H. B. 2646
(By Delegates Rodighiero and Eldridge)
[Introduced February 18, 2009; referred to the
Committee on Health and Human Resources then Finance.]
A BILL to amend and reenact §5-16-2 of the Code of West Virginia,
1931, as amended, relating to defining the term "Medicare
Advantage Prescription Drug Plan" in the Public Employees
Insurance Act.
Be it enacted by the Legislature of West Virginia:
That §5-16-2 of the Code of West Virginia, 1931, as amended,
be amended and reenacted to read as follows:
ARTICLE 16. WEST VIRGINIA PUBLIC EMPLOYEES INSURANCE ACT.
§5-16-2. Definitions.
The following words and phrases as used in this article,
unless a different meaning is clearly indicated by the context,
have the following meanings:
(1) "Agency" means the Public Employees Insurance Agency
created by this article.
(2) "Director" means the Director of the Public Employees
Insurance Agency created by this article.
(3) "Employee" means any person, including an elected officer, who works regularly full time in the service of the State of West
Virginia and, for the purpose of this article only, the term
"employee" also means any person, including an elected officer, who
works regularly full time in the service of a county board of
education; a county, city or town in the state; any separate
corporation or instrumentality established by one or more counties,
cities or towns, as permitted by law; any corporation or
instrumentality supported in most part by counties, cities or
towns; any public corporation charged by law with the performance
of a governmental function and whose jurisdiction is coextensive
with one or more counties, cities or towns; any comprehensive
community mental health center or comprehensive mental retardation
facility established, operated or licensed by the Secretary of
Health and Human Resources pursuant to section one, article two-a,
chapter twenty-seven of this code and which is supported in part by
state, county or municipal funds; any person who works regularly
full time in the service of the Higher Education Policy Commission,
the West Virginia Council for Community and Technical College
Education or a governing board, as defined in section two, article
one, chapter eighteen-b of this code; any person who works
regularly full time in the service of a combined city-county health
department created pursuant to article two, chapter sixteen of this
code; any person designated as a twenty-first Century Learner
Fellow pursuant to section eleven, article three, chapter
eighteen-a of this code; and any person who works as a long-term
substitute as defined in section one, article one, chapter eighteen-a of this code in the service of a county board of
education:
Provided, That a long-term substitute who is
continuously employed for at least one hundred thirty-three
instructional days during an instructional term, and until the end
of that instructional term, is eligible for the benefits provided
in this article until September 1, following that instructional
term:
Provided, however, That a long-term substitute employed
fewer than one hundred thirty-three instructional days during an
instructional term is eligible for the benefits provided in this
article only during such time as he or she is actually employed as
a long-term substitute. On and after January 1, 1994, and upon
election by a county board of education to allow elected board
members to participate in the Public Employees Insurance Program
pursuant to this article, any person elected to a county board of
education shall be considered to be an "employee" during the term
of office of the elected member. Upon election by the State Board
of Education to allow appointed board members to participate in the
Public Employees Insurance Program pursuant to this article, any
person appointed to the State Board of Education is considered an
"employee" during the term of office of the appointed member:
Provided further, That the elected member of a county board of
education and the appointed member of the State Board of Education
shall pay the entire cost of the premium if he or she elects to be
covered under this article. Any matters of doubt as to who is an
employee within the meaning of this article shall be decided by the
director.
On or after July 1, 1997, a person shall be considered an
"employee" if that person meets the following criteria:
(i) Participates in a job-sharing arrangement as defined in
section one, article one, chapter eighteen-a of this code;
(ii) Has been designated, in writing, by all other
participants in that job-sharing arrangement as the "employee" for
purposes of this section; and
(iii) Works at least one third of the time required for a
full-time employee.
(4) "Employer" means the State of West Virginia, its boards,
agencies, commissions, departments, institutions or spending units;
a county board of education; a county, city or town in the state;
any separate corporation or instrumentality established by one or
more counties, cities or towns, as permitted by law; any
corporation or instrumentality supported in most part by counties,
cities or towns; any public corporation charged by law with the
performance of a governmental function and whose jurisdiction is
coextensive with one or more counties, cities or towns; any
comprehensive community mental health center or comprehensive
mental retardation facility established, operated or licensed by
the Secretary of Health and Human Resources pursuant to section
one, article two-a, chapter twenty-seven of this code and which is
supported in part by state, county or municipal funds; a combined
city-county health department created pursuant to article two,
chapter sixteen of this code; and a corporation meeting the
description set forth in section three, article twelve, chapter eighteen-b of this code that is employing a twenty-first Century
Learner Fellow pursuant to section eleven, article three, chapter
eighteen of this code but the corporation is not considered an
employer with respect to any employee other than a twenty-first
Century Learner Fellow. Any matters of doubt as to who is an
"employer" within the meaning of this article shall be decided by
the director. The term "employer" does not include within its
meaning the National Guard.
(5) "Finance board" means the Public Employees Insurance
Agency finance board created by this article.
(6) "Person" means any individual, company, association,
organization, corporation or other legal entity, including, but not
limited to, hospital, medical or dental service corporations;
health maintenance organizations or similar organization providing
prepaid health benefits; or individuals entitled to benefits under
the provisions of this article.
(7) "Plan", unless the context indicates otherwise, means the
medical indemnity plan, the managed care plan option or the group
life insurance plan offered by the agency.
(8) "Retired employee" means an employee of the state who
retired after April 29, 1971, and an employee of the Higher
Education Policy Commission, the Council for Community and
Technical College Education, a state institution of higher
education or a county board of education who retires on or after
April 21, 1972, and all additional eligible employees who retire on
or after the effective date of this article, meet the minimum eligibility requirements for their respective state retirement
system and whose last employer immediately prior to retirement
under the state retirement system is a participating employer in
the state retirement system and in the Public Employees Insurance
Agency:
Provided, That for the purposes of this article, the
employees who are not covered by a state retirement system, but who
are covered by a state-approved or state-contracted retirement
program or a system approved by the director, shall, in the case of
education employees, meet the minimum eligibility requirements of
the State Teachers Retirement System and in all other cases, meet
the minimum eligibility requirements of the Public Employees
Retirement System and may participate in the Public Employees
Insurance Agency as retired employees upon terms as the director
sets by rule as authorized in this article. Employers with
employees who are, or who are eligible to become, retired employees
under this article shall be mandatory participants in the Retiree
Health Benefit Trust Fund created pursuant to article sixteen-d of
this chapter. Nonstate employers may opt out of the West Virginia
other post-employment benefits plan of the Retiree Health Benefit
Trust Fund and elect to not provide benefits under the Public
Employees Insurance Agency to retirees of the nonstate employer,
but may do so only upon the written certification, under oath, of
an authorized officer of the employer that the employer has no
employees who are, or who are eligible to become, retired employees
and that the employer will defend and hold harmless the Public
Employees Insurance Agency from any claim by one of the employer's past, present or future employees for eligibility to participate in
the Public Employees Insurance Agency as a retired employee. As a
matter of law, the Public Employees Insurance Agency shall not be
liable in any respect to provide plan benefits to a retired
employee of a nonstate employer which has opted out of the West
Virginia other post-employment benefits plan of the Retiree Health
Benefit Trust Fund pursuant to this section.
(9) "Medicare Advantage Prescription Drug Plan" means a plan
licensed by Centers for Medicare and Medicaid Services of the
federal government to provide both medical and prescription drug
benefits to Medicare recipients by a fee for service plan or
through a preferred provider organization.
NOTE: The purpose of this bill is to define the term "Medicare
Advantage Prescription Drug Plan" in the Public Employees Insurance
Act.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.