S.F. 2262 PART 5 1 IOWA HEALTH CARE COVERAGE PARTNERSHIP PROGRAM 2 Section 1. NEW SECTION . 8A.471 Definitions. 3 As used in this part, unless the context otherwise requires: 4 1. “Nonprofit employer” means a nonprofit corporation that 5 is either of the following and does not include a nonstate 6 public employer: 7 a. A corporation subject to chapter 504. 8 b. A corporation which qualifies under 26 U.S.C. § 9 501(c)(3). 10 2. “Nonstate public employee” means any employee or elected 11 official of a nonstate public employer. 12 3. “Nonstate public employer” means a political subdivision 13 of this state, including a quasi-public agency. 14 4. “Political subdivision of the state” means a political 15 subdivision of the state or its offices or units, including but 16 not limited to a county, city, community college, or school 17 district. 18 5. “State health or medical group insurance plan” or “state 19 plan” means a health or medical group insurance plan for 20 employees of the state. 21 Sec. 2. NEW SECTION . 8A.472 Eligibility. 22 1. Nonstate public employees and employees of a nonprofit 23 employer shall be considered state employees for purposes of 24 eligibility to obtain employee health or medical insurance from 25 a state health or medical group insurance plan as provided to 26 state employees by the department of administrative services 27 through the Iowa health care coverage partnership program. 28 2. A nonstate public employer or nonprofit employer is 29 not eligible to participate in a state health or medical 30 group insurance plan through the Iowa health care coverage 31 partnership program unless all employees and elected officials 32 of the nonstate public employer or all employees of the 33 nonprofit employer elect to enroll in the state plan pursuant 34 to the program. 35 -1- LSB 5253SV (1) 84 av/rj 1/ 9

S.F. 2262 3. If a nonstate public employer or nonprofit employer 1 elects to participate in a state health or medical group 2 insurance plan through the Iowa health care coverage 3 partnership program, the nonstate public employer or nonprofit 4 employer shall pay the costs of participation in the plan as 5 provided in this part 5. 6 4. An employee or elected official of a nonstate public 7 employer, or an employee of a nonprofit employer shall not 8 be enrolled in the state plan through the Iowa health care 9 coverage partnership program if such employee is covered 10 through the employee’s employer by health insurance plans or 11 insurance arrangements issued to or in accordance with a trust 12 established pursuant to collective bargaining subject to the 13 federal Labor Management Relations Act. 14 Sec. 3. NEW SECTION . 8A.473 Iowa health care coverage 15 partnership program —— coverage offered. 16 1. The Iowa health care coverage partnership program is 17 established in the department. Pursuant to the program, the 18 department shall offer coverage under the state health or 19 medical group insurance plan to nonstate public employees 20 and employees of nonprofit employers and shall pool such 21 employees with the state plan, provided the department received 22 an application from an employer of such employees and the 23 application is approved in accordance with the provisions 24 of this part 5. Employees and elected officials of such 25 employers shall be covered under the state plan pursuant to the 26 Iowa health care coverage partnership program under the same 27 conditions that state employees are covered under the state 28 plan and shall not be denied coverage on the basis of risk, 29 cost, preexisting conditions, or other factors not applicable 30 to state employees. 31 a. Premium payments for such coverage shall be remitted 32 by the nonstate public employer or nonprofit employer to the 33 department and shall be the same as those paid by the state 34 inclusive of any premiums paid by state employees, except as 35 -2- LSB 5253SV (1) 84 av/rj 2/ 9

S.F. 2262 otherwise provided in this part 5. 1 b. The department shall offer participation in the state 2 plan pursuant to the Iowa health care coverage partnership 3 program for no shorter than three-year intervals, and at 4 the end of any such interval, a nonstate public employer or 5 nonprofit employer may apply for coverage for an additional 6 interval. 7 c. The department, by rule, shall develop procedures 8 by which nonstate public employers and nonprofit employers 9 obtaining coverage for their employees pursuant to the Iowa 10 health care coverage partnership program may withdraw from such 11 coverage. Any such procedures shall provide that nonstate 12 public employees covered by collective bargaining shall 13 withdraw from such coverage in accordance with the provisions 14 of their collective bargaining agreements and applicable 15 statutes. 16 2. The department is not required to offer coverage to every 17 nonstate public employer or nonprofit employer seeking coverage 18 pursuant to the Iowa health care coverage partnership program 19 from every vendor providing coverage under the state plan. 20 3. The department may procure coverage to be offered 21 pursuant to the Iowa health care coverage partnership program 22 to nonstate public employees and employees of nonprofit 23 employers from vendors other than those providing coverage to 24 state employees and may offer insurance plans different from 25 those available to state employees. 26 4. The department shall develop and procure coverage 27 to be offered pursuant to the Iowa health care coverage 28 partnership program that meets minimum standards of quality and 29 affordability. 30 5. The department shall implement and administer the Iowa 31 health care coverage partnership program including but not 32 limited to creating applications and application procedures, 33 enrollment periods and procedures, and procedures for 34 withdrawal from the program. 35 -3- LSB 5253SV (1) 84 av/rj 3/ 9

S.F. 2262 6. Notwithstanding any other provision of state or 1 federal law, the state plan or the Iowa health care coverage 2 partnership program shall not be deemed an unauthorized insurer 3 or a multiple employer welfare arrangement. Any licensed 4 insurer in this state is eligible to conduct business with 5 the state plan and the Iowa health care coverage partnership 6 program. 7 Sec. 4. NEW SECTION . 8A.474 Nonstate public employees —— 8 coverage. 9 1. Nonstate public employees and elected officials may 10 obtain coverage under the state plan pursuant to the Iowa 11 health care coverage partnership program in accordance with 12 this section. 13 2. A nonstate public employer may submit an application 14 to the department for coverage under the state plan of all of 15 such employer’s employees and elected officials. If a nonstate 16 public employer submits such an application for coverage, the 17 department shall provide such coverage no later than the first 18 day of the third calendar month following such application. 19 3. Notwithstanding any other provisions of state law, 20 initial participation in the state plan shall be a permissive 21 subject of collective bargaining and shall be subject to 22 binding arbitration only if the employee organization and 23 the nonstate public employer mutually agree to bargain over 24 such initial participation. Such mutual agreement shall be 25 in writing and signed by the authorized representatives of 26 the employee organization and the nonstate public employer. 27 Continuation in the state plan, after initial participation, 28 shall be a mandatory subject of bargaining, and shall be 29 subject to binding arbitration in accordance with the same 30 procedures and standards that apply to any other mandatory 31 subject of bargaining pursuant to state law. 32 4. Premium rates for nonstate public employers shall be the 33 total premium rate paid by the state inclusive of any premiums 34 paid by state employees for the particular state health care 35 -4- LSB 5253SV (1) 84 av/rj 4/ 9

S.F. 2262 product offered by the state plan. 1 Sec. 5. NEW SECTION . 8A.475 Employees of nonprofit 2 employers —— coverage. 3 1. Employees of nonprofit employers may obtain coverage 4 under the state plan pursuant to the Iowa health care coverage 5 partnership program in accordance with this section. 6 2. A nonprofit employer may submit an application to the 7 department for coverage under the state plan of all of such 8 employer’s employees. If a nonprofit employer submits such an 9 application for coverage, the department shall provide such 10 coverage no later than the first day of the third calendar 11 month following such application. However, the department 12 shall not approve an application for coverage under the 13 state plan if the department determines that approval of such 14 coverage would cause the state plan to be subject to the 15 requirements of the federal Employee Retirement Income Security 16 Act of 1974, as codified at 29 U.S.C. § 1001 et seq. If the 17 department determines that the state plan is compliant with 18 such federal requirements, the department shall resume approval 19 of applications for coverage under the state plan as provided 20 in this section. 21 3. Premium rates for nonprofit employers shall be the total 22 premium rate paid by the state inclusive of any premiums paid 23 by state employees for the particular state health care product 24 offered by the state plan. 25 Sec. 6. NEW SECTION . 8A.476 Retirees —— coverage. 26 1. Nonstate public employers and nonprofit employers 27 eligible to obtain coverage for their employees under the state 28 plan pursuant to the Iowa health care coverage partnership 29 program may obtain such coverage for all of their retirees as 30 provided in this part 5. Premium payments for such coverage 31 shall be remitted by the nonstate public employer or nonprofit 32 employer to the department and shall be the same as those paid 33 by the nonstate public employer or nonprofit employer for 34 employees who are not retired. 35 -5- LSB 5253SV (1) 84 av/rj 5/ 9

S.F. 2262 2. Nothing in this part 5 shall diminish any right to 1 retiree health insurance pursuant to a collective bargaining 2 agreement or pursuant to any other provision of state or 3 federal law. 4 Sec. 7. NEW SECTION . 8A.477 Premium payments —— 5 administrative fees. 6 1. A nonstate public employer or nonprofit employer 7 participating in the state plan pursuant to the Iowa health 8 care coverage partnership program shall pay the monthly amount 9 determined by the department, for coverage of its employees 10 and elected officials and retirees, or its employees and 11 retirees, as appropriate under the state plan. A nonstate 12 public employer or nonprofit employer may require each covered 13 employee, elected official, or retiree to contribute a portion 14 of the cost of such coverage under the state plan, subject 15 to any collective bargaining obligation applicable to such 16 employer. If any payment due by a nonstate public employer or 17 nonprofit employer under this section is not timely paid, after 18 the due date interest shall be added to such payment at the 19 prevailing rate of interest, as determined by the department. 20 Such interest shall be paid by the nonstate public employer or 21 nonprofit employer. 22 2. The department shall charge a nonstate public employer 23 or nonprofit employer participating in the state plan pursuant 24 to the Iowa health care coverage partnership program, an 25 administrative fee calculated on a per-month basis per covered 26 employee, elected official, or retiree. 27 3. Payments made pursuant to this section shall be 28 deposited in the health insurance administration fund created 29 in section 8A.454. Moneys deposited in the health insurance 30 administration fund pursuant to this section shall be 31 separately accounted for and shall be expended for payment 32 of insurance premiums for employees, elected officials, 33 and retirees covered under the Iowa health care coverage 34 partnership program. 35 -6- LSB 5253SV (1) 84 av/rj 6/ 9

S.F. 2262 4. If a nonstate public employer fails to make premium 1 payments as required under this section, the department may 2 direct the treasurer of state, or any other office of the state 3 that is the custodian of any moneys made available by reason of 4 any grant, allocation, or appropriation by the state or state 5 agencies payable to the nonstate public employer at any time 6 subsequent to the failure of the nonstate public employer, to 7 pay such premiums and interest that are due and unpaid and 8 to withhold payment of moneys payable to the nonstate public 9 employer until the amount of the premiums and interest then due 10 and unpaid by the nonstate public employer has been paid to 11 the state or until the treasurer determines that arrangements, 12 satisfactory to the treasurer of state, have been made for the 13 payment of such premiums and interest. However, such moneys 14 shall not be withheld from a nonstate public employer if such 15 withholding will adversely affect the receipt of any federal 16 grant or aid in connection with such moneys. 17 5. If a nonprofit employer fails to make premium payments, 18 the department may terminate the nonprofit employer’s employee 19 or retiree participation in the state plan pursuant to the 20 Iowa health care coverage partnership program and request the 21 attorney general to recover any premiums and interest due and 22 unpaid. 23 Sec. 8. EFFECTIVE DATE. This Act takes effect January 1, 24 2013. 25 EXPLANATION 26 This bill establishes the Iowa health care coverage 27 partnership program in the department of administrative 28 services (DAS). The program allows employees, elected 29 officials, and retired employees of a nonstate public employer, 30 and employees and retirees of a nonprofit employer to be 31 considered state employees for the purpose of enrolling in a 32 state health or medical group insurance plan provided to state 33 employees by DAS and requires such participating employees 34 and elected officials, and retirees to be pooled with state 35 -7- LSB 5253SV (1) 84 av/rj 7/ 9

S.F. 2262 employees in the state plan. In order to be eligible to 1 participate in the partnership program, an employer must apply 2 for the coverage and all employees and elected officials of 3 such an employer must agree to enroll in a state health or 4 medical insurance plan. Employees and elected officials 5 of such employers receive health coverage under the same 6 conditions as state employees and shall not be denied coverage 7 on the basis of risk, cost, preexisting conditions, or other 8 factors not applicable to state employees. 9 Premium payments for coverage received through the program 10 must be the same as for state employees, including any premiums 11 paid by state employees. An employer must participate in the 12 partnership program for at least three years. 13 DAS is required to develop and procure coverage to be offered 14 through the partnership program that meets minimum standards 15 of quality and affordability and to implement and administer 16 the program. DAS is not required to offer coverage through the 17 partnership program from every vendor providing coverage under 18 the state plan, and may procure coverage from different vendors 19 and offer different insurance plans than those available to 20 state employees. 21 Each employer who participates in the Iowa health care 22 coverage partnership program must pay monthly premium amounts 23 for coverage to DAS, plus administrative fees calculated on a 24 per-month basis per employee, elected official, or retiree. An 25 employer may require each covered employee, elected official, 26 or retiree to contribute a portion of the cost of such coverage 27 under the state plan, subject to any collective bargaining 28 obligations. The payments are to be deposited in the health 29 insurance administration fund created in Code section 8A.454 30 for state employee premium payments, but must be separately 31 accounted for and expended for coverage being provided pursuant 32 to the partnership program. 33 If monthly premium payments are not made, DAS may charge 34 interest on the unpaid balance. If a nonstate public employer 35 -8- LSB 5253SV (1) 84 av/rj 8/ 9

S.F. 2262 fails to make premium payments, DAS may direct the treasurer 1 of state to withhold grants, allocations, or appropriations 2 payable to the nonstate public employer, until the premium 3 payments are made. If a nonprofit employer fails to make 4 premium payments, DAS may terminate participation of that 5 employer’s employees and retirees in the state plan and 6 request the attorney general to recover the unpaid premiums and 7 interest. 8 For purposes of the program, a “nonstate public employer” is 9 a political subdivision of the state, including but not limited 10 to counties, cities, community colleges, quasi-public agencies, 11 and school districts. A “nonprofit employer” is a corporation 12 organized or recognized as a nonprofit corporation under state 13 or federal law. 14 The bill takes effect January 1, 2013. 15 -9- LSB 5253SV (1) 84 av/rj 9/ 9