such a program, the client chooses his own care attendant (sometimes called a personal care assistant) to help him with personal care and activities of daily living. The client employs, trains, supervises, and may fire the attendant, but a financial intermediary takes care of the paper work. The program provides training to the client on how to function as the employer.
In the regular home care program, the client receives care through a home health care agency, which employs various home health care aides, homemakers, or chore persons for different functions and usually does not allow the client to choose the aide. The personal care assistant can take over a number of these different functions.
COMMITTEE ACTION
Labor and Public Employees Committee
Joint Favorable Substitute
Yea |
10 |
Nay |
4 |