AN ACT (1) TO ALLOW THE STATE HEALTH PLAN FOR TEACHERS AND STATE EMPLOYEES TO PROVIDE THE BASIC PLAN PREMIUM-FREE USING AVAILABLE CASH BALANCE RESERVES, (2) TO DELAY IMPLEMENTATION OF CERTAIN CHANGES TO THE STATE HEALTH PLAN UNTIL SEPTEMBER 2011, (3) TO COMPLY WITH THE FEDERAL AFFORDABLE CARE ACT, (4) TO CLARIFY THE STATE HEALTH PLAN'S SUBROGATION RIGHTS, (5) TO GRANT THE STATE TREASURER IMMEDIATE ACCESS TO CONFIDENTIAL STATE HEALTH PLAN DOCUMENTS TO PLAN FOR THE TRANSFER, AND (6) TO CLARIFY THE BOARD COMPOSITION AND STAGGER INITIAL APPOINTMENTS. Summarized in Daily Bulletin 5/18/11. Enacted May 26, 2011. Effective May 26, 2011, except as otherwise provided.
Summary date: Jun 1 2011 - View summary
Summary date: May 18 2011 - View summary
Senate committee substitute makes the following changes to 2nd edition.
Deletes all provisions of 2nd edition and replaces it with AN ACT (1) TO ALLOW THE STATE HEALTH PLAN FOR TEACHERS AND STATE EMPLOYEES TO PROVIDE THE BASIC PLAN PREMIUM-FREE USING AVAILABLE CASH BALANCE RESERVES, (2) TO DELAY IMPLEMENTATION OF CERTAIN CHANGES TO THE STATE HEALTH PLAN UNTIL SEPTEMBER 2011, (3) TO COMPLY WITH THE FEDERAL AFFORDABLE CARE ACT, (4) TO CLARIFY THE STATE HEALTH PLAN’S SUBROGATION RIGHTS, (5) TO GRANT THE STATE TREASURER IMMEDIATE ACCESS TO CONFIDENTIAL STATE HEALTH PLAN DOCUMENTS TO PLAN FOR THE TRANSFER, AND (6) TO CLARIFY THE BOARD COMPOSITION AND STAGGER INITIAL APPOINTMENTS.
Authorizes the State Health Plan for Teachers and State Employees (Plan) to offer the Basic Plan premium-free in 2011-12 if the Plan has sufficient available cash balance reserves. Directs the Plan to find savings, and to apply those savings and any available cash balance reserves to a premium-free plan option during 2012-13, if possible.
Amends Section 1.11 of Senate Bill 323 of the 2011 Regular Session to change the effective date of Part I to September 1, 2011 (was, July 1, 2011); however, the following sections of Senate Bill 323 become effective July 1, 2011: (1) Section 1.1 (appropriations from the General Fund and the Highway Fund); (2) Section 1.7 (allowing coverage for children up to 26 years old, in compliance with federal law); (3) Section 1.8 (salary related contributions); and (4) Section 1.10(c) (clarifying definition of health benefits representative). Amends GS 135-45(g), effective September 1, 2011, to prohibit the Executive Administrator and the Board of Trustees from changing specified Plan elements in effect on September 1, 2011, that would result in increased costs to the Plan or a reduction in benefits without an act of the General Assembly. Makes a conforming change by repealing Section 1.4 of Senate Bill 323. Directs the Revisor of Statutes to make specified changes when revising the General Statutes. Provides that credits toward deductibles and coinsurance maximums earned by Plan members during July and August 2011 will be carried forward and applied toward the new deductible and coinsurance maximums for the period beginning September 1, 2011. A Plan member must meet any additional amounts required by new deductible and coinsurance maximums effective September 1, 2011, if the Plan member fully meets deductible and coinsurance maximums during July and August 2011.
Amends GS 135-45.1(10), as amended by Senate Bill 323, to clarify that all dependent children are eligible for coverage up to the first month following the child’s 26th birthday, in compliance with the Federal Patient Protection Affordable Care Act. Amends GS 135-45.2(d), as amended, to clarify that a dependent child is not eligible for Plan coverage if the child is eligible for employer based health care outside of the Plan, other than a parent’s plan. Amends GS 135-45.3, as amended, to clarify that eligible employees younger than age 19 and dependents younger than age 19 may enroll at any time, and will not be subject to a waiting period for a preexisting condition. Makes a conforming change. Makes clarifying changes to GS 135-45.4, as amended. Effective July 1, 2011.
Amends GS 135-14(g), stating that the Plan or the Claims Processor has the right to recover overpayments as specified.
Provides that the State Treasurer has immediate access to all Plan records in order to plan for the January 1, 2012, transfer of the Plan.
Effective January 1, 2012, amends GS 135-48.20, as amended, to clarify that each appointing authority must consult with all other appointing authorities before making its own appointments to ensure that the Board of Trustees (Board) includes various, specified members. Repeals Section 2.13(b) of Senate Bill 323, which stated that the terms of current Board members continues through the end of their terms. Directs the terms of appointees under GS 135-48.20 to begin January 1, 2012, for terms as follows: (1) two and a half years for appointees under GS 135-48.20(i) and (2) three and a half years for appointees not under GS 135-48.20(i).
Effective when the act becomes law, unless otherwise indicated. States that no section of this act becomes effective unless Senate Bill 323 becomes law.
Summary date: Apr 27 2011 - View summary
House committee substitute makes the following change to 1st edition. Makes a technical change only.
Summary date: Mar 31 2011 - View summary
Adds new GS 55-49-12 exempting a health care sharing organization from health insurance regulatory laws, as long as the organization (1) maintains nonprofit status under the Internal Revenue Code; (2) limits participants to those sharing similar interests; (3) provides for participants’ needs through contributions from one participant to another in accordance with criteria established by the organization; (4) provides amounts that participants may contribute with no assumption of risk or promise to pay among participants or by the organization; (5) publishes monthly statements to participants; and (6) provides a written disclaimer on or with all applications and guideline materials, reading substantially as the notice set forth in the act. Effective October 1, 2011.