§ 3-123bbb — Enrollment procedures and requirements. Comptroller duties.

(a)(1) Notwithstanding the provisions of title 38a, the Comptroller shall offer to nonstate public employers and nonprofit employers, and their respective retirees, if applicable, coverage under a partnership plan or plans. Such plan or plans may be offered on a fully-insured or risk-pooled basis at the discretion of the Comptroller. Any health insurer, health care center or other entity that contracts with the Comptroller for the purposes of this section and any fully-insured plan offered by the Comptroller under such contract shall be subject to title 38a. Eligible employers shall submit an application to the Comptroller for coverage under any such plan or plans. (2) Beginning January 1, 2012, the Comptroller shall offer coverage under such plan or plans to nonstate public employers. Beginning January 1, 2013, the Comptroller shall offer coverage under such plan or plans to nonprofit employers. (b) (1) The Comptroller shall require nonstate public employers and nonprofit employers that elect to obtain coverage under a partnership plan to participate in such plan for not less than two-year intervals, except participation pursuant to an application described in subdivision (2) of subsection (i) of this section may be for one-year intervals. An employer may apply for renewal prior to the expiration of each interval. (2) The Comptroller shall develop procedures by which: (A) Such employers may apply to obtain coverage under a partnership plan, including procedures for nonstate public employers that are currently fully insured and procedures for nonstate public employers that are currently self-insured; (B) Employers receiving coverage for their employees pursuant to a partnership plan may (i) apply for renewal, or (ii) withdraw from such coverage, including, but not limited to, the terms and conditions under which such employers may withdraw prior to the expiration of the interval and the procedure by which any premium payments such employers may be entitled to or premium equivalent payments made in excess of incurred claims shall be refunded to such employer. Any such procedures shall provide that nonstate public employees covered by collective bargaining shall withdraw from such coverage in accordance with chapters 113 and 166; (C) Nonstate public employers may continue and renew coverage pursuant to subdivision (1) of subsection (i) of this section and initiate and renew enrollment and coverage pursuant to subdivision (2) of subsection (i) of this section; and (D) The Comptroller may collect payments and fees for unreported claims and expenses. (c) (1) The initial open enrollment for nonstate public employers shall be for coverage beginning July 1, 2012. Thereafter, open enrollment for nonstate public employers shall be for coverage periods beginning July first. (2) The initial open enrollment for nonprofit employers shall be for coverage beginning January 1, 2013. Thereafter, open enrollment for nonprofit employers shall be for coverage periods beginning January first and July first. (d) Nothing in this section or sections 3-123ccc and 3-123ddd shall require the Comptroller to offer coverage to every employer seeking coverage under sections 3-123ccc and 3-123ddd from every partnership plan offered by the Comptroller. (e) The Comptroller shall create applications for coverage for the purposes of sections 3-123ccc and 3-123ddd and for renewal of a partnership plan. Such applications shall require an employer to disclose whether the employer will offer any other health care benefits plan to the employees who are offered a partnership plan. (f) No employee shall be enrolled in a partnership plan if such employee is covered through such employee's 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. (g) (1) The Comptroller shall take such actions as are necessary to ensure that granting coverage to an employer under sections 3-123ccc and 3-123ddd will not affect the status of the state employee plan as a governmental plan under the Employee Retirement Income Security Act of 1974, as amended from time to time. Such actions may include, but are not limited to, cancelling coverage, with notice, to such employer and discontinuing the acceptance of applications for coverage from nonprofit employers. The Comptroller shall establish the form and time frame for the notice of cancellation to be provided to such employer. (2) The Comptroller shall resume providing coverage for, or accepting applications for coverage from, nonprofit employers if the Comptroller determines that granting coverage to such employers will not affect the state employee plan's status as a governmental plan under the Employee Retirement Income Security Act of 1974, as amended from time to time. (3) The Comptroller shall make a public announcement of the Comptroller's decision to discontinue or resume coverage or the acceptance of applications for coverage under a partnership plan or plans. (h) The Comptroller, in consultation with the Health Care Cost Containment Committee, shall: (1) Develop and implement patient-centered medical homes for the state employee plan and partnership plans offered under this section, in a manner that will reduce the costs of such plans; and (2) Review claims data of the state employee plan and partnership plans offered under this section, to target high-cost health care providers and medical conditions and monitor costly trends. (i) (1) A nonstate public employer that provides coverage pursuant to a partnership plan to a police officer who is killed in the line of duty shall continue to provide such coverage to the survivors of such officer who were covered under such plan at the time of such officer's death. Such coverage shall continue without break for a period of one year after such officer's death, and may be renewed annually for up to five years. Such nonstate public employer shall facilitate continuation and renewal of such coverage. (2) A nonstate public employer that did not provide coverage pursuant to a partnership plan to a police officer who is killed in the line of duty shall apply for coverage pursuant to a partnership plan for those survivors of such officer who were receiving health care benefit coverage through a plan offered to such officer at the time of such officer's death, at the request of such survivors. The Comptroller shall accept such application upon the terms and conditions applicable to the partnership plan for enrollment and provision of coverage to such survivors for one year. Such enrollment and coverage may be renewed annually for up to five years. Such nonstate public employer shall facilitate initiation and renewal of such enrollment and coverage.

Legislative History

(P.A. 11-58, S. 2; P.A. 24-27, S. 4.) History: P.A. 11-58 effective July 1, 2011; P.A. 24-27 amended Subsec. (b)(1) to add exception re application described in Subsec. (i)(2), amended Subsec. (b)(2) to add Subpara. (C) and redesignate existing Subpara. (C) as Subpara. (D) and added Subsec. (i) re coverage when police officer is killed in the line of duty, effective July 1, 2024.