2.2-1204 - Health insurance program for employees of local governments, local officers, teachers, etc.; definitions.
§ 2.2-1204. Health insurance program for employees of local governments,local officers, teachers, etc.; definitions.
A. The Department shall establish a plan or plans, hereinafter "plan" or"plans", subject to the approval of the Governor, for providing healthinsurance coverage for employees of local governments, local officers,teachers, and retirees, and the dependents of such employees, officers,teachers and retirees. The plan or plans shall be rated separately from theplan established pursuant to § 2.2-2818 to provide health and relatedinsurance coverage for state employees. Participation in such insurance planor plans shall be (i) voluntary, (ii) approved by the participant'srespective governing body, or by the local school board in the case ofteachers, and (iii) subject to regulations adopted by the Department. Inaddition, at the option of a governing body or school board that has electedto participate in the health insurance plan or plans offered by theDepartment, the governing body or school board may elect to participate inthe long-term care or other benefit program that the Department may makeavailable to the governing body or school board.
B. The plan established by the Department shall satisfy the requirements ofthe Virginia Public Procurement Act (§ 2.2-4300 et seq.), shall consist of aflexible benefits structure that permits the creation of multiple plans ofbenefits and may provide for separate rating groups based upon criteriaestablished by the Department. The Department shall adopt regulationsregarding the establishment of such a plan or plans, including, but notlimited to, requirements for eligibility, participation, access and egress,mandatory employer contributions and financial reserves, and theadministration of the plan or plans. The Department may engage the servicesof other professional advisors and vendors as necessary for the prudentadministration of the plan or plans. The assets of the plan or plans,together with all appropriations, premiums and other payments, shall bedeposited in the employee health insurance fund, from which payments forclaims, premiums, cost containment programs and administrative expenses shallbe withdrawn from time to time. The assets of the fund shall be held for thesole benefit of the employee health insurance fund. The fund shall be held inthe state treasury. Any interest on unused balances in the fund shall revertback to the credit of the fund. The State Treasurer shall charge reasonablefees to recover the actual costs of investing the assets of the plan or plans.
In establishing the participation requirements, the Department may providethat those employees, officers, and teachers without access toemployer-sponsored health care coverage may participate in the plan. It shallcollect all premiums directly from the employers of such employees, officers,and teachers.
C. In the event that the financial reserves of the plan fall to anunacceptably low level as determined by the Department, it shall have theauthority to secure from the State Treasurer a loan sufficient to raise thereserve level to one that is considered adequate. The State Treasurer maymake such a loan, to be repaid on such terms and conditions as established byhim.
D. For the purposes of this section:
"Employees of local governments" shall include all officers and employeesof the governing body of any county, city or town, and the directing orgoverning body of any political entity, subdivision, branch or unit of theCommonwealth or of any commission or public authority or body corporatecreated by or under an act of the General Assembly specifying the power orpowers, privileges or authority capable of exercise by the commission orpublic authority or body corporate, as distinguished from § 15.2-1300,15.2-1303, or similar statutes, provided that the officers and employees of asocial services department, welfare board, mental health, mental retardationand substance abuse services board, center for independent living funded inwhole or in part by the Department of Rehabilitative Services pursuant to theprovisions of Chapter 6 (§ 51.5-23 et seq.) of Title 51.5, or library boardof a county, city, or town shall be deemed to be employees of localgovernment.
"Governing body," with regard to a center for independent living, means thegoverning board of an applicant established to operate the center forindependent living as required by subsection B of § 51.5-23.
"Local officer" means the treasurer, registrar, commissioner of therevenue, attorney for the Commonwealth, clerk of a circuit court, sheriff, orconstable of any county or city or deputies or employees of any of thepreceding local officers.
"Teacher" means any employee of a county, city, or other local publicschool board.
E. Any stock and cash distributed to the Commonwealth pursuant to theconversion of Blue Cross and Blue Shield of Virginia, doing business asTrigon Blue Cross Blue Shield, from a mutual insurance company to a stockcorporation known as Trigon Healthcare, Inc., that is directly attributableto the health insurance plan or plans established for employees of localgovernments, local officers, teachers, and retirees, and the dependents ofsuch employees, officers, teachers and retirees, pursuant to subsection A(hereinafter referred to as the local choice plan distribution) shall bedeposited in the state treasury to the credit of the employee healthinsurance fund to be used as provided in this subsection. Such distributionshall not include any cash paid by Blue Cross and Blue Shield of Virginia orits successor to the Commonwealth in connection with such conversion that wasassumed as general fund revenue in Chapter 912 of the 1996 Acts of Assembly.All other stock and cash received by the Commonwealth pursuant to suchconversion of Blue Cross and Blue Shield of Virginia to a stock corporationshall be allocated as provided in subsection B of § 23-284.
The State Treasurer shall sell any stock received pursuant to the localchoice plan distribution as soon as practicable following its receipt,subject to any lockup period or other restriction on its sale, and theproceeds therefrom shall be deposited in the state treasury to the credit ofthe employee health insurance fund. Notwithstanding any other provision oflaw to the contrary, the State Treasurer shall not be liable for any lossesincurred from the sale or distribution of such stock.
The Department of Human Resource Management shall use any stock, or theproceeds therefrom, and cash received pursuant to the local choice plandistribution to reduce premiums payable by employers participating in a planor plans established pursuant to subsection A. In setting health insurancepremiums for such plan or plans, the Director of the Department of HumanResource Management shall allocate the value of such stock, or proceedstherefrom, and cash among each participating employer. Such allocation shallbe based on the proportionate amounts of premiums previously paid by eachparticipating employer. If a participating employer withdraws from such planor plans before all of the value allocated to it has been used for thebenefit of the participating employer, the remaining value shall betransferred to such participating employer upon his withdrawal.
(1989, c. 475, § 2.1-20.1:02; 1997, cc. 803, 888, 891; 2000, cc. 66, 620,649, 657; 2001, cc. 520, 806, 844; 2008, c. 403.)