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S1357.......................................by COMMERCE AND HUMAN RESOURCES
HEALTH INSURANCE - Amends existing law to provide that the director of the
Department of Administration has the authority to self-insure certain
health insurance coverage and to provide the director flexibility to
determine to self-insure group coverage.
01/28 Senate intro - 1st rdg - to printing
01/29 Rpt prt - to Com/HuRes
02/11 Rpt out - rec d/p - to 2nd rdg
02/12 2nd rdg - to 3rd rdg
02/19 3rd rdg - PASSED - 32-0-3
AYES--Andreason, Boatright, Branch, Bunderson, Burtenshaw, Cameron,
Crow, Danielson, Darrington, Deide, Dunklin, Frasure, Hansen,
Hawkins, Ingram, Ipsen, Keough, King, Lee, McLaughlin, Noh, Parry,
Richardson, Risch, Sandy, Schroeder, Sorensen, Stennett, Sweeney,
Thorne, Wheeler, Whitworth
NAYS--None
Absent and excused--Geddes, Riggs, Twiggs
Floor Sponsor - Cameron
Title apvd - to House
02/20 House intro - 1st rdg - to HuRes
03/13 Rpt out - rec d/p - to 2nd rdg
03/16 2nd rdg - to 3rd rdg
03/17 3rd rdg - PASSED - 69-0-1
AYES -- Alltus, Barraclough, Barrett, Bell, Bieter, Bivens,
Black(15), Black(23), Boe, Bruneel, Callister, Campbell, Chase,
Clark, Crane, Crow, Cuddy, Deal, Denney, Ellsworth, Field(13),
Field(20), Gagner, Geddes, Gould, Hadley, Henbest, Hornbeck, Jaquet,
Jones(9), Jones(22), Jones(20), Judd, Kellogg, Kempton, Kendell,
Kjellander, Kunz, Lake, Linford, Loertscher, Mader, Marley, McKague,
Meyer, Miller, Mortensen, Newcomb, Pischner, Pomeroy, Reynolds,
Richman, Ridinger, Robison, Sali, Schaefer, Stevenson, Stoicheff,
Stone, Stubbs, Taylor, Tilman, Tippets, Trail, Watson, Wheeler, Wood,
Zimmermann, Mr Speaker
NAYS -- None
Absent and excused -- Hansen
Floor Sponsor - Marley
Title apvd - to Senate
03/18 To enrol
03/19 Rpt enrol - Pres signed - Sp signed
03/20 To Governor
03/20 Governor signed
Session Law Chapter 185
Effective: 07/01/98
S1357|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-fourth Legislature Second Regular Session - 1998IN THE SENATE SENATE BILL NO. 1357 BY COMMERCE AND HUMAN RESOURCES COMMITTEE 1 AN ACT 2 RELATING TO THE POWERS AND DUTIES OF THE DIRECTOR OF THE DEPARTMENT OF ADMIN- 3 ISTRATION; AMENDING SECTION 67-5761, IDAHO CODE, TO PROVIDE THAT THE 4 DIRECTOR HAS AUTHORITY TO SELF-INSURE CERTAIN HEALTH INSURANCE COVERAGE 5 AND TO PROVIDE THE DIRECTOR FLEXIBILITY TO DETERMINE TO SELF-INSURE GROUP 6 COVERAGE. 7 Be It Enacted by the Legislature of the State of Idaho: 8 SECTION 1. That Section 67-5761, Idaho Code, be, and the same is hereby 9 amended to read as follows: 10 67-5761. POWERS AND DUTIES -- GROUP INSURANCE. (1) The director of the 11 department of administration shall have the authority to: 12 (a) Establish an advisory committee to be comprised of program partici- 13 pants. The advisory committee may include employee representatives. The 14 director shall consult with the advisory committee in the performance of 15 those duties as enumerated in subsection (2) of this section. 16 (b) Fix and promulgate rules for determining eligibility of personnel for 17 participation in any group plans. 18 (c) Determine the nature and extent of needs for group life insurance, 19 group annuities, group disability insurance, and group health care service 20 coverages with respect to personnel, including elected or appointed offi- 21 cers and employees, of all offices, departments, divisions, boards, com- 22 missions, institutions, agencies and operations of the government of the 23 state of Idaho and retired personnel, the premiums or prepayments for 24 which are payable in whole or in part from funds of the state. 25 "Disability" insurance includes all personal accident, health, hospital, 26 surgical, and medical coverages, and "health care service" includes all 27 services rendered for maintenance of good health and diagnosis, relief, or 28 treatment of any injury, ailment, or bodily condition. 29 (d) Determine the types, terms, conditions, and amounts of group insur- 30 ance, group annuities, or group coverage by health care service organiza- 31 tions, as the case may be, required by such needs. 32 (e) Negotiate and contract for, and have placed or continued in effect 33 all such insurance and coverages as may reasonably be obtainable from 34 insurers and health care service organizations, as the case may be, duly 35 authorized to transact such business in this state. The director may nego- 36 tiate deductibles to any group plan or coverage. Alternatively, the 37 director may self-insure any insurance or coverage and may contract with 38 any insurance company or third party administrator duly authorized to 39 transact business in this state or administer such plan. 40 (f) Prepare or otherwise obtain and make available to all personnel 41 affected thereby, printed information concerning all such group plans cur- 42 rently in effect, together with the rules governing eligibility, payment 43 of premium or prepayment where applicable, claims procedures, and other 2 1 matters designed to facilitate utilization and administration of such 2 plans. 3 (g) Administer all such group plans on behalf of thepolicyholder4or contract holderinsured , including but not limited 5 to: 6 (i) Enrollment and reporting to the insurer or health care service 7 organization of individuals eligible for coverage and covered under 8 particular policies or contracts, and termination of such enrollment 9 upon termination of eligibility; 10 (ii) Collection or pPayment of premiums or 11 prepayments for such coverage, policies and contracts 12 and accounting for the same; 13 (iii) Establishment of reasonable procedures for handling claims 14 arising under such coverage, policies and contracts, and 15 rendering assistance to claimants, as may be required in the presen- 16 tation and consideration of claims; 17 (iv) Effectuation of changes in such coverage, policies 18 and contracts and renewal or termination thereof ; 19 (v) Making and settlement of claims . 20 (2) Nothing herein shall be deemed to prohibit any such coverage, 21 policy or contract providing coverage also for dependents of personnel 22 under terms and conditions formulated and negotiated by the director. The 23 director shall formulate and negotiate a plan of health care service coverage 24 which includes retired personnel and dependents eligible for a retirement ben- 25 efit through the Idaho public employee retirement system which benefit equals 26 or exceeds the retiree medical insurance premium in effect for that retiree at 27 the date of retirement. Coverage for retired personnel shall parallel the cov- 28 erage provided to active state employees to the extent necessary, and shall 29 include a medicare credit for retirees who are covered by medicare. Any 30 increased cost on the health care plan for active employees as a result of 31 such coverage costs shall be paid for by the state and by active state employ- 32 ees in equal shares. Retired personnel shall be responsible for paying their 33 own premiums for any plan of health care service insurance coverage provided 34 pursuant to this section. No coverage, policy or contract35negotiated by the directorwhich provides coverage or benefits for per- 36 sonnel, dependents of personnel, or retired personnel shall create any vested 37 right or benefit for the retired personnel in retiree group insurance cover- 38 ages.
STATEMENT OF PURPOSE
RS07316C1
Prior informal interpretations of Idaho Code Section 67-5761, by the Department of
Administration's deputy attorney general have concluded that self-insurance by the State
of group health, hospital, surgical, medical and health care services insurance coverage is
not permitted. Amendment of Idaho Code Section 67-5761 is needed to:
Clearly establish that the Director of the Department of Administration has the
authority to self-insure such group coverage if it is cost effective to do so; and
Provide the Director flexibility to determine to self-insure group coverage.
FISCAL IMPACT
None. No fiscal impact unless the option were exercised.
CONTACT
Name: Joanna Guilfoy, Deputy Attorney General
Agency: Department of Administration
Phone: 334-3388
Name: Cynthia Ness, Manager
Agency: Office of Insurance Management
Phone: 334-3930
Statement of Purpose/Fiscal Impact
S1357