Large Employer Worker Health-Care Support

     The bill creates the large employer health-care support enterprise (enterprise) to impose, assess, and collect the large employer health-care support fee (enterprise fee) in the amount of $2,300 for each supported worker for the calendar year. A worker who is receiving medical assistance benefits under the state medical assistance program is a supported worker (supported worker).

     The business purpose of the enterprise is to help large employers retain supported workers who are not provided employer-sponsored affordable health coverage by using enterprise fee revenue to help finance the costs for medical assistance benefits for large employers' workers. This service reduces lost productivity due to worker illness and training costs to replace workers who may otherwise seek employment that provides affordable health coverage.

     An employer is subject to the enterprise fee if the employer is a large employer, which is defined in the bill as an employer that has 500 or more supported workers (large employer). An employer is exempted from paying the enterprise fee if the employer:

• Provides affordable health coverage to all workers working 20 or more hours per week or 80 or more hours per month;
• Is a franchisee of the employer;
• Is a nonprofit employer;
• Is a public employer; or
• Has a collective bargaining agreement with its employees that includes health-care coverage.

     Starting with a review of the 2027 calendar year, the department of health care policy and financing (HCPF) shall prepare a large employer report by March of the following calendar year that identifies large employers by their number of supported workers for the preceding calendar year. An employer may contest the employer's identification as a large employer. Once identified, a large employer shall either pay the enterprise fee for each of the large employer's supported workers or demonstrate that it provides affordable health coverage to all workers working 20 or more hours per week or 80 or more hours per month. The enterprise may adjust the amount of the enterprise fee to reflect the cost of the services, for inflation, or for other reasons. A large employer commits a petty offense and is subject to a civil penalty for failure to provide information necessary to calculate the enterprise fee or to either timely pay the enterprise fee or demonstrate that the large employer offers affordable health coverage as specified in the bill.

     Enterprise revenue is used to pay for medical assistance benefits for working-age adults under the state medical assistance program and to increase reimbursement rates for health-care providers providing medical assistance program services to ensure worker access to medical services.

     The enterprise is governed by the enterprise board, and the enterprise board shall report annually to the general assembly on the enterprise revenue and the enterprise's use of the enterprise revenue in support of large employers.

     If the enterprise determines that retaining additional enterprise fee revenue would cause the enterprise to receive more than $100 million dollars in its first 5 fiscal years, the state treasurer shall credit the additional fee revenue to the large employer fee cash fund created in the state treasury for administration by HCPF, and that fee revenue is subject to the state fiscal year spending limit imposed by section 20 of article X of the state constitution and the excess revenues cap. The money in the large employer fee cash fund shall be used by HCPF to pay for costs for medical assistance benefits to support large employers' supported workers.
(Note: This summary applies to this bill as introduced.)