(a) (1) There is created a local education insurance committee to be composed of the commissioner of education, the state treasurer, the commissioner of commerce and insurance, the comptroller of the treasury, the commissioner of finance and administration, a representative of local school boards to be selected by the commissioner of finance and administration, and three (3) teachers employed by local education agencies who participate in the group insurance plan established under this part. The teacher members must be appointed in the same manner described in § 8-34-302(a)(9)(A).(2) The commissioner of education, the state treasurer, the commissioner of commerce and insurance, the comptroller of the treasury, and the commissioner of finance and administration are authorized to designate an alternate representative to attend, participate, and vote at meetings of the local education insurance committee when that respective member is unable to attend. The designation of an alternate representative must be made in writing to the chair of the local education insurance committee.
(1) There is created a local education insurance committee to be composed of the commissioner of education, the state treasurer, the commissioner of commerce and insurance, the comptroller of the treasury, the commissioner of finance and administration, a representative of local school boards to be selected by the commissioner of finance and administration, and three (3) teachers employed by local education agencies who participate in the group insurance plan established under this part. The teacher members must be appointed in the same manner described in § 8-34-302(a)(9)(A).
(2) The commissioner of education, the state treasurer, the commissioner of commerce and insurance, the comptroller of the treasury, and the commissioner of finance and administration are authorized to designate an alternate representative to attend, participate, and vote at meetings of the local education insurance committee when that respective member is unable to attend. The designation of an alternate representative must be made in writing to the chair of the local education insurance committee.
(b) As used in this part:(1) “Claims data” means:(A) A general claims data set aggregated by month and year, for the most recent thirty-six (36) months of available data, and describing the claims experience with the following information:(i) Number of enrolled employees, including whether the individual is active or a retiree;(ii) Number of members;(iii) Charges submitted;(iv) Allowed amount;(v) Deductible amount;(vi) Copayments;(vii) Coinsurance amounts;(viii) Third-party amounts; and(ix) Net payment; and(B) A large claims data set aggregated by month and year, for the most recent thirty-six (36) months of available data, and describing the net or allowed payments for individuals exceeding twenty-five thousand dollars ($25,000), and describing the claims experience with the following information:(i) Fund code designating whether the individual is active or a retiree;(ii) Year of birth;(iii) Principal diagnosis code;(iv) The net or allowed amount paid on behalf of the individual; and(v) A sequential member reference number rather than the individual's name;(2) “Instructional employee” means those persons employed by a local education agency as teachers, as defined in § 8-34-101, and who are not eligible for insurance coverage under § 8-27-202;(3) “Local education agency” or “LEA” has the same definition as used in § 49-3-104 and includes educational cooperatives created pursuant to the Educational Cooperation Act, compiled in title 49, chapter 2, part 13;(4) “Local education insurance committee” means the local education insurance committee created in subsection (a); and(5) “Support staff employees” means those persons employed by a local education agency who are not instructional employees.
(1) “Claims data” means:(A) A general claims data set aggregated by month and year, for the most recent thirty-six (36) months of available data, and describing the claims experience with the following information:(i) Number of enrolled employees, including whether the individual is active or a retiree;(ii) Number of members;(iii) Charges submitted;(iv) Allowed amount;(v) Deductible amount;(vi) Copayments;(vii) Coinsurance amounts;(viii) Third-party amounts; and(ix) Net payment; and(B) A large claims data set aggregated by month and year, for the most recent thirty-six (36) months of available data, and describing the net or allowed payments for individuals exceeding twenty-five thousand dollars ($25,000), and describing the claims experience with the following information:(i) Fund code designating whether the individual is active or a retiree;(ii) Year of birth;(iii) Principal diagnosis code;(iv) The net or allowed amount paid on behalf of the individual; and(v) A sequential member reference number rather than the individual's name;
(A) A general claims data set aggregated by month and year, for the most recent thirty-six (36) months of available data, and describing the claims experience with the following information:(i) Number of enrolled employees, including whether the individual is active or a retiree;(ii) Number of members;(iii) Charges submitted;(iv) Allowed amount;(v) Deductible amount;(vi) Copayments;(vii) Coinsurance amounts;(viii) Third-party amounts; and(ix) Net payment; and
(i) Number of enrolled employees, including whether the individual is active or a retiree;
(ii) Number of members;
(iii) Charges submitted;
(iv) Allowed amount;
(v) Deductible amount;
(vi) Copayments;
(vii) Coinsurance amounts;
(viii) Third-party amounts; and
(ix) Net payment; and
(B) A large claims data set aggregated by month and year, for the most recent thirty-six (36) months of available data, and describing the net or allowed payments for individuals exceeding twenty-five thousand dollars ($25,000), and describing the claims experience with the following information:(i) Fund code designating whether the individual is active or a retiree;(ii) Year of birth;(iii) Principal diagnosis code;(iv) The net or allowed amount paid on behalf of the individual; and(v) A sequential member reference number rather than the individual's name;
(i) Fund code designating whether the individual is active or a retiree;
(ii) Year of birth;
(iii) Principal diagnosis code;
(iv) The net or allowed amount paid on behalf of the individual; and
(v) A sequential member reference number rather than the individual's name;
(2) “Instructional employee” means those persons employed by a local education agency as teachers, as defined in § 8-34-101, and who are not eligible for insurance coverage under § 8-27-202;
(3) “Local education agency” or “LEA” has the same definition as used in § 49-3-104 and includes educational cooperatives created pursuant to the Educational Cooperation Act, compiled in title 49, chapter 2, part 13;
(4) “Local education insurance committee” means the local education insurance committee created in subsection (a); and
(5) “Support staff employees” means those persons employed by a local education agency who are not instructional employees.