S865 - State Health Plan/Administrative Changes/Local Governments. (SL 2016-104)

Overview: S.L. 2016-104 makes several changes to the statutes governing the State Health Plan for Teachers and State Employees (the Plan) including:

• What information and at what frequency claims processors must provide information to the Plan.
• The purposes for which the Plan may use information obtained from claims processors.
• When information obtained by the Plan may be shared with a third party.
• Under what circumstances a claims processor, who discloses information, is exempt from civil liability.

This act also increases the number of local government employees and local government employees' dependents that may participate in the Plan from 10,000 to 16,000. The act prohibits local governments from charging employees more for their coverage than allowed under the structure set by the Plan and allows local governments to determine premiums for employees' dependents, but those premiums must not be greater than those set by the Plan. The act also sets a schedule for the increase in membership and allows local governments to withdraw from the Plan under certain circumstances.

In addition, the act clarifies when the Plan or an employer is responsible for federal filing requirements under certain sections of the Internal Revenue Code for retirees, direct bill members, and other individuals. Lastly, the act amends the definition of "health benefit plan" in the statutes governing Insurance (Chapter 58 of the General Statutes).

The provision of the act pertaining to local governments' participation in the Plan becomes effective on January 1, 2017, and applies to premiums paid on or after that date. The remainder of this act became effective July 22, 2016, and applies to contracts entered into on or after that date.