KRS 18A.2251: State employee health care plan buy-in. (Expired July 14, 1995)

(1) Any citizen of the United States, who has been a Kentucky resident for at least one

(1) year prior to purchasing coverage under this section, shall be permitted to

purchase health insurance coverage provided to state employees pursuant to KRS

18A.225 and 1 8A.2281, under the same terms and conditions as state employees

until the Kentucky Health Purchasing Alliance created pursuant to KRS 304.17A -

020 becomes operational. The premium charged for coverage for high risk

individuals as defined by the Kentucky Hea lth Policy Board shall not exceed two

hundred percent (200%) of the premium paid by the Commonwealth for state

employees. Policies issued under this section shall be valid for a period of one (1)

year, and at the time of the policy's expiration the insured shall be eligible for

participation in the Kentucky Health Purchasing Alliance created pursuant to KRS

304.17A-020.

(2) The secretary of the Finance and Administration Cabinet and the secretary of the

Cabinet for Human Resources shall provide for a system to enroll any citizen who

elects to purchase health insurance coverage under subsection (1) of this section

using the county offices of the Cabinet for Human Resources. Citizens desiring to

purchase coverage shall do so through the office of the Cabinet f or Human

Resources in the county of the citizen's residence. Payment for premiums shall be

made in advance on a quarterly or annual basis, in a manner to be determined by

administrative regulations of the Finance and Administration Cabinet promulgated

pursuant to KRS Chapter 13A.

(3) Following the close of each calendar year, the Kentucky Health Policy Board shall

determine for each of the insurance plans providing coverage to state employees and

persons electing to purchase coverage pursuant to this sectio n, the net premium,

being premiums less administrative expense allowances, the plan expenses, and

claim expenses losses for the year, taking into account investment income and other

appropriate gains and losses.

(4) Each health insurer's proportion of part icipation in the state employee health plan

shall be determined annually by the Kentucky Health Policy Board based on annual

statements and other reports deemed necessary by the board and filed by the insurer

with the board. The proportion of participation shall be determined by multiplying

the total cost of each state health insurance plan coverage operation by a fraction,

the numerator of which equals that insurer's premium and subscriber contract

charges for health insurance written in the state during t he preceding calendar year

and the denominator of which equals the total of all premiums and subscriber

contract charges written in the state. The amount of the assessment shall also be

adjusted to ensure that the Commonwealth's cost of providing coverage to state

employees does not increase more than the average rate of premium growth for state

employees during the five (5) years preceding July 15, 1994.

(5) Any deficit incurred by the state employee health insurance plan shall be recouped

by assessments on all health insurers doing business in the Commonwealth pursuant

to the assessment formula set forth by the Kentucky Health Policy Board. The

insurers may recover these amounts in the normal course of their respective

businesses without time limitation.

(6) The Kentucky Health Policy Board may abate or defer, in whole or in part, the

assessment of an insurer if, in the opinion of the board, payment of the assessment

would endanger the ability of the insurer to fulfill its contractual obligations. If an

assessment against an insurer is abated or deferred in whole or in part, the amount

by which the assessment is abated or deferred may be assessed against the other

insurers in a manner consistent with the basis for assessments set forth in this

section. The i nsurer receiving an abatement or deferment shall remain liable to the

Commonwealth for the deficiency for four (4) years.

(7) If assessments exceed actual losses and administrative expenses of the plan, the

excess shall be held at interest and used by the Commonwealth to offset future

losses or to reduce premiums. As used in this subsection, "future losses" includes

reserves for incurred but not reported claims.

(8) After July 14, 1995, this section shall become null and void.