GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2017
SESSION LAW 2017-135
HOUSE BILL 299
AN ACT to make clarifying and administrative changes to the laws relating to the North Carolina state health plan for teachers and state employees.
The General Assembly of North Carolina enacts:
SECTION 1. G.S. 135‑48.44(a) reads as rewritten:
"§ 135‑48.44. Cessation of coverage.
(a) Coverage under this Plan of an employee and his or her surviving spouse or eligible dependent children or of a retired employee and his or her surviving spouse or eligible dependent children shall cease on the earliest of the following dates:
…
(6) The last day of the month in which a covered individual is found to have knowingly and willfully made or caused to be made a false statement or false representation of a material fact regarding eligibility or enrollment information or in a claim for reimbursement of medical services under the Plan. The State Treasurer may make an exception to the provisions of this subdivision when persons subject to this subdivision have had a cessation of coverage for a period of five years and have made a full and complete restitution to the Plan for all fraudulent claim amounts. Nothing in this subdivision shall be construed to obligate the State Treasurer to make an exception as allowed for under this subdivision.
…."
SECTION 2. G.S. 135‑48.40(c)(2) reads as rewritten:
"(2) Employees and members
of the General Assembly with 10 but less than 20 years of retirement service
credit provided the employees were first hired on or after October 1, 2006, and
the members first took office on or after February 1, 2007. For such future
retirees, the State shall pay fifty percent (50%) of the Plan's total employer
premiums. Individual retirees shall pay the balance of the total premiums not
paid by the State.State, unless prohibited by law. The total premium
is the sum of the Plan's total employer premium contribution rate plus the
employee or retiree's contribution for individual and dependent coverage."
SECTION 3.(a) G.S. 135‑48.42(a) reads as rewritten:
"(a) Except as otherwise
required by applicable federal law, new employees must be given the opportunity
to enroll or decline enrollment for themselves and their dependents within 30
days from the date of employment or from first becoming eligible on a partially
contributory or other contributory basis. Coverage may become effective on the
first day of the month following date of entry on payroll or on the first day
of the following month. New employees age 19 and older not enrolling themselves
and their dependents age 19 and older within 30 days, or not adding dependents
when first eligible as provided herein may enroll during annual enrollment, but
may be subject to a 12‑month waiting period for preexisting health
conditions, except for employees who elect to change their coverage in
accordance with rules established by the State Treasurer for optional or
alternative plans available under the Plan. Children born to covered employees having
coverage type (2) or (3), as outlined in G.S. 135‑48.43(d) shall be automatically
covered at the time of birth without any waiting period for preexisting
health conditions. Children born to covered employees having coverage type (1)
shall be automatically covered at birth without any waiting period for
preexisting health conditions so long as the claims processor Plan
receives notification within 30 days of the date of birth that the
employee desires to change from coverage (1) to coverage type (2) or (3),
provided that birth and the employee pays any additional premium
required by the coverage type selected retroactive to the first day of the
month in which the child was born."
SECTION 3.(b) This section becomes effective October 1, 2017, and applies to children born to covered employees on or after that date.
SECTION 4. G.S. 135‑48.20 is amended by adding a new subsection to read:
"(n) Immunity. – Except to the extent provided under Article 31A of Chapter 143 of the General Statutes and to the extent of insurance coverage purchased pursuant to G.S. 58‑32‑15, a person serving on the Board of Trustees shall be immune individually from civil liability for monetary damages for any act, or failure to act, arising out of that service, except where any of the following apply:
(1) The person was not acting within the scope of that person's official duties.
(2) The person was not acting in good faith.
(3) The person committed gross negligence or willful or wanton misconduct that resulted in damages or injury.
(4) The person derived an improper personal financial benefit, either directly or indirectly, from the transaction.
(5) The person incurred the liability from the operation of a motor vehicle."
SECTION 5. G.S. 135‑48.1 reads as rewritten:
"§ 135‑48.1. General definitions.
As used in this Article unless the context clearly requires otherwise, the following definitions apply:
(1) Authorized representatives who are assisting the State Health Plan Division staff. – Staff of the Department of the State Treasurer, staff of the Department of Justice, or persons providing internal auditing assistance required under G.S. 143‑746(b).
(1a) Benefit period. – The period of time during which charges for covered services provided to a Plan member must be incurred in order to be eligible for payment by the Plan.
…."
SECTION 6. Part 1 of Article 3B of Chapter 135 of the General Statutes is amended by adding a new section to read:
"§ 135‑48.16. Fraud detection and audit programs.
(a) Access to Persons and Records. – In the course of conducting an investigation or an audit under G.S. 135‑48.30(a)(9), the Plan, or authorized representatives who are assisting the State Health Plan Division staff, shall have ready access to the following:
(1) Persons, books, records, reports, vouchers, correspondence, files, personnel files, investments, and any other documentation of any employing unit. The Plan shall have the authority to examine and make copies of the information described in this subdivision only insofar as it directly relates to a specific investigation or audit. The review of State tax returns shall be limited to matters of official business, and the Plan's report shall not violate the confidentiality provisions of the tax laws. A confidentiality agreement may be put in place with an agency providing documentation to the Plan.
(2) Persons, records, papers, reports, vouchers, correspondence, books, and any other documentation that is in the possession of any individual, private corporation, institution, association, board, or other organization that pertain to any benefits received, disbursed, or otherwise handled pursuant to a grant or contract from the federal government that is administered by the State Health Plan, the State, or its political subdivisions. Providers of social and medical services to a beneficiary shall make copies of records they maintain for services provided to the beneficiary.
Authorized representatives who are assisting the State Health Plan Division staff must have a HIPAA business associate agreement with the State Health Plan and enter into a HIPAA data sharing agreement with any vendor whose records they are copying.
(b) Records of Providers of Social and Medical Services. – Providers of social and medical services who provide ready access to the Plan under subdivision (2) of subsection (a) of this section shall make copies of records they maintain for services provided to a beneficiary available to the Plan or to the authorized representatives who are assisting the State Health Plan Division staff. The Plan, or authorized representatives who are assisting the State Health Plan Division staff, shall request records in writing by providing the name of each beneficiary from whom records are sought, the purpose of the request, the authority for the request, and a reasonable period of time for the production of record copies by the provider. A provider may charge and the Plan, or authorized representatives who are assisting the State Health Plan Division staff, shall, in accordance with G.S. 90‑411, pay a reasonable fee to the provider for copies of the records provided.
(c) Fraud Detection and Audit Reports and Work Papers. – The Plan shall maintain for 10 years a complete file of all compliance investigative reports, fraud investigative reports, and reports of other examinations, investigations, surveys, and reviews issued under the Plan's authority under G.S. 135‑48.30(a)(9). Fraud or compliance investigation work papers and other evidence or related supportive material directly pertaining to the work of the State Health Plan Division of the Department of State Treasurer shall be retained according to an agreement between the Plan and State Archives. To promote intergovernmental cooperation and avoid unnecessary duplication of fraud investigative effort, and notwithstanding local unit personnel policies to the contrary, pertinent work papers and other supportive material relating to issued fraud or compliance investigation reports may be, at the discretion of the Executive Administrator of the Plan, and unless otherwise prohibited by law, made available for inspection by duly authorized representatives of the State and federal government who desire access to, and inspection of, such records in connection with some matter officially before them, including criminal investigations. Except as provided in this section, or upon an order issued in Wake County Superior Court upon 10 days' notice and hearing finding that access is necessary to a proper administration of justice, fraud investigation work papers and related supportive material shall be kept confidential, including any information developed as a part of the investigation."
SECTION 7.(a) G.S. 105‑259(b) is amended by adding a new subdivision to read:
"(39a) To furnish to the Department of State Treasurer periodically upon request the State tax return of a beneficiary, or the wage and income statement of a beneficiary, or the NC‑3 information of an employer for the purpose of assisting a fraud or compliance investigation or audit under G.S. 135‑48.30(a)(9), or in accordance with G.S. 135‑48.16; provided, however, that no federal tax information may be disclosed under this subdivision unless such a disclosure is permitted by section 6103 of the Code."
SECTION 7.(b) The Department of Revenue and the Department of the State Treasurer shall, within a reasonable time following the effective date of this act but not later than June 30, 2018, enter into a confidential information sharing agreement settling data transfer protocols, required security measures, audit mechanisms, and the like, so that the two departments can thereafter develop and implement the information exchange authorized by this act.
SECTION 8. G.S. 135‑48.41 is amended by adding a new subsection to read:
"(k) If a retiree is a prisoner serving an active sentence in the State prison system and covered under G.S. 148‑19, then the incarcerated retiree shall not, during the time of incarceration, be eligible for retiree coverage under G.S. 135‑48.40(a)(1), 135‑48.40(b)(3), 135‑48.40(c)(2), or 135‑48.40(d)(11)."
SECTION 9.(a) G.S. 135‑9 reads as rewritten:
"§ 135‑9. Exemption from garnishment, attachment, etc.
Except for the applications of the
provisions of G.S. 110‑136, and G.S. 110‑136.3 et seq.,
and in connection with a court‑ordered equitable distribution under
G.S. 50‑20, the right of a person to a pension, or annuity, or a
retirement allowance, to the return of contributions, the pension, annuity or
retirement allowance itself, any optional benefit or any other right accrued or
accruing to any person under the provisions of this Chapter, and the moneys in
the various funds created by this Chapter, are exempt from levy and sale,
garnishment, attachment, or any other process whatsoever, and shall be
unassignable except as in this Chapter specifically otherwise provided.
Application for System approval of a domestic relations order dividing a
person's interest under the Retirement System shall be accompanied by an order
consistent with the system‑designed template order provided on the System's
Web site. For orders entered on or after January 1, 2015, payment to a member's
former spouse pursuant to any such domestic relations order shall be limited to
the lifetime of that former spouse and, upon the death of that former spouse,
the former spouse's share shall revert to the member. Notwithstanding any
provisions to the contrary, any overpayment of benefits or erroneous
payments to a member in a State‑administered retirement system or the
former Disability Salary Continuation Plan or the Disability Income Plan of
North Carolina, including any benefits paid to, or State Health Plan premiums or
claims paid on behalf of, any member or beneficiary who is later determined
to have been ineligible for those benefits, benefits or unentitled to
those amounts, may be offset against any retirement allowance, return of
contributions or any other right accruing under this Chapter to the same
person, the person's estate, or designated beneficiary."
SECTION 9.(b) G.S. 128‑31 reads as rewritten:
"§ 128‑31. Exemptions from execution.
Except for the applications of the
provisions of G.S. 110‑136, and G.S. 110‑136.3 et seq.,
and in connection with a court‑ordered equitable distribution under
G.S. 50‑20, the right of a person to a pension, an annuity, or a
retirement allowance, to the return of contributions, the pension, annuity or
retirement allowance itself, any optional benefit or any other right accrued or
accruing to any person under the provisions of this Article, and the moneys in
the various funds created by this Article, are exempt from levy and sale,
garnishment, attachment, or any other process whatsoever, and shall be
unassignable except as in this Article specifically otherwise provided.
Application for System approval of a domestic relations order dividing a
person's interest under the Retirement System shall be accompanied by an order
consistent with the system‑designed template order provided on the
System's Web site. For orders entered on or after January 1, 2015, payment to a
member's former spouse pursuant to any such domestic relations order shall be
limited to the lifetime of that former spouse and, upon the death of that
former spouse, the former spouse's share shall revert to the member.
Notwithstanding any provisions to the contrary, any overpayment of benefits
or erroneous payments to a member in a State‑administered retirement
system, the Disability Salary Continuation Plan, or the Disability Income Plan
of North Carolina, including any benefits paid to, or State Health Plan
premiums or claims paid on behalf of, any member who is later determined
to have been ineligible for those benefits, benefits or unentitled to
those amounts, may be offset against any retirement allowance, return of
contributions or any other right accruing under this Chapter to the same
person, the person's estate, or designated beneficiary."
SECTION 9.(c) G.S. 120‑4.29 reads as rewritten:
"§ 120‑4.29. Exemption from garnishment, attachment.
Except for the applications of the
provisions of G. S. 110‑136, and in connection with a court‑ordered
equitable distribution under G.S. 50‑20, the right of a person to a
pension, annuity, or retirement allowance, to the return of contributions, or
to the receipt of the pension, annuity or retirement allowance itself, any
optional benefit or any other right accrued or accruing to any person under the
provisions of this Article, and the moneys in the various funds created by this
Article, are exempt from levy and sale, garnishment, attachment, or any other
process whatsoever, and shall be unassignable except as this Article
specifically provides. Notwithstanding any provisions to the contrary, any
overpayment of benefits to a member in a State‑administered retirement
system or Disability Salary Continuation Plan may be offset against any
retirement allowance, return of contributions or any other right accruing under
this Chapter to the same person, the person's estate, or designated
beneficiary.Notwithstanding any provisions to the contrary, any overpayment
of benefits or erroneous payments to a member in a State‑administered
retirement system, the Disability Salary Continuation Plan, or the Disability
Income Plan of North Carolina, including any benefits paid to, or State Health
Plan premiums or claims paid on behalf of, any member who is later determined
to have been ineligible for those benefits or unentitled to those amounts, may
be offset against any retirement allowance, return of contributions, or any
other right accruing under this Article to the same person, the person's estate,
or designated beneficiary."
SECTION 9.(d) G.S. 127A‑40 is amended by adding a new subsection to read:
"(j) Except for the applications of the provisions of G.S. 110‑136, and in connection with a court‑ordered equitable distribution under G.S. 50‑20, the pensions provided are not subject to attachment, garnishments, or judgments against the member or former member of the National Guard entitled to them, nor are any rights in the fund or the pensions or benefits assignable. Notwithstanding any provisions to the contrary, any overpayment of benefits or erroneous payment to a member in a State‑administered retirement system, the Disability Salary Continuation Plan, or the Disability Income Plan of North Carolina, including any benefits paid to, or State Health Plan premiums or claims paid on behalf of, any member who is later determined to have been ineligible for those benefits or unentitled to those amounts, may be offset against any retirement allowance, return of contributions, or any other right accruing under this Article to the same person, the person's estate, or designated beneficiary."
SECTION 10. Except as otherwise provided, this act is effective when it becomes law.
In the General Assembly read three times and ratified this the 28th day of June, 2017.
s/ Daniel J. Forest
President of the Senate
s/ David R. Lewis
Presiding Officer of the House of Representatives
s/ Roy Cooper
Governor
Approved 4:11 p.m. this 20th day of July, 2017