{"data":{"id":"us-ky/krs-6.948","jurisdiction":"us-ky","citation":"KRS 6.948","heading":"Definitions for section -- Health mandate impact statement and federal cost","body":"defrayal impact statement requirement for bill or amendment with mandated\nhealth benefit -- State employee health plan impact statement requirement for\nbill or amendment wi th mandated health benefit applicable to state employee\nhealth plan -- Preparation of statement -- Requirements -- Contents -- Time for\ncompletion of statements.\n(1) As used in this section:\n(a) \"Amendment\" includes a committee substitute;\n(b) \"Department\" means the Department of Insurance;\n(c) \"Federal cost defrayal impact statement\" means a statement prepared and\ntransmitted in accordance with subsection (6) of this section;\n(d) \"Health benefit plan\" has the same meaning as in KRS 304.17A -005, except\nthat for purposes of this section the term does not include:\n1. A state employee health plan; or\n2. Any other self-insured policy, certificate, plan, or contract;\n(e) \"Health mandate impact statement\" means a statement prepared and\ntransmitted in accordance with subsection (5) of this section;\n(f) \"Mandated health benefit\" means a requirement that any health benefit plan or\nstate employee health plan:\n1. Provide a specified benefit, including but not limited to a specified\ncoverage;\n2. Pay, indemnify, or reimburse for a specified medical service; or\n3. Pay, indemnify, or reimburse specified health care providers for specific\nhealth care services;\n(g) \"Sponsor\" means a member of the General Assembly that has made a request\nto the Legislative Research Commission for a bill or amendment;\n(h) \"State employee health plan\" means any fully insured health benefit plan or\nself-insured plan issued or renewed to publi c employees under KRS 18A.225\nor 18A.2254; and\n(i) \"State employee health plan impact statement\" means a statement prepared\nand transmitted in accordance with subsection (7) of this section.\n(2) (a) Any bill or amendment that contains a mandated health ben efit shall be\nidentified by the staff of, and on a form specified by, the Legislative Research\nCommission.\n(b) If a bill or amendment is identified as having a mandated health benefit under\nparagraph (a) of this subsection, the staff of the Legislative Res earch\nCommission shall:\n1. Notify the sponsor of the bill or amendment that a health mandate\nimpact statement, federal cost defrayal impact statement, and state\nemployee health plan impact statement, as applicable, are required; and\n2. Upon introduction, adoption, or filing of the legislation:\na. For a mandated health benefit that applies to any health benefit\nplan, request the department to prepare and transmit a health\nmandate impact statement and federal cost defrayal impact\nstatement in accordance with this section; and\nb. For a mandated health benefit that applies to any state employee\nhealth plan, request the Department of Employee Insurance to\nprepare and transmit a state employee health plan impact statement\nin accordance with this section.\n(3) (a) The individuals referenced in paragraph (b) of this subsection may, in\naccordance with that paragraph, request the department or the Department of\nEmployee Insurance, as applicable, to prepare any or all of the following:\n1. A health mandate impact statement;\n2. A federal cost defrayal impact statement; or\n3. A state employee health plan impact statement.\n(b) Any or all of the following may make a request under paragraph (a) of this\nsubsection:\n1. For any introduced bill or adopted or filed amendment:\na. The sponsor of the bill or amendment; or\nb. Any of the following members from a chamber of the General\nAssembly with possession of the legislation:\ni. Any member of the majority or minority leadership; or\nii. A chair of a standing committee; and\n2. For any bi ll or amendment that has not been introduced, filed, or\nadopted, the sponsor of the bill or amendment.\n(4) (a) Except as provided in paragraph (b) of this subsection, when a request is made\nunder this section, the department or Department of Employee Insur ance,\nincluding its staff and third-party contractors, shall:\n1. Keep the bill or amendment confidential until the bill or amendment is\npublished for public distribution by the Legislative Research\nCommission; and\n2. Keep the impact statement, including the request for the statement and\nany information relating thereto,  confidential until the statement is\npublished for public distribution by the Legislative Research\nCommission.\n(b) Paragraph (a) of this subsection shall not apply to any communications with\nor transmittals to:\n1. Staff or third -party contractors designate d by the department or\nDepartment of Employee Insurance to receive and prepare the impact\nstatements required under this section;\n2. Staff designated by the Legislative Research Commission;\n3. The requester; or\n4. Any other person designated by the requester.\n(c) Any health mandate impact statement, federal cost defrayal impact statement,\nor state employee health plan impact statement requested under this section\nshall be prepared and transmitted by the department or Department of\nEmployee Insurance as provided in this section.\n(5) A health mandate impact statement shall:\n(a) Be in writing;\n(b) Be signed by the commissioner of the department or the commissioner's\ndesignee;\n(c) Determine the extent to which the mandated health benefit will:\n1. Increase or dec rease administrative expenses of insurers offering health\nbenefit plans;\n2. Increase or decrease health benefit plan premiums in the market or\nmarkets to which the mandate applies; and\n3. Impact the total cost of health care for health benefit plan insured s,\nincluding any potential cost savings that may be realized; and\n(d) Be completed and transmitted to staff designated by the Legislative Research\nCommission and the requester as soon as possible, but not later than thirty\n(30) days after the request is ma de to the department, unless the requestor and\ncommissioner of the department agree otherwise.\n(6) (a) A federal cost defrayal impact statement shall:\n1. Be in writing;\n2. Be signed by the commissioner of the department or the commissioner's\ndesignee;\n3. a. Indicate:\ni. Whether a bill or amendment that contains a mandated health\nbenefit may result in the state being required to make\npayments to defray costs under 42 U.S.C. sec. 18031(d)(3)\nand 45 C.F.R. sec. 155.170, as amended; and\nii. If applicable, which  provision or provisions of the bill or\namendment may trigger the requirement to make payments\nto defray costs under 42 U.S.C. sec. 18031(d)(3) and 45\nC.F.R. sec. 155.170, as amended.\nb. When making a determination under subdivision a. of this\nsubparagraph, the department shall consider whether the provision\nor provisions would apply under KRS 304.17A-099(2);\n4. If it is indicated under subparagraph 3. of this paragraph that the bill or\namendment may result in the state being required to make payments,\ninclude a cost defrayal fiscal analysis prepared in accordance with\nparagraph (b) of this subsection; and\n5. Be c ompleted and transmitted to staff designated by the Legislative\nResearch Commission and the requestor as soon as possible, but not\nlater than the following, unless the requestor and the commissioner of\nthe department agree otherwise:\na. For an indication required under subparagraph 3. of this paragraph,\nten (10) business days after the request is made to the department;\nand\nb. For a cost defrayal fiscal analysis required under subparagraph 4.\nof this paragraph, thirty (30) days after the request is made to the\ndepartment.\n(b) A cost defrayal fiscal analysis shall:\n1. Be conducted by:\na. The department; and\nb. An actuary selected by the department;\n2. Be based on an analysis performed in accordance with generally\naccepted actuarial principles and methodologies;\n3. Determine the extent to which benefits required under the bill or\namendment are already covered by health insurers; and\n4. Include an estimate of the payments the state may be required to make\nunder 42 U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.1 70, as\namended, if the bill or amendment is enacted into law.\n(7) A state employee health plan impact statement shall:\n(a) Be in writing;\n(b) Be signed by the commissioner of the Department of Employee Insurance or\nthe commissioner's designee;\n(c) Determine the extent to which:\n1. The mandated health benefit will increase or decrease state employee\nhealth plan premiums; and\n2. The increased or decreased premiums identified in subparagraph 1. of\nthis paragraph may be passed on to public employees; and\n(d) Be completed and transmitted to staff designated by the Legislative Research\nCommission and the requester as soon as possible, but not later than thirty\n(30) days after the request is made to the Department of Employee Insurance,\nunless the requestor and com missioner of the Department of Employee\nInsurance agree otherwise.","path":["KRS Chapter 6"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=54574","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:48:25Z","sha256":"56f2a19f69b08bbf16219c99ef64f22ed577da900c4608c5f072c2f2a9434afc","source_id":"us-ky","stale":false,"prev":"us-ky/krs-6.945","next":"us-ky/krs-6.949"},"notice":"GroundRules: Original legal text. Not legal advice."}