SENATE DOCKET, NO. 1838        FILED ON: 1/18/2019

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1537

The Commonwealth of Massachusetts

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PRESENTED BY:

Cindy F. Friedman

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act reforming the group insurance commission.

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PETITION OF:

SENATE DOCKET, NO. 1838        FILED ON: 1/18/2019

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1537

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-First General Court
(2019-2020)

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An Act reforming the group insurance commission.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Section 3 of chapter 32A of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by striking out the first sentence and inserting in place thereof the following sentence:- There shall be established within the executive office of administration and finance, but not under its jurisdiction, a special unpaid commission, to be known as the group insurance commission, consisting of the commissioner of administration and finance, the commissioner of insurance, and 15 members, 1 of whom shall be appointed by the president of the Retired State, County, & Municipal Employees Association of Massachusetts, 1 of whom shall be a health economist appointed by the governor, 1 of whom shall have substantial experience in health care delivery, including behavioral health, in the commonwealth, appointed by the governor, 1 of whom shall have substantial experience in health care administration appointed by the governor, 1 of whom shall have substantial experience in employee benefits administration appointed by the governor, 1 of whom shall have substantial experience with and knowledge of health insurance plans appointed by the governor, at least 3 of whom shall be full-time state employees, 1 shall be appointed by the president of the Massachusetts Public Employees Council, #93, AFSCME, Massachusetts State Labor Council, AFL-CIO, 1 shall be appointed by the president of the Massachusetts State Employees Association, NAGE, and 1 shall be appointed by the president of the Local 5000, S.E.I.U., 1 of whom shall be appointed by the president of the Service Employees International Union, Local 509, 1 of whom shall be appointed by the president of the Massachusetts Organization of State Engineers and Scientists, 1 of whom shall be a management representative appointed by the governor from a list of 3 representatives nominated by the Massachusetts Municipal Association and 1 of whom shall be the president of the teachers' union with the greatest amount of active and retired members enrolled in commission health plans.

SECTION 2. Said section 3 of said chapter 32A, as so appearing, is hereby amended by striking out, in lines 23 and 24, the words “appointed by the governor from a list of 3 representatives”.

SECTION 3. Said section 3 of said chapter 32A, as so appearing, is hereby amended by striking out, in line 24, the word “nominated” and inserting in place thereof the following word:- designated.

SECTION 4. Said section 3 of said chapter 32A, as so appearing, is hereby further amended by striking out the fourth, fifth and sixth sentences and inserting in place thereof the following sentences:-

No member appointed shall be an insurance agent, broker, employee or officer of an insurance company that currently does business with or has done business with the commonwealth in the past 3 years. Upon the expiration of the term of office of an appointive member, his successor shall be appointed in like manner for a term of 3 years. If there is an appointive member vacancy, either expected or unexpected, the applicable person or organization with appointment authority under this section shall appoint a replacement for the vacant position not more than 90 days after the vacancy. If the appointive member vacancy is for the management representative under this section, the governor shall appoint a replacement for the vacant position not more than 90 days after receiving a list of nominated representatives from the applicable organization. If an appointive member vacancy is not filled within 90 days of a vacancy, the executive director of the commission shall appoint a replacement pursuant to the requirements of this section.

SECTION 5. Said chapter 32A is hereby further amended by adding the following section:-

Section 4B. (a) Prior to any vote by the commission on matters that substantially alter the insurance coverage or health plans offered under this chapter, including, but not limited to, any changes in the identity or number of health plans offered or any changes in the existing plan design of any health plan, including changes to member cost-sharing or changes to covered medical, behavioral health or pharmacy benefits, the executive director of the commission shall provide to the members of the commission all relevant information necessary to make an informed decision on the vote. The information shall be provided to the members of the commission at a commission meeting prior to the meeting at which the vote is scheduled, but in no event shall such information be provided less than 14 days in advance of the vote.

(b) On any matter subject to the requirements of subsection (a), the commission shall hold at least 4 public hearings across the commonwealth prior to the vote.

SECTION 6. Notwithstanding any general or special law to the contrary, the group insurance commission shall consult with stakeholders to review and evaluate: (i) the impacts of existing public procurement laws; (ii) public record and open meeting laws; and (iii) regulations on the group insurance commission’s deliberative process.

At minimum, the group insurance commission shall consult with: (i) the secretary of administration and finance; (ii) the attorney general; (iii) the commissioner of insurance; (iv) the operational services division of the executive office for administration and finance; and (v) the inspector general.

The group insurance commission shall provide a report on: (i) any anticipated updates to commission procedures related to state procurement and open meeting laws resulting from its consultation with stakeholders; (ii) any anticipated regulatory changes the commission plans to take based on its consultation with stake holders on its deliberative process; (iii) the recommended  notice period the commission will provide to members prior to a vote that would substantially alter the insurance coverage or health plans offered under this chapter including, but not limited to, any changes in the identity or number of health plans offered, existing plan design of any health plan, member cost-sharing or covered medical, behavioral health or pharmacy benefits; and (iv) any recommended statutory changes needed to meet these goals.

The group insurance commission shall submit its findings and recommendations, together with drafts of legislation necessary to carry those recommendations into effect, to the clerks of the senate and the house of representatives, and the joint committee on public service not later than October 1, 2019.

SECTION 7. Notwithstanding any general or special law to the contrary, beginning on January 1, 2021: (i) upon the first vacancy or expiration of the term of office of a “public member” of the group insurance commission established by section 3 of chapter 32A of the General Laws, the governor shall appoint a successor who shall have substantial experience in behavioral health care delivery in the commonwealth; (ii) upon the second vacancy or expiration of the term of office of such a “public member”, the governor shall appoint a successor who shall have substantial experience in health care administration; (iii) upon the third vacancy or expiration of the term of office of such a “public member”, the governor shall appoint a successor who shall have substantial experience in employee benefits administration; and (iv) upon the fourth vacancy or expiration of the term of office of such a “public member”, the governor shall appoint a successor who shall have substantial experience with and knowledge of health insurance plans. Notwithstanding the foregoing, if an appointee under this section is also a vacancy under this section, the governor shall appoint a successor who has the substantial experience of the member creating the vacancy.