Report Title:

Health Fund; Benefit Plans

 

Description:

Establishes a public-private partnership that allows the Health Fund to share in the cost of a single health benefit plan for those public employees who have dual health plan coverage with a private sector employer and a public employer. (HD1)

 

HOUSE OF REPRESENTATIVES

H.B. NO.

642

TWENTY-FIRST LEGISLATURE, 2001

H.D. 1

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO THE HAWAII PUBLIC EMPLOYEES HEALTH FUND.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The Hawaii public employees health fund estimates that approximately seventeen per cent of the public employees enrolled in the health fund's medical services plan, or 2,340 individuals, have dual medical coverage provided by a private employer under the public employee's spouse's prepaid health care plan. The number of public employees having dual medical coverage through an employee organization plan is not known. However, if seventeen per cent of the health fund population is used to interpolate the number of public employees in the employee organization health benefit plans who have dual coverage, it is estimated that an additional 7,337 public employees have dual medical plan coverage through employee organizations.

The legislature finds that the cost of providing health benefit coverage is escalating and that it is not economical or in the best interest of the State and other public employers to have the Health Fund pay full premium for excess coverage.

SECTION 2. Section 87-1, of the Hawaii Revised Statutes, is amended to read as follows:

"§87-1 Definitions. As used in this chapter:

[(1)] "Board" means the board of trustees as described in section 87-11;

[(2)] "Carrier" means a voluntary association, corporation, partnership, or organization engaged in providing, paying for, arranging for, or reimbursing the cost of health or long-term care services under group insurance contracts or medical, hospital, or dental services agreements;

[(3)] "Contributions" means money payments made to the fund by the State or the several counties or an employee-beneficiary or qualified-beneficiary;

[(4)] "Dependent-beneficiary" means an employee-beneficiary's spouse and any unmarried child, including an adopted child, stepchild, foster child, or recognized natural child who lives with the employee-beneficiary, deemed eligible by the board to receive health or dental services of a health benefits plan;

[(5)] "Employee" means an employee or officer of the state or county government or the legislature,

[(A)] (1) Including:

[(i)] (A) An elective officer or a person who has served as a member of the legislature for at least ten years;

[(ii)] (B) A per diem employee;

[(iii)] (C) An officer or employee under an authorized leave of absence;

[(iv)] (D) An employee of the Hawaii national guard although paid from federal funds;

[(v)] (E) A retired member of the employees' retirement system, the county pension system, or the police, firefighters, or bandsmen pension system of the State or county;

[(vi)] (F) A salaried and full-time member of a board, commission, or agency appointed by the governor or the mayor of a county; and

[(vii)] (G) A person employed by contract for a period not exceeding one year, where the director of human resources development, personnel services, or civil service has certified that the service is essential or needed in the public interest and that, because of circumstances surrounding its fulfillment, personnel to perform the service cannot be obtained through normal civil service recruitment procedures,

[(B)] (2) But excluding:

[(i)] (A) A designated beneficiary of a retired member of the employees' retirement system, the county pension system, or the police, firefighters, or bandsmen pension system of the State or county;

[(ii)] (B) Except as allowed under [[]paragraph[] (5)(A)(vii),] (1)(G), a person employed temporarily on a fee or contract basis; and

[(iii)] (C) A person employed for less than three months and whose employment is less than one-half of a full-time equivalent position.

[(6)] "Employee-beneficiary" means an employee, the beneficiary of an employee who is killed in the performance of the employee's duty, an employee who retired prior to the establishment of the fund, or the beneficiary of a retired member of the employees' retirement system, a county pension system, or a police, firefighters, or bandsmen pension system of the State or county, upon the death of the retired member and, which beneficiary, if a child, does not marry, or if a surviving spouse, does not remarry; provided that for the purposes of this paragraph, "family member" means the deceased retired member's or employee's spouse and unmarried child under the age of nineteen years (including a legally adopted child and a stepchild or recognized natural child who lives with the deceased retired member or employee in a regular parent-child relationship), or any unmarried child regardless of age who is incapable of self-support because of a mental or physical incapacity which existed prior to the unmarried child's reaching the age of nineteen years; and provided further that the employee, the employee's beneficiary, or the beneficiary of the deceased retired member is deemed eligible by the board to receive health or dental services of a health benefits plan or a long-term care benefits plan; provided, however, that the board may not deem eligible for a health benefits plan the employee, the employee's beneficiary or the beneficiary of the deceased retired member who receives any health benefit coverage under a prepaid health care plan described in chapter 393;

[(7)] "Fund" means the trust fund described in section

87-2;

[(8)] "Health benefits plan" means (A) a group insurance contract or medical, hospital, surgical, prescribed drugs, vision, or dental service agreement in which a carrier agrees to provide, pay for, arrange for, or reimburse the cost of medical, hospital, surgical, prescribed drugs, vision, or dental services as determined by the board; or (B) a similar schedule of benefits established by the board and provided through the fund on a self-insured basis;

[(9)] "Long-term care benefits plan" means (A) a group insurance contract or service agreement in which a carrier agrees to provide, pay for, arrange for, or reimburse the cost of long-term care benefits as determined by the board, or (B) a similar schedule of benefits established by the board and provided through the fund on a self-insured basis;

[(10)] "Periodic charge" means the periodic payment by the board to a carrier for any health benefits, or long-term care benefits plan;

[(11)] "Qualified-beneficiary" means, for purposes of the long-term care benefits plan, a former employee or an employee who is not eligible for benefits due to a reduction in work hours including the employee's spouse or a divorced spouse of an employee or retiree provided the person was enrolled in the plan prior to loss of benefits; and

[(12)] "Trustee" means a trustee of the board of trustees as described in section 87-11."

SECTION 3. Section 87-4, of the Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) The State through the department of budget and finance and the several counties through their respective departments of finance shall pay to the fund a monthly contribution equal to the amount established under chapter 89C or specified in the applicable public sector collective bargaining agreement, whichever is appropriate, for each of their respective employee-beneficiaries and employee-beneficiaries with dependent-beneficiaries, which shall be used toward the payment of costs of a health benefits plan; provided that the monthly contribution shall not exceed the actual cost of a health benefits plan[.]; provided, however, that if a dependent-beneficiary and an employee-beneficiary are covered by a prepaid health care plan as described in chapter 393, and the dependent beneficiary and the employee-beneficiary are also enrolled in a health benefits plan sponsored by the public employees health fund or similar plan sponsored by an employee organization for at least three months, the State and the county shall make or receive a contribution from an employer covered by chapter 393, to the public employees health fund as follows:

(1) Reimburse the employer of the dependent-beneficiary the sum of $ for enrolling the employee into the employer's dependent beneficiary plan, provided further the employee shall not be eligible for re-enrollment under this section except as provided by law.

(2) If the dependent-beneficiary waives all required health care benefits pursuant to section 393-21, the director of labor and industrial relations may approve such waivers if the dependent-beneficiary is provided health care coverage under the public employees health fund and the employer makes the full required contribution under chapter 393, to the health fund plan. If both husband and wife are employee-beneficiaries, the total contribution by the State or the appropriate county shall not exceed the monthly contribution of a family plan for both of them. If, however, the State or any of the several counties establish cafeteria plans in accordance with section 125 of the Internal Revenue Code of 1986, as amended, and part II of chapter 78, the monthly contribution to the fund for those employee-beneficiaries who participate in a cafeteria plan shall be made through the cafeteria plan. In this event, the payments made by the State or the counties shall include the State's and the counties' respective contributions to the fund and the employee-beneficiary's share of the cost of the health benefits plan selected and authorized by the employee-beneficiary through the cafeteria plan."

SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 5. This Act shall take effect July 1, 2020.