(1) (a) The general assembly hereby finds and declares that:
It is the intent of the general assembly that all children in the state, including lowerincome children, have access to affordable and adequate health insurance.
The children of state employees are ineligible for existing federal and state programs, including medicaid and the children's basic health plan, that provide health insurance to lower-income children whose families are not otherwise able to afford health insurance.
Although the state pays a portion of the health insurance premiums for those stateemployees who enroll in a health insurance plan offered by the state, many lower-income state employees nonetheless cannot afford to pay the required employee contribution to the plan premiums for any plan or the higher employee contribution to a plan with a low deductible and therefore decline to enroll in a health insurance plan or enroll in a high deductible plan, leaving their children without adequate health insurance coverage.
In order to ensure that children of lower-income state employees have access toaffordable and adequate health insurance, it is necessary, appropriate, and in the best interests of the state to encourage lower-income state employees who have dependents other than their spouses to enroll in health insurance plans offered by the state by supplementing the state contribution to their plan premiums in order to reduce the amount of their required employee contributions to plan premiums or to encourage them to enroll in low deductible plans.
(A) By using disease management programs to reduce the costs of health care forstate employees who are enrolled in state group benefit plans that provide medical benefits, the state can provide the group benefit plans to more state employees for less money and achieve better outcomes.
National data indicates that the establishment of disease management programs canreduce by fifty percent asthma-related hospital admissions and thereby help the state provide lower cost group benefit plans for all state employees.
The establishment of a pilot disease management program that includes, but is notlimited to, a pilot childhood asthma program will maximize the use of moneys allocated for the purpose of supplementing existing health insurance plans for lower-income state employees.
(b) The general assembly further finds and declares that the intent of the general assembly in providing supplements as specified in this section, and the expectation of the general assembly with respect to the executive administration of the provision of supplements, is:
To provide access to affordable and adequate health insurance to as many children oflower-income state employees as possible; and
Because the high deductibles typical of health insurance plans that offer lower premiums can impair or destroy the economic self-sufficiency of lower-income families when health problems arise, to encourage lower-income state employees with dependents other than their spouses to enroll in higher premium plans with low deductibles.
(2) As used in this section, unless the context otherwise requires:
(a) "Eligible state employee" means an employee, as defined in section 24-50-603 (7), who:
Is eligible, by virtue of his or her state employment, to enroll in a group benefit planthat provides medical or dental benefits;
Has an annual household income of less than three hundred percent of the federalpoverty line; and
Has at least one dependent other than the employee's legal spouse.
"Employee contribution" means the amount contributed by an eligible state employeeto pay part of the premium for a qualifying group benefit plan in which the eligible state employee is enrolled.
"Qualifying group benefit plan" means a group benefit plan that provides medical ordental benefits.
"State contribution" means the amount contributed by the state to pay part of thepremium for a qualifying group benefit plan in which a state employee is enrolled.
(3) (a) For the 2008-09 state fiscal year and for each state fiscal year thereafter, the state, after first allocating the interest and income and next allocating the principal of the supplemental state contribution fund created in section 24-50-609 (5) to pay the costs of increased nonsupplemental state contributions, shall expend the available principal of the state supplemental contribution fund to pay a monthly supplement to the state contribution for each eligible state employee who timely applies for the supplement pursuant to subsection (4) of this section and enrolls in a qualifying group benefit plan in order to reduce the eligible state employee's employee contribution by the amount of the supplement. The amount of the supplement shall be the amount that reduces the aggregate amount of the eligible state employee's employee contribution for all qualifying group benefit plans to zero; except that, if the available principal of the supplemental state contribution fund is insufficient to provide full supplements for all eligible state employees as specified in paragraph (b) of this subsection (3):
The available principal shall first be used to provide each eligible state employee whohas an annual household income of less than two hundred percent of the federal poverty line a supplement in an amount equal to the lesser of the equivalent percentage of the applicable employee contribution for each such eligible state employee that uses all of the available principal or the amount needed to reduce the employee contribution of each such eligible state employee for all qualifying group benefit plans to zero.
Remaining available principal next shall be used to provide each eligible state employee who has an annual household income of two hundred percent or more of the federal poverty line but less than two hundred fifty percent of the federal poverty line a supplement in an amount equal to the lesser of the equivalent percentage of the applicable employee contribution for each such eligible state employee that uses all of the available principal or the amount needed to reduce the employee contribution of each such eligible state employee for all qualifying group benefit plans to zero.
Remaining available principal last shall be used to provide each eligible state employee who has an annual household income of at least two hundred fifty percent of the federal poverty line a supplement in an amount equal to the lesser of the equivalent percentage of the applicable employee contribution for each such eligible state employee that uses all of the available principal of the fund or the amount needed to reduce the employee contribution of each such eligible state employee for all qualifying group benefit plans to zero.
All supplements shall be paid from the available principal of the supplemental statecontribution fund created in section 24-50-609 (5). The total amount of all supplements paid for any given fiscal year shall be the lesser of the amount of all available principal of the supplemental state contribution fund or the amount of the available principal needed to reduce the employee contribution of each eligible state employee for all qualifying group benefit plans to zero. If an eligible state employee who receives a supplement is enrolled in separate qualifying group benefit plans for medical and dental benefits, the state shall supplement the state contribution to the plan that provides medical benefits until the employee contribution for that plan is reduced to zero before supplementing the state contribution to the plan that provides dental benefits.
For purposes of this subsection (3):
"Available principal of the supplemental state contribution fund" or "available principal" means, for any given fiscal year, the sum of the amount of tobacco litigation settlement moneys transferred by the state treasurer to the fund on July 1 of the fiscal year and any other principal of the fund minus the amount of principal allocated during the fiscal year to pay the costs of increased nonsupplemental state contributions pursuant to paragraph (a) of this subsection (3).
"Increased nonsupplemental state contributions" means, for any given fiscal year, theaggregate amount of increases in state contributions, excluding supplements, resulting from:
Enrollment in qualifying group benefit plans of eligible state employees who appliedfor supplements for the fiscal year and were not enrolled in qualifying group benefit plans during the prior fiscal year; and
Addition of dependents who were not covered by a qualifying group benefit planduring the prior fiscal year to the qualifying group benefit plans of eligible state employees who applied for supplements during the fiscal year.
A state employee shall apply to the department of personnel for a supplement. Theapplication shall be on a form prescribed by the director, and the employee shall provide any supporting information that the director may reasonably require to allow the department to verify that the state employee is an eligible state employee. A state employee shall file an application for a supplement annually during the open enrollment period or open enrollment grace period for enrolling in group benefit plans for the next state fiscal year, and, if the applicant is an eligible state employee and enrolls in a qualifying group benefit plan, the applicant shall receive a supplement for the next state fiscal year. A newly hired state employee shall not be eligible for a supplement in the state fiscal year in which he or she is hired, but may apply for a supplement during the open enrollment period or open enrollment grace period for enrolling in group benefit plans for the next state fiscal year.
Notwithstanding the provisions of section 24-1-136 (11)(a), no later than January 15,2009, and no later than each succeeding January 15, the department of personnel shall report to the health and human services committees of the house and senate and the joint budget committee of the general assembly or any successor committees regarding the supplemental state contribution program established in this section. The report shall include, at a minimum, information regarding:
The number of eligible state employees receiving supplements in the current statefiscal year and any prior state fiscal years in which supplements were provided;
The total amount of supplements that have been or will be paid in the current statefiscal year and that were paid in any prior state fiscal years in which supplements were provided;
The average monthly and yearly amounts of the individual supplements provided forthe current state fiscal year and for any prior state fiscal years in which supplements were provided;
The number of dependent children of eligible state employees receiving supplementscovered by a qualifying group benefit plan during the current state fiscal year and for any prior state fiscal years in which supplements were provided; and
The amount of increased nonsupplemental state contributions, as defined in subparagraph (II) of paragraph (c) of subsection (3) of this section, for the current state fiscal year and for any prior state fiscal years in which supplements were provided.
Source: L. 2007: Entire section added, p. 1669, § 1, effective May 31. L. 2010: (2)(a)(II), (3)(a)(I), (3)(a)(II), and (3)(a)(III) amended, (HB 10-1422), ch. 419, p. 2085, § 70, effective August 11.