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Introduced Version House Bill 4616 History

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Key: Green = existing Code. Red = new code to be enacted
H. B. 4616


(By Delegates White and Walters)

[Introduced February 18, 2008; referred to the

Committee on Finance.]





A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §5-16-28, relating to health reimbursement accounts for local government employees.

Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended by adding thereto a new section, designated §5-16-28, to read as follows:

§5-16-28. Optional Healthcare Reimbursement Account Program for

Local Government Employees.

(a)The Director of the West Virginia Public Employees Agency is directed to provide a three year pilot program for those groups which are not state agencies whose employees are defined as an employee who works regularly at 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. The pilot shall begin July 1, 2008.
(b) The purpose of the pilot program will be to determine the effectiveness of the use of health reimbursement arrangements in combination with high deductible health benefit plans.
(c) With respect to the health benefit plans authorized by this section, the carrier shall reimburse network health care providers at the same health care provider reimbursement rates in effect for the managed care and health maintenance organization plans offered by the West Virginia public employees insurance agency.
(d) Participation in the pilot on the part of an employer as described in (a) is voluntary however the following conditions of participation must be met:
(1) The employer must have at least 50 employees that are currently covered by Public Employees Insurance Agency and the employer has been covered by PEIA for the last 24 months as of January 1, 2008;
(2) All of the employees of the employer that are eligible for coverage must participate in the pilot if they choose to receive health benefits from the employer;
(3) The employer will be required to pay an amount to PEIA for retirement health costs that are equal to those paid by other similar employers that are insured under the traditional PEIA or managed care offerings;
(4) The employer must provide evidence to PEIA that the employer has established a health reimbursement arrangement for it employees.
(e) The West Virginia public employees insurance agency shall by March 15, 2008 issue a request for participation for private insurance carriers to participate in the pilot. Any licensed health carrier desiring to participate must agree to the following terms and conditions:
(1) All products will be community rated among all employers in the program;
(2) Any employer as defined in (a) may participate in the program on a guaranteed issue basis;
(3) Any carrier participating must understand that they will not be provided any claims data on any employer by PEIA;
(4) The plan year for the pilot will begin on July 1 of each year.
(5) Provide a benefit that when combined with a health reimbursement account is 95 percent actuarially equivalent to the PEIA Plan B as of January 1, 2008, for the purpose of this calculation actuarially equivalent includes contributions to health reimbursement accounts in the current year.
(6) Provide the actual rates for the program.
(7) Provide reasonable data that will allow PEIA to assess the pilot.
(f) Any health carrier that agrees to the conditions set forth in (e) shall be allowed to participate in the pilot by PEIA providing they are on good standing with the offices of the insurance commissioner. All responses must be due within 15 days from the issuance of the request for participation. Each year PEIA will issue a new request for the coming year. PEIA must certify the participating health carriers by April 15, 2008. Once PEIA certifies participating health carriers, PEIA must communicate to the eligible employers the availability of the pilot and that it is available July 1, 2008.
(g) PEIA will allow any employer that participates in the pilot for at least a year to return to the traditional PEIA coverage without penalty.
(h) Employers participating in this program will be required to provide the following:
(1) A health reimbursement arrangement for their employees;
(2) An educational program for employees on the on the new program;
(3)The governing body shall adopt a resolution approving participation in the pilot and holding PEIA harmless for any medical, pharmacy or other claims incurred during the time period of the pilot.
(4) Pay to PEIA the annual administrative fee. These funds will be used to cover PEIA's expense in administering this pilot.
(i) Employers participating in this pilot may elect to continue basic and optional life insurance under the PEIA.
(j) PEIA will submit a report to the legislature detailing the results of the pilot by December 31, 2009, and annually thereafter. Participating health carriers and employers shall provide claims aggregated claims data and other reasonable information that will assist the agency.
(k) This pilot shall expire in three years unless the director of the PEIA extends it for an additional three years.

Note: The purpose of the bill is to establish a healthcare reimbursement account program for local government employees

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.

§33-16-15a is new; therefore, strike-throughs and underscoring have been omitted.
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