SECTIONS 21660-21664 - California Statutes

GOVERNMENT CODE

SECTION 21660-21664

21660. This chapter may be cited as the Public Employees' Long-Term
Care Act.

21661. (a) The board shall contract with carriers offering
long-term care insurance plans.
The long-term care insurance plans shall be made available
periodically during open enrollment periods determined by the board.
(b) The board shall award contracts to carriers who are qualified
to provide long-term care benefits, and may develop and administer
self-funded long-term care insurance plans. The board may offer one
or more long-term care insurance plans.
(c) The long-term care insurance plans shall include home,
community, and institutional care and shall, to the extent determined
by the board, provide substantially equivalent coverage to that
required under Chapter 2.6 (commencing with Section 10231) of Part 2
of Division 2 of the Insurance Code, if the carrier has been approved
by the Department of Managed Health Care pursuant to Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code.
(d) The classes of persons who shall be eligible to enroll are:
(1) Active and retired members and annuitants of the Public
Employees' Retirement System, and their spouses, parents, siblings,
and spouses' parents.
(2) Active and retired members and annuitants of the State
Teachers' Retirement Plan, and their spouses, parents, siblings, and
spouses' parents.
(3) Active and retired members and annuitants of the Judges'
Retirement System, and their spouses, parents, siblings, and spouses'
parents.
(4) Active and retired members and annuitants of the Judges'
Retirement System II, and their spouses, parents, siblings, and
spouses' parents.
(5) Active and retired members and annuitants of the Legislators'
Retirement System, and their spouses, parents, siblings, and spouses'
parents.
(6) Members of the California Assembly and Senate and their
spouses, parents, siblings, and spouses' parents.
(7) Active and retired members and annuitants, and other classes
of employees of a public agency that is located in this state, and
their spouses, parents, siblings, and spouses' parents.
(e) An individual specified in paragraphs (1) to (7), inclusive,
of subdivision (d) may not be eligible unless he or she resides in
the United States, its territories and possessions, or in a country
in which a provider network can be established comparable in quality
and effectiveness to those established in the United States.
(f) Notwithstanding paragraphs (1) to (7), inclusive, of
subdivision (d), no person may be enrolled unless he or she meets the
eligibility and underwriting criteria established by the board.
(g) Notwithstanding paragraphs (1) to (7), inclusive, of
subdivision (d), enrollment of active employees of the State of
California shall be subject to Section 19867.
(h) The board shall establish eligibility criteria for enrollment,
establish appropriate underwriting criteria for potential enrollees,
define the scope of covered benefits, define the criteria to receive
benefits, and set any other standards as needed. As used in this
section, "sibling" shall mean a sibling who is at least 18 years of
age.
(i) The long-term care insurance plans may not become part of, or
subject to, the retirement or health benefits programs administered
by the system.
(j) For any self-funded long-term care plan developed by the
board, the premiums shall be deposited in the Public Employees'
Long-term Care Fund.

21662. The board shall consult with employer and employee
representatives of the state and local government entities for whom
the board administers retirement benefits. The board and each
employer is authorized to recover the administrative costs of the
long-term care insurance program from insurance carriers and
premiums. Costs recovered by the board from insurance carriers and
premiums shall be deposited in the Public Employees' Long-Term Care
Fund.

21663. (a) The board may enter into contracts with long-term care
insurance carriers, pursuant to Section 21661, and with entities
offering services relating to the administration of long-term care
plans, without compliance with any provisions of law relating to
competitive bidding.
(b) The board may fix the beginning and ending dates of the
contracts in a manner it deems consistent with administration of this
part. The board shall periodically review each contract according to
a reasonable schedule mutually agreed upon by the parties.
Irrespective of any agreed-upon termination date or period for
review, the board may terminate a contract at any time under
conditions determined by the board, and may automatically renew a
contract from term to term, or for any lesser period it deems
appropriate.
(c) The Department of General Services shall review and approve
all contracts entered into pursuant to this section, to ensure that
each written instrument contains the principal necessary provisions
and proper technical terms and phrases, is formally correct, is
arranged in proper and methodical order, and is adapted to the
specific requirements of the agreement between the parties. The
department's review and approval does not supersede the board's
authority to negotiate and reach agreement with long-term care
insurance carriers or with entities offering services relating to the
administration of long-term care plans, with respect to the rates,
terms, and conditions of contracts entered into pursuant to this
section.

21664. (a) The Public Employees' Long-term Care Fund is established
for the purpose of administering any self-funded long-term care plan
developed by the board and for recovering the administrative costs
of the long-term care program from insurance carriers and premiums.
Notwithstanding Section 13340, the Public Employees' Long-term Care
Fund is continuously appropriated, without regard to fiscal years, to
the board to carry out the purposes of this article, consistent with
its fiduciary duty. Funding for the board's administrative costs is
subject to appropriation by the Legislature and shall be paid out of
the Public Employees' Long-term Care Fund.
(b) The board may set the premiums for any self-funded long-term
care plan and assess charges against carriers and the premiums to
recover the administrative costs of the long-term care program.
(c) The board shall have the exclusive control of the
administration and investment of the Public Employees' Long-term Care
Fund. The board may invest funds in the Public Employees' Long-term
Care Fund pursuant to the law governing its investment of the
retirement fund. The board may authorize its investment staff, or may
contract with independent investment managers, to manage the
investments of the Public Employees' Long-term Care Fund.
(d) Income, of whatever nature, earned on the Public Employees'
Long-term Care Fund during any fiscal year, shall be credited to the
fund.
(e) The Legislature finds and declares that the Public Employees'
Long-term Care Fund is a trust fund held for the exclusive benefit of
enrollees in the long-term care plans offered pursuant to this
article.
(f) It is the intent of the Legislature to provide, in the future,
appropriate resources to properly administer the long-term care
program.