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News Published: May 27, 2008 - 12:21:49 PM


Health insurance for municipalities, small businesses poses no threat to state health insurance

By Attorney General's office


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Attorney General Richard Blumenthal, in a formal legal opinion today, said a statute that would enable state-equivalent health insurance for municipalities, non-profits and small businesses will not – and cannot legally – impact the state’s pending contracts with health insurers covering state employees.

An Act Establishing the Connecticut Healthcare Partnership (House Bill 5536), as approved by the legislature, will initially create an entirely new distinct pool of insureds – separate from state employees and uncovered by four pending contracts.

The contracts for insurance coverage for these new insureds -- municipalities, small businesses, municipally related businesses, and non-profit organizations -- would be separately negotiated by the state comptroller.

In a legal opinion to House Majority Leader Christopher G. Donovan, Blumenthal said this new potential pool of insureds will not affect the state’s pending contracts with three health insurers that successfully bid on the state employee health plan and that have virtually concluded contracts.

Both the insurers and the state are now legally bound by these agreements and any unilateral change or withdrawal would be unlawful, Blumenthal said.

“There is no legal or practical reason to veto this legislation because of an unfounded fear of legally untenable charges,” Blumenthal said. “This measure in fact provides real hope for small businesses, municipalities, municipally related businesses, and non-profit organizations to reduce health care costs without imposing economic burdens on insurers or the state.”

Majority Leader Donovan said, “This opinion should put the governor’s concerns to rest. Let’s open our plan to people throughout the state.”

Last year, the state comptroller issued a request for proposals concerning health insurance for state employees, state retirees and their dependents for fiscal year 2008-2009. In addition, price caps were solicited for the subsequent two years. Contract awards based on the resulting bids have been issued by the state comptroller and contracts have been developed.

Certain health insurers have raised concerns that they did not bid on a pool of employees that includes unknown numbers of small business employers, municipally related businesses, non-profit organizations and municipalities.

The insurers say costs may increase and they may rescind their assurances of capping potential increases in the next two years because of House Bill 5536.

“This contention is simply false legally,” Blumenthal said. “Any contract between the health insurer and the state comptroller must clearly comport with the request for proposal, including the required offering of coverage to all state employees, retirees and their dependents, whose claims experience forms the basis of insurer bids. Clearly, any mandatory inclusion of significant numbers of new individuals or entities in the existing health insurance pool would be materially different from the RFP and would violate state bidding procedures and state law.”

After releasing his opinion today, Blumenthal urged the governor to sign the bill and enable municipalities, small businesses and non-profits access to fair and affordable health insurance.

Blumenthal said, “The governor joined me in standing up to the insurers when they broke state laws requiring full and fair disclosure of health insurance provider rates and other important records. I ask her to stand strong again and reject these legally unfounded, unfortunate threats from the same insurers, who seek to distract and deceive her and Connecticut citizens. If the insurers break their commitments, I will hold them accountable.

“The state’s contract with the health insurers holds them to their bids, just as the contract holds the state to its promises in the RFP. Any changes to the contract requirements would have to be mutually agreed as an amendment to the contract or through a new RFP. The state cannot unilaterally add insureds to the existing contract. Neither can the insurers increase their costs.”

Although the new and old pools could be bid together in future RFPs and contracts, coverage for the new pool would have to be negotiated or bid separately for the current contractual period.

As approved by the General Assembly, House Bill 5536 does not force the state comptroller to alter the conditions of the existing contracts.

“Based on the clear statutory language and strong legislative history, the comptroller must negotiate with health insurers to provide equivalent health insurance plans, minimum provider access, benefits and rates as offered to state employees,” Blumenthal said. “The bill envisions covering the new pool of employees at rates offered to the state. If no health insurers are willing to offer such insurance, the state cannot provide it to these new employers.

“Most importantly, at any point, the state can stop the process if there is an unforeseen fiscal impact on the state employee health insurance plan.

“I strongly urge approval of this legislation with the assurance that its provisions will have no impact on state employee health insurance costs. Rather, the legislation offers an opportunity for small employers, non-profit organizations and municipalities to make health insurance vastly more affordable.”




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