40-4704.Same; health partnership; duties.The health partnership shall develop and offer two or more healthbenefit plans to small employers. In any health benefit plan developedunder this act, any carrier may contract for coverage within the scope ofthis act notwithstanding any mandated coverages otherwise required bystate law. Except for preventative and health screening services, theprovisions of K.S.A. 40-2,100 to 40-2,105, inclusive, 40-2114and subsection (i) of 40-2209 and 40-2229 and 40-2230, and40-2,163, 40-2,164, 40-2,165 and 40-2,166, and amendments thereto, shall not bemandatory with respect to any health benefit plan developed under this act. Inperforming these duties, the health partnership shall:
(a) Develop and offer two or more lower-cost benefit plans such that:
(1) Each health benefit plan is consistent with any criteria established bythe health partnership;
(2) each health benefit plan shall be offered by all participating carriersexcept that no participating carrier shall be required to offer any healthbenefit plan, or portion thereof, which such participating carrier is notlicensed or authorized to offer in this state;
(3) no participating carrier shall offer any health benefit plan developedunder this act to any small employer unless such small employer iscovered through the health partnership.
(b) Develop and make available one or more supplemental health benefit plansor one or more other benefit options so that the total package of healthbenefits available to all children eligible for the state children'shealth insurance program established pursuant to K.S.A. 68-2001 etseq., and amendments thereto, meets, at a minimum, standardsestablished by the federal health insurance program.
(c) Offer coverage to any qualifying small employer.
(d) Offer eligible employees of participating small employers a choiceof participating carriers where feasible.
(e) (1) Include centralized and consolidated enrollment, billing andcustomer service functions;
(2) use one standard enrollment form for all participating carriers; and
(3) submit one consolidated bill to the small employer.
(f) Issue or cause to be issued a request for proposals and contract with aqualified vendor for any administrative or other service not performed by thehealth committee or provided to the health committee under subsection (b) ofK.S.A. 40-4702, and amendments thereto.
(g) Issue a request for proposals and selectively contract with carriers.
(h) Establish conditions ofparticipation for small employers that conform with K.S.A. 40-2209b etseq., and amendments thereto, and the health insurance portability andaccountability act of 1996 (Public Law 104-191).
(i) Enroll small employers and their eligible employees and dependents inhealth benefit plans developed under this act.
(j) Bill and collect premiums from participating small employersincluding any share of the premium paid by such small employer'senrolled employees.
(k) Remit funds collected under subsection (h) to the appropriate contractedcarriers.
(l) Provide that each low-or-modest wage employee shall bepermitted to enroll in such employee's choice of participating carrier whereavailable.
(m) Develop premium rating policies for small employers.
(1) In consultation with the health committee, the health partnership shallensure, to the maximum extent possible, that the combined effect of the premiumrating and subsidy policies is that subsidized eligibleemployees and the dependents of such subsidized eligibleemployees can afford coverage.
(2) Any rating policy developed under this subsection may vary with respectto subsidy status of eligible employees and thedependents of such eligible employees.
(n) Be authorized to contract for additional group vision, dental and lifeinsurance plans, and other limited insurance products.
(o) Take whatever action is necessary to assure that any eligible employeeor dependent of such eligible employee whoreceives health benefit coverage through the health partnershipand who is eligible for the state medical assistance program shall remaineligible to participate in the state health insurance premium payment program.
(p) Coordinate with the department of social and rehabilitation services toassure that any funds available for the coverage of infants and pregnant womenunder the state medical assistance program are also available for the benefitof eligible infants and pregnant women who receive health benefit coveragethrough the health partnership as an eligible employee or dependent of sucheligible employee.
(q) Work with the department of social andrehabilitation services office of medical policy and medicaid to develop asingle employee application that may be used by the health plan and themedicaidand state children's healthinsurance program to determine eligibility.
(r) Screen employee applications for subsidyeligibility and dependent children for medicaid and state children's healthinsurance program premium support eligibility.
History: L. 2000, ch. 147, § 50;L. 2002, ch. 112, § 4;L. 2004, ch. 159, § 16; July 1.
40-4704.Same; health partnership; duties.The health partnership shall develop and offer two or more healthbenefit plans to small employers. In any health benefit plan developedunder this act, any carrier may contract for coverage within the scope ofthis act notwithstanding any mandated coverages otherwise required bystate law. Except for preventative and health screening services, theprovisions of K.S.A. 40-2,100 to 40-2,105, inclusive, 40-2114and subsection (i) of 40-2209 and 40-2229 and 40-2230, and40-2,163, 40-2,164, 40-2,165 and 40-2,166, and amendments thereto, shall not bemandatory with respect to any health benefit plan developed under this act. Inperforming these duties, the health partnership shall:
(a) Develop and offer two or more lower-cost benefit plans such that:
(1) Each health benefit plan is consistent with any criteria established bythe health partnership;
(2) each health benefit plan shall be offered by all participating carriersexcept that no participating carrier shall be required to offer any healthbenefit plan, or portion thereof, which such participating carrier is notlicensed or authorized to offer in this state;
(3) no participating carrier shall offer any health benefit plan developedunder this act to any small employer unless such small employer iscovered through the health partnership.
(b) Develop and make available one or more supplemental health benefit plansor one or more other benefit options so that the total package of healthbenefits available to all children eligible for the state children'shealth insurance program established pursuant to K.S.A. 68-2001 etseq., and amendments thereto, meets, at a minimum, standardsestablished by the federal health insurance program.
(c) Offer coverage to any qualifying small employer.
(d) Offer eligible employees of participating small employers a choiceof participating carriers where feasible.
(e) (1) Include centralized and consolidated enrollment, billing andcustomer service functions;
(2) use one standard enrollment form for all participating carriers; and
(3) submit one consolidated bill to the small employer.
(f) Issue or cause to be issued a request for proposals and contract with aqualified vendor for any administrative or other service not performed by thehealth committee or provided to the health committee under subsection (b) ofK.S.A. 40-4702, and amendments thereto.
(g) Issue a request for proposals and selectively contract with carriers.
(h) Establish conditions ofparticipation for small employers that conform with K.S.A. 40-2209b etseq., and amendments thereto, and the health insurance portability andaccountability act of 1996 (Public Law 104-191).
(i) Enroll small employers and their eligible employees and dependents inhealth benefit plans developed under this act.
(j) Bill and collect premiums from participating small employersincluding any share of the premium paid by such small employer'senrolled employees.
(k) Remit funds collected under subsection (h) to the appropriate contractedcarriers.
(l) Provide that each low-or-modest wage employee shall bepermitted to enroll in such employee's choice of participating carrier whereavailable.
(m) Develop premium rating policies for small employers.
(1) In consultation with the health committee, the health partnership shallensure, to the maximum extent possible, that the combined effect of the premiumrating and subsidy policies is that subsidized eligibleemployees and the dependents of such subsidized eligibleemployees can afford coverage.
(2) Any rating policy developed under this subsection may vary with respectto subsidy status of eligible employees and thedependents of such eligible employees.
(n) Be authorized to contract for additional group vision, dental and lifeinsurance plans, and other limited insurance products.
(o) Take whatever action is necessary to assure that any eligible employeeor dependent of such eligible employee whoreceives health benefit coverage through the health partnershipand who is eligible for the state medical assistance program shall remaineligible to participate in the state health insurance premium payment program.
(p) Coordinate with the department of social and rehabilitation services toassure that any funds available for the coverage of infants and pregnant womenunder the state medical assistance program are also available for the benefitof eligible infants and pregnant women who receive health benefit coveragethrough the health partnership as an eligible employee or dependent of sucheligible employee.
(q) Work with the department of social andrehabilitation services office of medical policy and medicaid to develop asingle employee application that may be used by the health plan and themedicaidand state children's healthinsurance program to determine eligibility.
(r) Screen employee applications for subsidyeligibility and dependent children for medicaid and state children's healthinsurance program premium support eligibility.
History: L. 2000, ch. 147, § 50;L. 2002, ch. 112, § 4;L. 2004, ch. 159, § 16; July 1.
40-4704.Same; health partnership; duties.The health partnership shall develop and offer two or more healthbenefit plans to small employers. In any health benefit plan developedunder this act, any carrier may contract for coverage within the scope ofthis act notwithstanding any mandated coverages otherwise required bystate law. Except for preventative and health screening services, theprovisions of K.S.A. 40-2,100 to 40-2,105, inclusive, 40-2114and subsection (i) of 40-2209 and 40-2229 and 40-2230, and40-2,163, 40-2,164, 40-2,165 and 40-2,166, and amendments thereto, shall not bemandatory with respect to any health benefit plan developed under this act. Inperforming these duties, the health partnership shall:
(a) Develop and offer two or more lower-cost benefit plans such that:
(1) Each health benefit plan is consistent with any criteria established bythe health partnership;
(2) each health benefit plan shall be offered by all participating carriersexcept that no participating carrier shall be required to offer any healthbenefit plan, or portion thereof, which such participating carrier is notlicensed or authorized to offer in this state;
(3) no participating carrier shall offer any health benefit plan developedunder this act to any small employer unless such small employer iscovered through the health partnership.
(b) Develop and make available one or more supplemental health benefit plansor one or more other benefit options so that the total package of healthbenefits available to all children eligible for the state children'shealth insurance program established pursuant to K.S.A. 68-2001 etseq., and amendments thereto, meets, at a minimum, standardsestablished by the federal health insurance program.
(c) Offer coverage to any qualifying small employer.
(d) Offer eligible employees of participating small employers a choiceof participating carriers where feasible.
(e) (1) Include centralized and consolidated enrollment, billing andcustomer service functions;
(2) use one standard enrollment form for all participating carriers; and
(3) submit one consolidated bill to the small employer.
(f) Issue or cause to be issued a request for proposals and contract with aqualified vendor for any administrative or other service not performed by thehealth committee or provided to the health committee under subsection (b) ofK.S.A. 40-4702, and amendments thereto.
(g) Issue a request for proposals and selectively contract with carriers.
(h) Establish conditions ofparticipation for small employers that conform with K.S.A. 40-2209b etseq., and amendments thereto, and the health insurance portability andaccountability act of 1996 (Public Law 104-191).
(i) Enroll small employers and their eligible employees and dependents inhealth benefit plans developed under this act.
(j) Bill and collect premiums from participating small employersincluding any share of the premium paid by such small employer'senrolled employees.
(k) Remit funds collected under subsection (h) to the appropriate contractedcarriers.
(l) Provide that each low-or-modest wage employee shall bepermitted to enroll in such employee's choice of participating carrier whereavailable.
(m) Develop premium rating policies for small employers.
(1) In consultation with the health committee, the health partnership shallensure, to the maximum extent possible, that the combined effect of the premiumrating and subsidy policies is that subsidized eligibleemployees and the dependents of such subsidized eligibleemployees can afford coverage.
(2) Any rating policy developed under this subsection may vary with respectto subsidy status of eligible employees and thedependents of such eligible employees.
(n) Be authorized to contract for additional group vision, dental and lifeinsurance plans, and other limited insurance products.
(o) Take whatever action is necessary to assure that any eligible employeeor dependent of such eligible employee whoreceives health benefit coverage through the health partnershipand who is eligible for the state medical assistance program shall remaineligible to participate in the state health insurance premium payment program.
(p) Coordinate with the department of social and rehabilitation services toassure that any funds available for the coverage of infants and pregnant womenunder the state medical assistance program are also available for the benefitof eligible infants and pregnant women who receive health benefit coveragethrough the health partnership as an eligible employee or dependent of sucheligible employee.
(q) Work with the department of social andrehabilitation services office of medical policy and medicaid to develop asingle employee application that may be used by the health plan and themedicaidand state children's healthinsurance program to determine eligibility.
(r) Screen employee applications for subsidyeligibility and dependent children for medicaid and state children's healthinsurance program premium support eligibility.
History: L. 2000, ch. 147, § 50;L. 2002, ch. 112, § 4;L. 2004, ch. 159, § 16; July 1.
