February Session, 2014
LCO No. 3756
SEN. FASANO, 34th Dist.
"AN ACT CONCERNING THE DUTIES OF THE CONNECTICUT HEALTH INSURANCE EXCHANGE. "
In line 186, after "exchange." insert the following: "Participation in such negotiations shall be voluntary."
After the last section, add the following and renumber sections and internal references accordingly:
"Sec. 501. Subsection (b) of section 38a-1086 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(b) The exchange shall not refuse to certify a health benefit plan as a qualified health plan:
(1) On the basis that (A) the plan is a fee-for-service plan, or (B) the health benefit plan provides treatments necessary to prevent patients' deaths in circumstances the exchange determines are inappropriate or too costly; or
(2) By conditioning such certification on the imposition of premium price controls by the exchange or on a health carrier's participation in premium negotiations under subsection (b) of section 38a-1084, as amended by this act.
Sec. 502. Subsection (c) of section 38a-1083 of the 2014 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(c) The exchange is authorized and empowered to:
(1) Have perpetual successions as a body politic and corporate and to adopt bylaws for the regulation of its affairs and the conduct of its business;
(2) Adopt an official seal and alter the same at pleasure;
(3) Maintain an office in the state at such place or places as it may designate;
(4) Employ such assistants, agents, managers and other employees as may be necessary or desirable;
(5) Acquire, lease, purchase, own, manage, hold and dispose of real and personal property, and lease, convey or deal in or enter into agreements with respect to such property on any terms necessary or incidental to the carrying out of these purposes, provided all such acquisitions of real property for the exchange's own use with amounts appropriated by this state to the exchange or with the proceeds of bonds supported by the full faith and credit of this state shall be subject to the approval of the Secretary of the Office of Policy and Management and the provisions of section 4b-23;
(6) Receive and accept, from any source, aid or contributions, including money, property, labor and other things of value;
(7) Charge assessments or user fees to health carriers that are capable of offering a qualified health plan through the exchange or otherwise generate funding necessary to support the operations of the exchange and impose interest and penalties on such health carriers for delinquent payments of such assessments or fees;
(8) Procure insurance against loss in connection with its property and other assets in such amounts and from such insurers as it deems desirable;
(9) Invest any funds not needed for immediate use or disbursement in obligations issued or guaranteed by the United States of America or the state and in obligations that are legal investments for savings banks in the state;
(10) Issue bonds, bond anticipation notes and other obligations of the exchange for any of its corporate purposes, and to fund or refund the same and provide for the rights of the holders thereof, and to secure the same by pledge of revenues, notes and mortgages of others;
(11) Borrow money for the purpose of obtaining working capital;
(12) Account for and audit funds of the exchange and any recipients of funds from the exchange;
(13) Make and enter into any contract or agreement necessary or incidental to the performance of its duties and execution of its powers. The contracts entered into by the exchange shall not be subject to the approval of any other state department, office or agency, provided copies of all contracts of the exchange shall be maintained by the exchange as public records, subject to the proprietary rights of any party to the contract;
(14) To the extent permitted under its contract with other persons, consent to any termination, modification, forgiveness or other change of any term of any contractual right, payment, royalty, contract or agreement of any kind to which the exchange is a party;
(15) Award grants to trained and certified individuals and institutions that will assist individuals, families and small employers and their employees in enrolling in appropriate coverage through the exchange. Applications for grants from the exchange shall be made on a form prescribed by the board;
(16) Limit the number of plans offered, and use selective criteria in determining which plans to offer, through the exchange, provided (A) individuals and employers have an adequate number and selection of choices, and (B) a health carrier's participation or lack thereof in premium negotiations under subsection (b) of section 38a-1084, as amended by this act, shall not be considered as a factor for purposes of this subdivision;
(17) Evaluate jointly with the SustiNet Health Care Cabinet the feasibility of implementing a basic health program option as set forth in Section 1331 of the Affordable Care Act;
(18) Sue and be sued, plead and be impleaded;
(19) Adopt regular procedures that are not in conflict with other provisions of the general statutes, for exercising the power of the exchange; and
(20) Do all acts and things necessary and convenient to carry out the purposes of the exchange, provided such acts or things shall not conflict with the provisions of the Affordable Care Act, regulations adopted thereunder or federal guidance issued pursuant to the Affordable Care Act. "
This act shall take effect as follows and shall amend the following sections: