Introduced Version
HOUSE BILL No. 1896
_____
DIGEST OF INTRODUCED BILL
Citations Affected:
IC 5-10-8.
Synopsis: Benefits for part-time state employees. Extends
participation in state provided group health insurance programs to state
employees who hold part-time appointments, as defined by the state
personnel department, to either merit or nonmerit positions.
Effective: July 1, 2001.
Day
January 17, 2001, read first time and referred to Committee on Ways and Means.
Introduced
First Regular Session 112th General Assembly (2001)
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HOUSE BILL No. 1896
A BILL FOR AN ACT to amend the Indiana Code concerning state
offices and administration.
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 5-10-8-1; (01)IN1896.1.1. -->
SECTION 1.
IC 5-10-8-1
, AS AMENDED BY P.L.50-2000,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 1. The following definitions apply in this chapter:
(1) "Employee" means:
(A) an elected or appointed officer or official, or a full-time
employee;
(B) if the individual is employed by a school corporation, a
full-time or part-time employee;
(C) for a local unit public employer, a full-time or part-time
employee or a person who provides personal services to the
unit under contract during the contract period;
or
(D) a senior judge appointed under
IC 33-2-1-8
;
or
(E) for an individual employed by the state, a full-time
employee, or, as used in section 7 of this chapter only for
purposes of providing a group health insurance plan, an
employee who holds a part-time appointment, as defined
by the state personnel department, to either a merit or
nonmerit position;
whose services have continued without interruption at least thirty
(30) days.
(2) "Group insurance" means any of the kinds of insurance
fulfilling the definitions and requirements of group insurance
contained in IC 27-1.
(3) "Insurance" means insurance upon or in relation to human life
in all its forms, including life insurance, health insurance,
disability insurance, accident insurance, hospitalization insurance,
surgery insurance, medical insurance, and supplemental medical
insurance.
(4) "Local unit" includes a city, town, county, township, public
library, or school corporation.
(5) "New traditional plan" means a self-insurance program
established under section 7(b) 7(c) of this chapter to provide
health care coverage.
(6) "Public employer" means the state or a local unit, including
any board, commission, department, division, authority,
institution, establishment, facility, or governmental unit under the
supervision of either, having a payroll in relation to persons it
immediately employs, even if it is not a separate taxing unit.
(7) "Public employer" does not include a state educational
institution (as defined under
IC 20-12-0.5-1
).
(8) "Retired employee" means:
(A) in the case of a public employer that participates in the
public employees' retirement fund, a former employee who
qualifies for a benefit under
IC 5-10.3-8
;
(B) in the case of a public employer that participates in the
teachers' retirement fund under IC 21-6.1, a former employee
who qualifies for a benefit under
IC 21-6.1-5
; and
(C) in the case of any other public employer, a former
employee who meets the requirements established by the
public employer for participation in a group insurance plan for
retired employees.
(9) "Retirement date" means the date that the employee has
chosen to receive retirement benefits from the employees'
retirement fund.
SOURCE: IC 5-10-8-3.1; (01)IN1896.1.2. -->
SECTION 2.
IC 5-10-8-3.1
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2001]: Sec. 3.1. (a) A public
employer that contracts for a group insurance plan or establishes a
self-insurance plan for its employees may withhold or cause to be
withheld from participating employees' salaries or wages whatever part
of the cost of the plan the employees are required to pay. The chief
fiscal officer responsible for issuing paychecks or warrants to the
employees shall make deductions from the individual employees'
paychecks or warrants to pay the premiums for the insurance. Except
as provided by section 7(d) 7(e) of this chapter, the fiscal officer shall
require written authorization from state employees, and may require
written authorization from local employees, to make the deductions.
One (1) authorization signed by an employee is sufficient authorization
for the fiscal officer to continue to make deductions for this purpose
until revoked in writing by the employee.
(b) A public employer that contracts for a group insurance plan or
establishes a self-insurance plan for its retired employees may require
that the retired employees pay any part of the cost of the plan that is not
paid by the public employer. A retired employee may assign part or all
of the retired employee's benefit payable under
IC 5-10.3-8
,
IC 21-6.1-5
, or any other retirement program for this required payment.
SOURCE: IC 5-10-8-7; (01)IN1896.1.3. -->
SECTION 3.
IC 5-10-8-7
IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2001]: Sec. 7. (a) For purposes of providing
a group health insurance plan under this section, "employee"
includes an employee who holds a part-time appointment, as
defined by the state personnel department, to either a merit or
nonmerit position.
( b) The state, excluding state educational institutions (as defined by
IC 20-12-0.5-1
), may not purchase or maintain a policy of group
insurance, except life insurance or long term care insurance under a
long term care insurance policy (as defined in
IC 27-8-12-5
), for its
employees.
(b) (c) With the consent of the governor, the state personnel
department may establish self-insurance programs to provide group
insurance other than life or long term care insurance for state
employees and retired state employees. The state personnel department
may contract with a private agency, business firm, limited liability
company, or corporation for administrative services. A commission
may not be paid for the placement of the contract. The department may
require, as part of a contract for administrative services, that the
provider of the administrative services offer to an employee
terminating state employment the option to purchase, without evidence
of insurability, an individual policy of insurance.
(c) (d) Notwithstanding subsection (a), (b), with the consent of the
governor, the state personnel department may contract for health
services for state employees through one (1) or more prepaid health
care delivery plans.
(d) (e) The state personnel department shall adopt rules under
IC 4-22-2
to establish long term and short term disability plans for state
employees (except employees who hold elected offices (as defined by
IC 3-5-2-17
)). The plans adopted under this subsection may include
any provisions the department considers necessary and proper and
must:
(1) require participation in the plan by employees with six (6)
months of continuous, full-time service;
(2) require an employee to make a contribution to the plan in the
form of a payroll deduction;
(3) require that an employee's benefits under the short term
disability plan be subject to a thirty (30) day elimination period
and that benefits under the long term plan be subject to a six (6)
month elimination period;
(4) prohibit the termination of an employee who is eligible for
benefits under the plan;
(5) provide, after a seven (7) day elimination period, eighty
percent (80%) of base biweekly wages for an employee disabled
by injuries resulting from tortious acts, as distinguished from
passive negligence, that occur within the employee's scope of
state employment;
(6) provide that an employee's benefits under the plan may be
reduced, dollar for dollar, if the employee derives income from:
(A) Social Security;
(B) the public employees' retirement fund;
(C) the Indiana state teachers' retirement fund;
(D) pension disability;
(E) worker's compensation;
(F) benefits provided from another employer's group plan; or
(G) remuneration for employment entered into after the
disability was incurred.
(The department of state revenue and the department of workforce
development shall cooperate with the state personnel department
to confirm that an employee has disclosed complete and accurate
information necessary to administer subdivision (6).)
(7) provide that an employee will not receive benefits under the
plan for a disability resulting from causes specified in the rules;
and
(8) provide that, if an employee refuses to:
(A) accept work assignments appropriate to the employee's
medical condition;
(B) submit information necessary for claim administration; or
(C) submit to examinations by designated physicians;
the employee forfeits benefits under the plan.
(e) (f) This section does not affect insurance for retirees under
IC 5-10.3 or IC 21-6.1.
(f) (g) The state may pay part of the cost of self-insurance or prepaid
health care delivery plans for its employees.
(g) (h) A state agency may not provide any insurance benefits to its
employees that are not generally available to other state employees,
unless specifically authorized by law.
(h) (i) The state may pay a part of the cost of group medical and life
coverage for its employees.
SOURCE: IC 5-10-8-7.3; (01)IN1896.1.4. -->
SECTION 4.
IC 5-10-8-7.3
, AS ADDED BY P.L.121-1999,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 7.3. (a) As used in this section, "covered
individual" means an individual who is:
(1) covered under a self-insurance program established under
section
7(b) 7(c) of this chapter to provide group health coverage;
or
(2) entitled to services under a contract with a prepaid health care
delivery plan that is entered into or renewed under section
7(c)
7(d) of this chapter.
(b) As used in this section, "early intervention services" means
services provided to a first steps child under
IC 12-17-15-3
and 20
U.S.C. 1432(4).
(c) As used in this section, "first steps child" means an infant or
toddler from birth through two (2) years of age who is enrolled in the
Indiana first steps program and is a covered individual.
(d) As used in this section, "first steps program" refers to the
program established under
IC 12-17-15
and 20 U.S.C. 1431 et seq. to
meet the needs of:
(1) children who are eligible for early intervention services; and
(2) their families.
The term includes the coordination of all available federal, state, local,
and private resources available to provide early intervention services
within Indiana.
(e) As used in this section, "health benefits plan" means a:
(1) self-insurance program established under section
7(b) 7(c) of
this chapter to provide group health coverage; or
(2) contract with a prepaid health care delivery plan that is
entered into or renewed under section
7(c) 7(d) of this chapter.
(f) A health benefits plan that provides coverage for early
intervention services shall reimburse the first steps program for
payments made by the program for early intervention services that are
covered under the health benefits plan.
(g) The reimbursement required under subsection (f) is limited to an
annual maximum benefit of three thousand five hundred dollars
($3,500) per first steps child.
(h) The reimbursement required under subsection (f) may not be
applied to any annual or aggregate lifetime limit on the first steps
child's coverage under the health benefits plan.
(i) The first steps program may pay required deductibles,
copayments, or other out-of-pocket expenses for a first steps child
directly to a provider. A health benefits plan shall apply any payments
made by the first steps program to the health benefits plan's
deductibles, copayments, or other out-of-pocket expenses according to
the terms and conditions of the health benefits plan.
SOURCE: IC 5-10-8-7.5; (01)IN1896.1.5. -->
SECTION 5.
IC 5-10-8-7.5
, AS ADDED BY P.L.170-1999,
SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 7.5. (a) As used in this section, "covered
individual" means a male individual who is:
(1) covered under a self-insurance program established under
section
7(b) 7(c) of this chapter to provide group health coverage;
or
(2) entitled to services under a contract with a health maintenance
organization (as defined in
IC 27-13-1-19
) that is entered into or
renewed under section
7(c) 7(d) of this chapter.
(b) As used in this section, "prostate specific antigen test" means a
standard blood test performed to determine the level of prostate
specific antigen in the blood.
(c) A self-insurance program established under section
7(b) 7(c) of
this chapter to provide health care coverage must provide covered
individuals with coverage for prostate specific antigen testing.
(d) A contract with a health maintenance organization that is entered
into or renewed under section
7(c) 7(d) of this chapter must provide
covered individuals with prostate specific antigen screening.
(e) The coverage required under subsections (c) and (d) must
include the following:
(1) At least one (1) prostate specific antigen test annually for a
covered individual who is at least fifty (50) years of age.
(2) At least one (1) prostate specific antigen test annually for a
covered individual who is less than fifty (50) years of age and
who is at high risk for prostate cancer according to the most
recent published guidelines of the American Cancer Society.
(f) The coverage required under this section may not be subject to
dollar limits, deductibles, copayments, or coinsurance provisions that
are less favorable to covered individuals than the dollar limits,
deductibles, copayments, or coinsurance provisions applying to
physical illness generally under the self-insurance program or contract
with a health maintenance organization.
(g) The coverage for prostate specific antigen screening shall be
provided in addition to benefits specifically provided for x-rays,
laboratory testing, or wellness examinations.
SOURCE: IC 5-10-8-7.7; (01)IN1896.1.6. -->
SECTION 6.
IC 5-10-8-7.7
, AS ADDED BY P.L.78-2000,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 7.7. (a) As used in this section, "health care plan"
means:
(1) a self-insurance program established under section 7(b) 7(c)
of this chapter to provide group health coverage; or
(2) a contract entered into under section 7(c) 7(d) of this chapter
to provide health services through a prepaid health care delivery
plan.
(b) As used in this section, "health care provider" means a:
(1) physician licensed under IC 25-22.5; or
(2) hospital licensed under IC 16-21;
that provides health care services for surgical treatment of morbid
obesity.
(c) As used in this section, "morbid obesity" means:
(1) a weight of at least two (2) times the ideal weight for frame,
age, height, and gender, as specified in the 1983 Metropolitan
Life Insurance tables;
(2) a body mass index of at least thirty-five (35) kilograms per
meter squared, with comorbidity or coexisting medical conditions
such as hypertension, cardiopulmonary conditions, sleep apnea,
or diabetes; or
(3) a body mass index of at least forty (40) kilograms per meter
squared without comorbidity.
For purposes of this subsection, body mass index is equal to weight in
kilograms divided by height in meters squared.
(d) The state shall provide coverage for nonexperimental, surgical
treatment by a health care provider of morbid obesity:
(1) that has persisted for at least five (5) years; and
(2) for which nonsurgical treatment that is supervised by a
physician has been unsuccessful for at least eighteen (18)
consecutive months.
SOURCE: IC 5-10-8-7.8; (01)IN1896.1.7. -->
SECTION 7.
IC 5-10-8-7.8
, AS ADDED BY P.L.54-2000,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 7.8. (a) As used in this section, "covered
individual" means an individual who is:
(1) covered under a self-insurance program established under
section 7(b) 7(c) of this chapter to provide group health coverage;
or
(2) entitled to services under a contract with a health maintenance
organization (as defined in
IC 27-13-1-19
) that is entered into or
renewed under section 7(c) 7(d) of this chapter.
(b) A:
(1) self-insurance program established under section 7(b) 7(c) of
this chapter to provide health care coverage; or
(2) contract with a health maintenance organization that is entered
into or renewed under section 7(c) 7(d) of this chapter;
must provide coverage for colorectal cancer examinations and
laboratory tests for cancer for any nonsymptomatic covered individual,
in accordance with the current American Cancer Society guidelines.
(c) For a covered individual who is:
(1) at least fifty (50) years of age; or
(2) less than fifty (50) years of age and at high risk for colorectal
cancer according to the most recent published guidelines of the
American Cancer Society;
the coverage required under this section must meet the requirements set
forth in subsection (d).
(d) A covered individual may not be required to pay an additional
deductible or coinsurance for the colorectal cancer examination and
laboratory testing benefit that is greater than an annual deductible or
coinsurance established for similar benefits under a self-insurance
program or contract with a health maintenance organization. If the
program or contract does not cover a similar benefit, a deductible or
coinsurance may not be set at a level that materially diminishes the
value of the colorectal cancer examination and laboratory testing
benefit required under this section.
SOURCE: IC 5-10-8-10; (01)IN1896.1.8. -->
SECTION 8.
IC 5-10-8-10
, AS ADDED BY P.L.91-1999,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 10. The state shall cover the examinations
required under
IC 16-41-17-2
under a:
(1) self-insurance program established or maintained under
section
7(b) 7(c) of this chapter to provide group health coverage;
and
(2) contract entered into or renewed under section
7(c) 7(d) of
this chapter to provide health services through a prepaid health
care delivery plan.