CSHB 10(L&C): "An Act relating to pooling by employers for purposes of group health insurance; and providing for an effective date."
00 CS FOR HOUSE BILL NO. 10(L&C) 01 "An Act relating to pooling by employers for purposes of group health insurance; and 02 providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 21.54.060 is amended to read: 05 Sec. 21.54.060. Group health insurance defined. Group health insurance is 06 that form of health insurance covering groups of persons as defined below, with or 07 without one or more members of their families or one or more of their dependents, or 08 covering one or more members of the families or one or more dependents of the 09 groups of persons and issued upon the following basis: 10 (1) under a policy issued to an employer or trustees of a fund 11 established by an employer, who shall be considered the policyholder, insuring 12 employees of the employer for the benefit of persons other than the employer; in this 13 paragraph the term "employees" includes the officers, managers, and employees of the 14 employer, the individual proprietor or partner if the employer is an individual
01 proprietor or partnership, the officers, managers, and employees of subsidiary or 02 affiliated corporations, the individual proprietors, partners, and employees of 03 individuals and firms if the business of the employer and the individual or firm is 04 under common control through stock ownership, contract, or otherwise; in this 05 paragraph, "employees" may include retired employees; a policy issued to insure 06 employees of a public body may provide that the term "employees" includes elected or 07 appointed officials; the policy may provide that the term "employees" includes the 08 trustees or their employees, or both, if their duties are principally connected with the 09 trusteeship; a policy issued to insure employees of a corporation may provide that the 10 term "employees" includes directors of the corporation, whether or not the directors 11 receive compensation; 12 (2) under a policy issued to an association, including a labor union, 13 that has a constitution and bylaws and that has been organized and is maintained in 14 good faith for purposes other than that of obtaining insurance, insuring members, 15 employees, or employees of members of the association for the benefit of persons 16 other than the association or its officers or trustees; in this paragraph, the term 17 "employees" may include retired employees; 18 (3) under a policy issued to the trustees of a fund established by two or 19 more employers in the same or related industry or by one or more labor unions or by 20 one or more employers and one or more labor unions or by an association as defined 21 in (2) of this section, which trustees shall be considered the policyholder, to insure 22 employees of the employers or members of the unions or of the association, or 23 employees of members of the association, for the benefit of persons other than the 24 employers or the unions or the association; in this paragraph, the term "employees" 25 may include the officers, managers, and employees of the employer, and the individual 26 proprietor or partners if the employer is an individual proprietor or partnership; in this 27 paragraph, the term "employees" may include retired employees; the policy may 28 provide that the term "employees" includes the trustees or their employees, or both, if 29 their duties are principally connected with the trusteeship; 30 (4) under a policy issued to a person or organization to which a policy 31 of group life insurance may be issued or delivered in this state to insure a class or
01 classes of individuals that could be insured under the group life policy; 02 (5) under a policy issued to cover any other substantially similar group 03 that, in the discretion of the director, may be subject to the issuance of a group health 04 insurance policy or contract; 05 (6) a group health insurance policy that contains provisions for the 06 payment by the insurer of benefits for expenses incurred on account of hospital, 07 nursing, medical, or surgical services for members of the family or dependents of a 08 person in the insured group may provide for the continuation of the benefit provisions, 09 or a part or parts of them, after the death of the person in the insured group; 10 (7) under a policy issued to an association of employers covering 11 the employees and dependents of the employees; an association of employers 12 under this paragraph shall comply with the following requirements: 13 (A) the association shall have a constitution and bylaws; 14 (B) the association shall be maintained in good faith for the 15 benefit of persons other than the association or its officers or trustees; 16 (C) membership in the association shall be restricted to a 17 large or small employer that is a resident of the state; however, an 18 employer domiciled in another state may become a member of the 19 association for purposes of obtaining coverage through the association 20 only for the employees and dependents of the employees of that employer 21 who are residents of this state; 22 (D) the association may not condition membership in the 23 association or coverage under a health insurance policy issued to the 24 association on any of the factors listed under AS 21.54.100(a). 25 * Sec. 2. AS 21.56.120 is amended by adding a new subsection to read: 26 (e) In determining the premium rates for a small employer covered under an 27 association health insurance policy authorized under AS 21.54.060(7), a small 28 employer insurer may not use the claims experience of the small employer while the 29 employer was covered under another health insurance policy and may use only that 30 underwriting information obtained through the insurer's normal application process for 31 new small employer groups that are not written under the association plan.