[As Amended by Senate Committee of the Whole]

As Amended by Senate Committee
Session of 2000
By Committee on Ways and Means

11             AN  ACT concerning the establishment of the Kansas business health
12             partnership
14       Be it enacted by the Legislature of the State of Kansas:
15             Section  1. As used in this act:
16             (a) ``Carrier'' means any insurance company, nonprofit medical and
17       hospital service corporation, nonprofit optometric, dental, or pharmacy
18       service corporation, municipal group-funded pool, fraternal benefit so-
19       ciety or health maintenance organization, as these terms are defined by
20       chapter 40 of the Kansas Statutes Annotated, and amendments thereto,
21       that offers health benefit plans covering eligible employees of one or more
22       small employers in the state.
23             (b) ``Health committee'' means the Kansas business health policy
24       committee as specified in section 2, and amendments thereto.
25             (c) ``Dependent'' means the spouse or any child of an eligible
26       employee.
27             (d) ``Eligible employee'' shall have the meaning ascribed to it in
28       K.S.A. 40-2209d and amendments thereto.
29             (e) ``Health benefit plan'' means any hospital or medical expense pol-
30       icy, health, hospital or medical services corporation contract, and a plan
31       provided by a municipal group-funded pool, or a health maintenance
32       organization contract offered by any employer or any certificate issued
33       under any such policy, contract or plan.
34             (f) ``Kansas business health partnership'' or ``health partnership''
35       means a nonrisk bearing nonprofit corporation that has responded to a
36       request for a proposal by the health committee and has been selected by
37       the health committee to provide health insurance through multiple un-
38       affiliated participating carriers to small employers and their employees.
39             (g) ``Low-and-modest ``Low wage or modest wage employee''
40       means any employee whose gross wage family income does not exceed
41       200% of the poverty level.
42             (h) ``Small employer'' shall have the meaning ascribed to it in K.S.A.


  1       40-2209d and amendments thereto. [Small employer also includes any
  2       self-employed person.]
  3             Sec.  2. (a) The governor of the state of Kansas shall appoint a cabinet
  4       level committee which shall be known as the Kansas business health pol-
  5       icy committee.
  6             (b) The Kansas business health policy committee, hereinafter re-
  7       ferred to as the health committee, shall consist of:
  8             (1) The secretary of the department of commerce and housing or
  9       the secretary's designee;
10             (2) the secretary of the department of social and rehabilitative re-
11       habilitation services or the secretary's designee;
12             (3) the commissioner of insurance or the commissioner's designee;
13             (4) one member appointed by the president of the senate; and
14             (5) one member appointed by the speaker of the house of
15       representatives.;
16        (6) one member appointed by the minority leader of the senate;
17             (7) one member appointed by the minority leader of the house
18       of representatives; and
19             (8) three members at large from the private sector appointed by
20       the governor.
21             Not more than one member appointed pursuant to paragraphs (4) and
22       (5) of this subsection shall belong to the same political party. The secre-
23       tary of each state agency represented on this committee shall provide
24       such staff and other resources as the health committee may require.
25             (c)  (1) The initial meeting of the health committee shall be convened
26       within 60 days after the effective date of this act by the governor at a time
27       and place designated by the governor.
28             (2) Meetings of the health committee subsequent to its initial meet-
29       ing shall be held and conducted in accordance with policies and proce-
30       dures established by the health committee.
31             (3) Commencing at the time of the initial meeting of the health com-
32       mittee, the powers, authorities, duties and responsibilities conferred and
33       imposed upon the health committee by this act shall be operative and
34       effective.
35             (d) The health committee shall develop and approve a request for
36       proposals for a qualified entity to serve as the Kansas business health
37       partnership, hereinafter referred to as health partnership, which shall
38       provide a mechanism to combine federal and state subsidies with contri-
39       butions from employers and employees to purchase health insurance for
40       low-and-modest wage employees in accordance with guidelines devel-
41       oped by the health committee.
42             (e) The health committee shall evaluate responses to the request for
43       proposals and select the qualified entity to serve as the health partnership.


  1             (f) The health committee shall:
  2             (1) Develop and approve subsidy eligibility criteria provided that:
  3             (A) Only low-and-modest wage employees of small employers that
  4       have low-and-modest wage employees shall be eligible for subsidies; and
  5        (A) Low wage and modest wage employees of small employers
  6       shall be eligible for subsidies if:
  7             (1) The small employer has not previously offered health insur-
  8       ance coverage; or
  9             (2) the small employer has previously offered health insurance
10       coverage and a majority of such small employer's employees are
11       low wage or modest wage employees as defined in section 1;
12             (B) any small employer's employee with a child who is eligible for
13       coverage under the state childrens' health insurance program established
14       by K.S.A. 1999 Supp. 38-2001 et seq., and amendments thereto, and the
15       health insurance premium payment program or in the state medical as-
16       sistance program shall be eligible automatically for a subsidy and shall be
17       included in the determination of eligibility for the small employer and its
18       low-and-modest wage employees; and (C) At least 70% of the small
19       employer's employees are insured through the partnership; and
20             (2) determine and arrange for eligibility determination for subsidies
21       of low-and-modest wage employees. low wage or modest wage em-
22       ployees; and
23             (3) develop subsidy schedules based upon employee wage levels
24             (g) The health committee shall oversee and monitor the ongoing op-
25       eration of any subsidy program and the financial accountability of all sub-
26       sidy funds.
27             (h) In the event that the health partnership established under this act
28       is unable to obtain good faith bids from an adequate number of carriers,
29       the health committee can require the development of good faith bids
30       from and the participation in the health partnership by any carrier that
31       contracts with either the department of administration or the department
32       of social and rehabilitation services to provide fully-insured health cov-
33       erage as required to implement the objectives of this act.
34             (i) The health committee is hereby authorized to accept funds from
35       the federal government, or its agencies, or any other source whatsoever
36       for research studies, investigation, planning and other purposes related
37       to implementation of the objectives of this act. Any funds so received
38       shall be deposited in the state treasury and shall be credited to a special
39       revenue fund which is hereby created and shall be known as the health
40       committee insurance fund and used in accordance with or direction of
41       the contributing federal agencies. Expenditures from such fund may be
42       made for any purpose in keeping with the responsibilities, functions and
43       authority of the department. Warrants on such fund shall be drawn in


  1       the same manner as required of other state agencies upon vouchers
  2       signed by the secretary of the department of social and rehabilitation
  3       services upon receiving prior approval of the health committee.
  4             (j) (i) The health committee is authorized to develop policies for the
  5       use of additional federal or private funds to subsidize health insurance
  6       coverage for low-and-modest wage employees of predominantly low-wage
  7       small employers.
  8        (j) The health committee is hereby authorized to organize, or
  9       cause to be organized, one or more advisory committees. No mem-
10       ber of any advisory committee established under this subsection
11       shall receive any payment or other compensation from the health
12       partnership. The membership of each advisory committee estab-
13       lished under this subsection shall contain at least one representative
14       who is a small employer and one representative who is an eligible
15       employee as defined in section 1 and one representative of the in-
16       surance industry.
17             Sec.  3. (a) The health partnership selected by the health committee
18       shall:
19             (1) Be a domestic not-for-profit corporation; and
20             (2) have a board of directors which includes among its members at
21       least one director who is a small employer and at least one director who
22       is an employee.
23             (3) No director shall have any interest in any business which sells
24       health insurance or which provides or delivers any health care services.
25             (b) Operate the Kansas business health partnership.
26             Sec.  4. The health partnership shall develop and offer two or more
27       health benefit plans to small employers. In any health benefit plan de-
28       veloped under this act, any carrier may contract for coverage within the
29       scope of this act notwithstanding any mandated coverages otherwise re-
30       quired by state law. The Except for preventative and health screening
31       services, the provisions of K.S.A. 40-2,100 to 40-2,105, inclusive, 40-2114
32       and subsection (D) (i) of 40-2209 and 40-2229 and 40-2230, and K.S.A.
33       1999 Supp. 40-2,163, 40-2,164, 40-2,165 and 40-2,166, and amendments
34       thereto, shall not be mandatory with respect to any health benefit plan
35       developed under this act. In performing these duties, the health part-
36       nership shall:
37             (a) Develop and offer two or more lower-cost benefit plans such that:
38             (1) Each health benefit plan is consistent with any criteria established
39       by the health partnership;
40             (2) each health benefit plan shall be offered by all participating car-
41       riers except that no participating carrier shall be required to offer
42       any health benefit plan, or portion thereof, which such participat-
43       ing carrier is not licensed or authorized to offer in this state;


  1             (3) no participating carrier shall offer any health benefit plan devel-
  2       oped under this act to any small employer unless such small employer is
  3       covered through the health partnership; and
  4             (4) a supplemental benefit plan or other benefit option shall be de-
  5       veloped and made available so that the total package of benefits available
  6       to eligible children meet federal and state childrens' health insurance
  7       program standards established by K.S.A. 1999 Supp. 38-2001 et seq., and
  8       amendments thereto, and the health insurance premium payment pro-
  9       gram in the state medical assistance program as implemented by the
10       department of social and rehabilitation services.
11        (b) Develop and make available one or more supplemental
12       health benefit plans or one or more other benefit options so that the
13       total package of health benefits available to all eligible children
14       who receive health benefits through the health partnership meets,
15       at a minimum, standards established by the federal health insur-
16       ance program.
17             (b) (c) Offer coverage to any qualifying small employer.
18             (c) (d) Offer employees of participating small employers a choice of
19       participating carriers.
20             (d) (e)  (1) Include centralized and consolidated enrollment, billing
21       and customer service functions;
22             (2) use one standard enrollment form for all participating carriers;
23       and
24             (3) submit one consolidated bill to the small employer.
25        (f) Issue or cause to be issued a request for proposals and con-
26       tract with a qualified vendor for any administrative or other service
27       not performed by the health committee or provided to the health
28       committee under subsection (b) of section 2.
29             (e) (g) Issue a request for proposals and selectively contract with
30       carriers.
31             (f) (h) Establish conditions of participation for small employers that
32       conform with K.S.A. 40-2209b et seq., and amendments thereto, and the
33       health insurance portability and accountability act of 1996 (Public Law
34       104-191).
35             (g) (i) Enroll small employers and their eligible employees and de-
36       pendents in health benefit plans developed under this act.
37             (h) (j) Bill and collect premiums from participating small employers
38       including any share of the premium paid by such small employer's en-
39       rolled employees.
40             (i) (k) Remit funds collected under subsection (h) to the appropriate
41       contracted carriers.
42             (j) (l) Provide that each eligible low-or-modest wage employee shall
43       be permitted to enroll in such employee's choice of participating carrier.


  1             (k) (m) Develop premium rating policies for small employers.
  2        (1) In consultation with the health committee, the health part-
  3       nership shall ensure, to the maximum extent possible, that the com-
  4       bined effect of the premium rating and subsidy policies is that sub-
  5       sidized workers and the dependents of such subsidized workers can
  6       afford coverage.
  7             (2) Any rating policy developed under this subsection may vary
  8       with respect to subsidy status of workers and the dependents of such
  9       workers.
10             (l) (n) Be authorized to contract for additional group vision, dental
11       and life insurance plans, and other limited insurance products.
12        (o) Take whatever action is necessary to assure that any adult
13       or child who receives health benefit coverage through the health
14       benefit partnership and who is eligible for the state medical assis-
15       tance program shall remain eligible to participate in the state health
16       insurance premium payment program.
17             (p) Coordinate with the department of social and rehabilitation
18       services to assure that any funds available for the coverage of in-
19       fants and pregnant women under the state medical assistance pro-
20       gram are also available for the benefit of eligible infants and preg-
21       nant women who receive health benefit coverage through the health
22       partnership.
23             Sec.  5. The department of social and rehabilitation services shall de-
24       velop and seek federal approval of a family waiver for the state childrens'
25       health insurance program established by K.S.A. 1999 Supp. 38-2001 et
26       seq., and amendments thereto, and the health insurance premium pay-
27       ment program in the state medical assistance program for purposes of
28       coverage through the health partnership. The health committee may
29       provide a mechanism for direct subsidies to low and modest wage
30       employees of employers acquiring coverage through a direct con-
31       tract with a carrier rather than through the health partnership, and
32       for provision to such employees of a supplemental benefit plan as
33       described in subsection (a) of section 4.
34        Sec.  6. The department of social and rehabilitation services
35       shall investigate and pursue all possible policy options to bring into
36       this partnership to title XIX and the title XXI eligible families of any
37       employees employed by a small employer. Further, the department
38       of social and rehabilitation services shall develop and seek federal
39       approval of any appropriate variance or state plan amendment for
40       the state children's health insurance program established by K.S.A.
41       1999 Supp. 38-2001 et seq., and amendments thereto, and the state
42       medical assistance program required to accomplish the purposes of
43       this act.


  1        Sec.  6. 7. This act shall take effect and be in force from and after its
  2       publication in the statute book.