CHAPTER 112
HOUSE BILL No. 2247
An Act concerning the Kansas business health partnership act;
relating to the removal of
the sunset provision and making other clarifications of the act;
amending K.S.A. 40-
4701, 40-4702, 40-4704, 40-4706 and 40-4707 and repealing
the existing sections.
Be it enacted by the Legislature of the State of Kansas:
Section 1. K.S.A. 40-4707 is hereby
amended to read as follows: 40-
4707. (a) K.S.A. 40-4701 through 40-4707 and
amendments thereto shall
be known as the Kansas business health partnership act.
(b) The provisions of the Kansas
business health partnership act shall
expire on July 1, 2002.
Sec. 2. K.S.A. 40-4701 is hereby
amended to read as follows: 40-
4701. As used in K.S.A. 40-4701 through 40-4707 and amendments
thereto:
(a) ``Carrier'' means any insurance
company, nonprofit medical and
hospital service corporation, nonprofit optometric, dental, or
pharmacy
service corporation, municipal group-funded pool, fraternal benefit
so-
ciety or health maintenance organization, as these terms are
defined by
chapter 40 of the Kansas Statutes Annotated, and amendments
thereto,
that offers health benefit plans covering eligible employees of one
or more
small employers in the state.
(b) ``Health committee'' means the Kansas
business health policy
committee as specified in K.S.A. 40-4702, and amendments
thereto.
(c) ``Dependent'' means the spouse or any
child of an eligible em-
ployee.
(d) ``Eligible employee'' shall have the
meaning ascribed to it in
K.S.A. 40-2209d and amendments thereto.
(e) ``Health benefit plan'' means any
hospital or medical expense pol-
icy, health, hospital or medical services corporation contract, and
a plan
provided by a municipal group-funded pool, or a health
maintenance
organization contract offered by any employer or any certificate
issued
under any such policy, contract or plan.
(f) ``Kansas business health
partnership'' or ``health partnership''
means a nonrisk bearing nonprofit corporation that has responded to
a
request for a proposal by the health committee and has been
selected by
the health committee to provide health insurance through multiple
un-
affiliated participating carriers to small employers and their
eligible em-
ployees.
(g) ``Low wage or modest wage employee''
means any eligible em-
ployee whose family income does not exceed 200% of the poverty
level.
(h) ``Small employer'' shall have the
meaning ascribed to it in K.S.A.
40-2209d and amendments thereto.
Sec. 3. K.S.A. 40-4702 is hereby
amended to read as follows: 40-
4702. (a) The governor of the state of Kansas shall appoint a
cabinet level
committee which shall be known as the Kansas business health
policy
committee.
(b) The Kansas business health policy
committee, hereinafter re-
ferred to as the health committee, shall consist of:
(1) The secretary of the department of
commerce and housing or the
secretary's designee;
(2) the secretary of the department of
social and rehabilitation serv-
ices or the secretary's designee;
(3) the commissioner of insurance or the
commissioner's designee;
(4) one member appointed by the president
of the senate;
(5) one member appointed by the speaker
of the house of represen-
tatives;
(6) one member appointed by the minority
leader of the senate;
(7) one member appointed by the minority
leader of the house of
representatives; and
(8) three members at large from the
private sector appointed by the
governor.
The secretary of each state agency represented
on this committee shall
provide such staff and other resources as the health committee may
re-
quire.
(c) (1) The initial meeting of the
health committee shall be convened
within 60 days after the effective date of this act by the governor
at a time
and place designated by the governor.
(2) Meetings of the health committee
subsequent to its initial meet-
ing shall be held and conducted in accordance with policies and
proce-
dures established by the health committee.
(3) Commencing at the time of the initial
meeting of the health com-
mittee, the powers, authorities, duties and responsibilities
conferred and
imposed upon the health committee by this act shall be operative
and
effective.
(d) The health committee shall develop
and approve a request for
proposals for a qualified entity to serve as the Kansas business
health
partnership, hereinafter referred to as health partnership, which
shall
provide a mechanism to combine federal and state subsidies with
contri-
butions from small employers and eligible employees
to purchase health
insurance in accordance with guidelines developed by the health
com-
mittee.
(e) The health committee shall evaluate
responses to the request for
proposals and select the qualified entity to serve as the health
partnership.
(f) The health committee shall:
(1) Develop and,
approve and revise subsidy eligibility criteria pro-
vided that:
(A) Low wage and modest wage employees of
small employers shall
be eligible for subsidies if:
(1) The small employer has not previously
offered health insurance
coverage; or
(2) the small employer has previously
offered health insurance cov-
erage and a majority of such small employer's employees are low
wage
or modest wage employees as defined in K.S.A. 40-4701, and
amendments
thereto;
(B) any small employer's eligible
employee with a child who is eligible
for coverage under the state childrens' health insurance program
estab-
lished by K.S.A. 38-2001 et seq., and amendments thereto, or
in the state
medical assistance program shall be eligible automatically for a
subsidy
and shall be included in the determination of eligibility for the
small
employer and its low-and-modest wage employees; and
(C) at least 70% of the small employer's
eligible employees without
group health insurance coverage from another source are
insured through
the partnership; and
(2) determine and arrange for eligibility
determination for subsidies
of low wage or modest wage employees; and
(3) develop subsidy schedules based upon
eligible employee wage
levels and family income.
(g) The health committee shall oversee
and monitor the ongoing op-
eration of any subsidy program and the financial accountability of
all sub-
sidy funds. If, in the judgment of the health committee, the
entity selected
to serve as the health partnership fails to perform as intended,
the health
committee may terminate its selection and designation of that
entity as
the health partnership and may issue a new request for proposal
and select
a different qualified entity to serve as the health
partnership.
(h) The health committee is hereby
authorized to accept funds from
the federal government, or its agencies, or any other source
whatsoever
for research studies, investigation, planning and other purposes
related
to implementation of the objectives of this act. Any funds so
received
shall be deposited in the state treasury and shall be credited to a
special
revenue fund which is hereby created and shall be known as the
health
committee insurance fund and used in accordance with or direction
of
the contributing federal agencies. Expenditures from such fund may
be
made for any purpose in keeping with the responsibilities,
functions and
authority of the department. Warrants on such fund shall be drawn
in
the same manner as required of other state agencies upon
vouchers
signed by the secretary of the department of social and
rehabilitation
services upon receiving prior approval of the health committee.
(i) The health committee is authorized to
develop policies for the
administration of the subsidy program and for the use of
additional fed-
eral or private funds to subsidize health insurance coverage for
low-and-
modest wage employees of predominantly low-wage small
employers.
(j) The health committee is hereby
authorized to organize, or cause
to be organized, one or more advisory committees. No member of
any
advisory committee established under this subsection shall have
previ-
ously received or currently receive any payment or other
compensation
from the health partnership. The membership of each advisory
committee
established under this subsection shall contain at least one
representative
who is a small employer and one representative who is an eligible
em-
ployee as defined in K.S.A. 40-4701, and amendments thereto,
and one
representative of the insurance industry.
Sec. 4. K.S.A. 40-4704 is hereby
amended to read as follows: 40-
4704. The health partnership shall develop and offer two or more
health
benefit plans to small employers. In any health benefit plan
developed
under this act, any carrier may contract for coverage within the
scope of
this act notwithstanding any mandated coverages otherwise required
by
state law. Except for preventative and health screening services,
the pro-
visions of K.S.A. 40-2,100 to 40-2,105, inclusive, 40-2114 and
subsection
(i) of 40-2209 and 40-2229 and 40-2230, and 40-2,163, 40-2,164,
40-2,165
and 40-2,166, and amendments thereto, shall not be mandatory with
re-
spect to any health benefit plan developed under this act. In
performing
these duties, the health partnership shall:
(a) Develop and offer two or more
lower-cost benefit plans such that:
(1) Each health benefit plan is
consistent with any criteria established
by the health partnership;
(2) each health benefit plan shall be
offered by all participating car-
riers except that no participating carrier shall be required to
offer any
health benefit plan, or portion thereof, which such participating
carrier
is not licensed or authorized to offer in this state;
(3) no participating carrier shall offer
any health benefit plan devel-
oped under this act to any small employer unless such small
employer is
covered through the health partnership.
(b) Develop and make available one or
more supplemental health
benefit plans or one or more other benefit options so that the
total pack-
age of health benefits available to all children eligible
children who re-
ceive health benefits through the health
partnership for the state chil-
dren's health insurance program established pursuant to K.S.A.
68-2001
et seq., and amendments thereto, meets, at a minimum,
standards estab-
lished by the federal health insurance program.
(c) Offer coverage to any qualifying
small employer.
(d) Offer eligible employees of
participating small employers a choice
of participating carriers where feasible.
(e) (1) Include centralized and
consolidated enrollment, billing and
customer service functions;
(2) use one standard enrollment form for
all participating carriers;
and
(3) submit one consolidated bill to the
small employer.
(f) Issue or cause to be issued a request
for proposals and contract
with a qualified vendor for any administrative or other service not
per-
formed by the health committee or provided to the health
committee
under subsection (b) of K.S.A. 40-4702, and amendments
thereto.
(g) Issue a request for proposals and
selectively contract with carriers.
(h) Establish conditions of participation
for small employers that con-
form with K.S.A. 40-2209b et seq., and amendments thereto,
and the
health insurance portability and accountability act of 1996 (Public
Law
104-191).
(i) Enroll small employers and their
eligible employees and depend-
ents in health benefit plans developed under this act.
(j) Bill and collect premiums from
participating small employers in-
cluding any share of the premium paid by such small employer's
enrolled
employees.
(k) Remit funds collected under
subsection (h) to the appropriate
contracted carriers.
(l) Provide that each
eligible low-or-modest wage employee shall be
permitted to enroll in such employee's choice of participating
carrier
where available.
(m) Develop premium rating policies for
small employers.
(1) In consultation with the health
committee, the health partnership
shall ensure, to the maximum extent possible, that the combined
effect
of the premium rating and subsidy policies is that subsidized
workers
eligible employees and the dependents of such subsidized
workers eligible
employees can afford coverage.
(2) Any rating policy developed under
this subsection may vary with
respect to subsidy status of workers eligible
employees and the dependents
of such workers eligible employees.
(n) Be authorized to contract for
additional group vision, dental and
life insurance plans, and other limited insurance products.
(o) Take whatever action is necessary to
assure that any adult or child
eligible employee or dependent of such eligible employee who
receives
health benefit coverage through the health benefit
partnership and who
is eligible for the state medical assistance program shall remain
eligible
to participate in the state health insurance premium payment
program.
(p) Coordinate with the department of
social and rehabilitation serv-
ices to assure that any funds available for the coverage of infants
and
pregnant women under the state medical assistance program are
also
available for the benefit of eligible infants and pregnant women
who re-
ceive health benefit coverage through the health partnership as
an eligible
employee or dependent of such eligible employee.
Sec. 5. K.S.A. 40-4706 is hereby
amended to read as follows: 40-
4706. The department of social and rehabilitation services shall
investi-
gate and pursue all possible policy options to bring into this
partnership
title XIX and the title XXI eligible families of any
eligible employees em-
ployed by a small employer. Further, the department of social and
re-
habilitation services shall develop and seek federal approval of
any ap-
propriate variance or state plan amendment for the state children's
health
insurance program established by K.S.A. 38-2001 et seq., and
amend-
ments thereto, and the state medical assistance program required to
ac-
complish the purposes of this act.
Sec. 6. K.S.A. 40-4701, 40-4702, 40-4704, 40-4706 and
40-4707 are
hereby repealed.
Sec. 7. This act shall take effect and be in force
from and after its
publication in the statute book.
Approved May 16, 2002.
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