Important Information on Senate Bill 94
Dear Friends,
To remove uncertainty about exactly what passed in SB 94, which evolved into a bill that captures the benefit period extensions and 2nd election privileges under ARRA for state continuation, I am pasting a link to the bill as it passed on the final day of the General Assembly session.
Here is a summary of the components of the bill.
1. It adds a definition, "assistance eligible individual" (AEI) to Georgia law (Code section 33-24-21.1) and ties that definition explicitly to Section 3001 of Title III of the federal American Recovery and Reinvestment Act of 2009.
2. It provides that AEIs are entitled to all the same provisions of state continuation law with the exception they have a benefit period of nine months.
3. It states that AEIs are entitled to the federal 65% premium subsidy provided by ARRA for state continuation. The exception here unlike with COBRA is that the 35% premium is remitted to the insurer and the insurer is required to pursue the balance through a tax credit.
4. It provides for 2nd election in the same manner as ARRA does for COBRA for qualifying events that occurred between September 1, 2008 and a notice date that as of yet has not been established and is the subject of federal and state rule-making under ARRA and SB 94. Further, it provides that an AEI cannot reach back and recover benefits or premium assistance for past periods, but as long as they elect as provided under the Act and remain eligible for state continuation, they can "toll forward" their benefit period for state continuation for up to nine months.
5. It provides a sunset clause that states that the State of Georgia and insurers will have no liability to extend additional benefits to non-AEIs or to extend additional benefits to AEIs beyond the period covered by ARRA beyond September 2010, unless such benefits are extended by the General Assembly, the federal government or both governments.
6. This is the only permanent change to 33-24-21.1 enacted by SB 94. All continuation claims will not be used to rate or re-rate an employer group, but claims experience for continuation will affect the employer group to the extent they are spread across the entire group pool.
7. This was added as an amendment in the Senate in agrees/disagrees before final passage in the House. HRA only language contained in HB 412 was added to SB 94. It provides that if an employer provides an HRA-only program for EEs, this act in and of itself does not constitute employer sponsorship of any health plan. In addition, it states that if individual coverage is purchased by EEs using $$$ from the HRA, this act in and of itself does not constitute a health plan offering by the employer. Further, the employer is not obligated to provide a plan and any insurer/vendor that provides or administers the HRA funding account is not obligated to provide health plan coverage.
I'm sure this will generate questions and debate. I am providing this now as a service because I know how critically important this issue is to your practices. GA DOI has informed me they will be meeting ASAP to assess their duties under the Act and provide guidance and notices as required to those who are affected by this new law. SB 94 will take effect when signed by the Governor or on such date as is provided if it is not signed. Feel free to respond and ask as many questions as you like. You can also call me: 678-697-6213 cell and 678-880-0986 office.
Michael Wardrip
