,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #acai  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #b1 #bjag,mr4    
,m>*ant 7= himself1 ,mr4 ,?ornb]ry1 &   
,mr4 ,craw=d7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce  ,a ,,bill  ,to am5d title    
,,xxvii ( ! ,public ,heal? ,s]vice ,act 
to p]mit coop]ative gov]n+ ( public     
entity heal? b5efits ?r\gh local        
gov]nm5ts 9 second>y ,/ates4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,local &
 ,municipal ,heal? ,c>e ,*oice ,act (   
#bjag4  #b4 ,coop]ative gov]n+ ( public 
entity gr\p heal? cov]age ,title ,,xxvii
 ( ! ,public ,heal? ,s]vice ,act 7#db   
,u4,s4,c4 #cjj;gg et seq47 is am5d$--   
7#a7 by r$esignat+ ! section #bgid 7#db 
,u4,s4,c4 #cjj;gg-#ie7 relat+ to uni=m  
fraud & abuse ref]ral =mat z section    
#bgie2 &  7#b7 by add+ at ! end ! foll[+
 new section3  #bgif4 ,au?ority to (f]  
public entity gr\p heal? cov]age to     
local gov]nm5ts 9 a second>y ,/ate  7a7 
,9 g5]al ,a local gov]nm5t 9 a second>y 

,/ate 7z def9$ 9 subsection 7h77#g77 may
 provide gr\p heal? cov]age to its      
(fic]s1 employees1 or retirees 7& _!    
dep5d5ts7 ?r\gh a local gov]nm5t        
employee heal? b5efits pool or program  
au?oriz$ "u ! laws ( a prim>y ,/ate1    
subject to ! provisions ( ?is section4  
7b7 ,eligibility = multi/ate activity ,a
 local gov]nm5t employee heal? b5efits  
pool or program %all be eligible to (f] 
gr\p heal? cov]age to (ficials1         
employees1 & retirees 7& _! dep5d5ts7 ( 
a local gov]nm5t locat$ 9 a second>y    
,/ate ?r\gh an int]local agreem5t ) su* 
local gov]nm5t1 or z approv$ by an      
applicable ,/ate au?ority 9 su* second>y
 ,/ate1 unless--  7#a7 9 ! case ( a pool
 or program t prim>ily s]ves municipal  
(fic]s1 employees1 or retirees 7& _!    
dep5d5ts71 an objection is made to !    
(f]+ ( su* cov]age by ! municipal league
 or association locat$ 9 ! second>y     
,/ate )9 #ij days ( ! date on :i* !     
au?ority is grant$ or an int]local      
agreem5t is execut$2 or  7#b7 9 ! case (

 a pool or program t prim>ily s]ves     
c\nty (fic]s1 employees1 retirees 7& _! 
dep5d5ts71 an objection is made to !    
(f]+ ( su* cov]age by ! c\nty           
association locat$ 9 ! second>y ,/ate )9
 #ij days ( ! date on :i* ! au?ority is 
grant$ or an int]local agreem5t is      
execut$4  7c7 ,application ( cov]$ laws 
( prim>y ,/ate ,! cov]$ laws 7z def9$ 9 
subsection 7h77#b77 ( ! prim>y ,/ate    
%all apply to gr\p heal? cov]age (f]$ by
 a local gov]nm5t employee heal? b5efits
 pool or program 9 ! prim>y ,/ate & 9   
any second>y ,/ate1 b only if ! cov]age 
& ! pool or program comply ) !          
conditions ( ?is section ) respect to ! 
(f]+ ( cov]age 9 any second>y ,/ate4    
7d7 ,limit$ application ( second>y ,/ate
 laws  7#a7 ,9 g5]al ,except z provid$ 9
 ?is section1 a local gov]nm5t employee 
heal? b5efits pool or program t (f]s    
gr\p heal? cov]age 9 a second>y ,/ate to
 ! (fic]s1 employees1 or retirees 7& _! 
dep5d5ts7 ( a local gov]nm5t locat$ 9   
su* second>y ,/ate1 is exempt f any     

cov]$ laws ( ! second>y ,/ate 7& any    
rules1 regulations1 agreem5ts1 or ord]s 
s\ght or issu$ by su* ,/ate "u or relat$
 to su* cov]$ laws74  7#b7 ,second>y    
,/ate au?ority ,a second>y ,/ate may    
require a local gov]nm5t employee heal? 
b5efits pool or program to d any or all 
( ! foll[+3  7,a7 ,regi/ration ,to      
regi/] ) an applicable ,/ate au?ority 9 
su* ,/ate ) jurisdiction ov] local      
gov]nm5t employee heal? b5efits pools or
 programs & designate su* au?ority z its
 ag5t solely = ! purpose ( receiv+      
s]vice ( legal docum5ts or process4     
7,b7 ,docum5tation ,to file ) an        
applicable ,/ate au?ority 9 su* ,/ate-- 
7i7 a writt5 int5t to d bus9ess 9 t     
,/ate2  7ii7 copies ( ! memb]%ip or     
int]local agreem5ts ent]$ into betwe5 ! 
local gov]nm5t employee heal? b5efits   
pool or program & a local gov]nm5t ( t  
,/ate2 &  7iii7 copies ( annual audit$  
f9ancial /atem5ts ( ! local gov]nm5t    
employee heal? b5efits pool or program  
fil$ ) ! prim>y ,/ate4  7,c7 ,compliance

 ) injunctions ,to comply ) an          
injunction issu$ by a c\rt ( compet5t   
jurisdiction1 ^u a petition by an       
applicable ,/ate au?ority 9 su* ,/ate   
alleg+ t ! pool or program is 9 haz>d\s 
f9ancial condition4  7,d7 ,compliance ) 
,/ate fraud & abuse laws ,to comply )   
any ,/ate law reg>d+ fraud & abuse1     
except t if ! ,/ate seeks an injunction 
reg>d+ ! conduct describ$ 9 ?is         
subp>agraph1 su* injunction mu/ be      
obta9$ f a c\rt ( compet5t jurisdiction4
  7,e7 ,compliance ) ,/ate unfair claims
 settlem5t practices laws ,to comply )  
any ,/ate law reg>d+ unfair claims      
settlem5t practices4  7#c7 ,limitations 
on second>y ,/ate au?ority ,if a local  
gov]nm5t employee heal? b5efits pool or 
program (f]s gr\p heal? insurance       
cov]age to (ficials1 employees1 &       
retirees 7& _! dep5d5ts7 ( a local      
gov]nm5t locat$ 9 a second>y ,/ate      
pursuant to subsection 7b71 su* second>y
 ,/ate may n d any ( ! foll[+3  7,a7    
,c\nt]sign$ by local ag5t or brok]      

,require any gr\p heal? cov]age issu$ by
 ! pool or program to be c\nt]sign$ by  
an insurance ag5t or brok] resid+ 9 t   
second>y ,/ate4  7,b7 ,submit to        
duplicative f9ancial exam9ations        
,require ! pool or program to submit to 
an exam9ation ( its f9ancial condition  
by an applicable ,/ate au?ority 9 su*   
,/ate1 unless--  7i7 an applicable ,/ate
 au?ority ( ! prim>y ,/ate has n done an
 exam9ation )9 ! p]iod recomm5d$ by !   
,national ,association ( ,insurance     
,commission]s2 &  7ii7 any su*          
exam9ation by ! second>y ,/ate is       
conduct$ 9 accordance ) ! exam9]s'      
h&book ( ! ,national ,association (     
,insurance ,commission]s & is coord9at$ 
to avoid unju/ifi$ duplication &        
unju/ifi$ repetition4  7,c7 ,discrim9ate
 aga9/ pool or program ,o!rwise         
discrim9ate aga9/ ! pool or program     
issu+ gr\p heal? cov]age 9 bo? ! prim>y 
,/ate & 9 any second>y ,/ate4  7e7      
,disclosure requirem5t ,prior to provid+
 gr\p heal? cov]age to ! (fic]s1        

employees1 or retirees 7& _! dep5d5ts7 (
 a local gov]nm5t locat$ 9 a second>y   
,/ate1 a local gov]nm5t employee heal?  
b5efits pool or program %all provide    
notice to su* individuals t ! heal?     
cov]age is gov]n$ by ! cov]$ laws &     
regulations ( ! prim>y ,/ate1 z well z  
by any applicable ,f$]al laws &         
regulations4  7f7 ,/atus ( gr\p heal?   
cov]age 9 second>y ,/ate ,a local       
gov]nm5t employee heal? b5efits pool or 
program t is n regulat$ z an insur] 9   
its prim>y ,/ate1 & ^: gr\p heal? plans 
are n regulat$ z insurance 9 its prim>y 
,/ate1 %all n be subject to !           
jurisdiction ( a ,/ate insurance        
regulatory ag5cy 9 any second>y ,/ate4  
7g7 ,designation ( prim>y ,/ate  7#a7   
,designation ( a s+le ,/ate ,a local    
gov]nm5t employee heal? b5efits pool or 
program may only designate "o ,/ate z   
its prim>y ,/ate ) respect to all su*   
cov]age x (f]s "u ?is section4  7#b7    
,initial op]ations 9 prim>y ,/ate ,su*  
pool or program may n (f] gr\p heal?    

cov]age 9 a second>y ,/ate until x is   
deem$ to be do+ bus9ess 9 ! prim>y      
,/ate4  7h7 ,def9itions ,9 ?is section3 
7#a7 ,applicable ,/ate au?ority ,! t]m  
applicable ,/ate au?ority means1 )      
respect to a local gov]nm5t employee    
heal? b5efits pool or program 9 a ,/ate1
 any (ficial or (ficials designat$ by ! 
,/ate to adm9i/] ! requirem5ts ( ?is    
section = ! ,/ate ) respect to su* pool 
or program1 includ+ ! (ficial or        
(ficials ) au?ority to approve int]local
 agreem5ts "u applicable ,/ate law1 b   
%all n include any ,/ate insurance      
regulatory ag5cy4  7#b7 ,cov]$ laws     
7,a7 ,9 g5]al ,! t]m cov]$ laws means ! 
laws1 rules1 regulations1 agreem5ts1 &  
ord]s p]ta9+ to any ( ! foll[+3 7i7     
,gr\p heal? cov]age issu$ by a local    
gov]nm5t employee heal? b5efits pool or 
program4  7ii7 ,! (f]1 sale1 rat+       
7includ+ m$ical und]writ+71 r5ewal1 &   
issuance ( gr\p heal? cov]age to local  
gov]nm5t (ficials1 employees1 & retirees
 or _! dep5d5ts4  7iii7 ,! managem5t1   

op]ations1 & inve/m5t activities ( a    
local gov]nm5t employee heal? b5efits   
pool or program4  7iv7 ,loss control &  
claims adm9i/ration = a local gov]nm5t  
employee heal? b5efits pool or program )
 respect to liability = :i* ! pool or   
program provides cov]age4  7v7 ,!       
paym5t1 on a nondiscrim9atory basis1 (  
applicable premium & o!r taxes 7includ+ 
high risk pool assessm5ts7 :i* are levi$
 on heal? insurance issu]s1 brok]s1 or  
policyhold]s "u ! laws ( ! ,/ate4  7,b7 
,exception ,su* t]m does n include any  
law1 rule1 regulation1 agreem5t1 or ord]
 gov]n+ ! use ( c>e or co/ managem5t    
te*niques1 includ+ any requirem5t relat$
 to provid] contract+1 network access or
 adequacy1 heal? c>e data collection1 or
 quality assurance4  7#c7 ,gr\p heal?   
cov]age ,! t]m gr\p heal? cov]age means 
m$ical c>e exp5se reimbursem5t provid$  
"u a gr\p heal? plan4  7#d7 ,local      
gov]nm5t ,! t]m local gov]nm5t means a  
c\nty1 municipality1 special di/rict1   
s*ool di/rict1 junior college di/rict1  

h\s+ au?ority1 or o!r political         
subdivision or public entity def9$ "u   
,/ate law4  7#e7 ,local gov]nm5t        
employee heal? b5efits pool or program  
,! t]m local gov]nm5t employee heal?    
b5efits pool or program means a risk    
pool au?oriz$ or p]mitt$ by ,/ate /atute
 or o!rwise regulat$ by a ,/ate ag5cy "u
 :i*--  7,a7 a local gov]nm5t or gr\p ( 
local gov]nm5ts1 directly or ?r\gh a    
pool1 provide heal? c>e b5efits prim>ily
 = local gov]nm5t (ficials1 employees1 &
 retirees & _! dep5d5ts2 &  7,b7 su*    
pool may provide heal? c>e b5efits f !  
assets ( ! pool or its memb] local      
gov]nm5ts ?r\gh any comb9ation (        
self-fund$ arrangem5ts or fully insur$  
products1  & includes any o!r ,/ate     
au?oriz$ program design$ to provide     
heal? b5efits to local gov]nm5t         
(ficials1 employees1 & retirees & _!    
dep5d5ts4  7#f7 ,prim>y ,/ate ,! t]m    
prim>y ,/ate means1 ) respect to gr\p   
heal? cov]age (f]$ by a local gov]nm5t  
employee heal? b5efits pool or program1 

! ,/ate designat$ by ! pool or program z
 ! ,/ate ^: cov]$ laws %all gov]n ! pool
 or program 9 ! issuance ( su* cov]age  
"u ?is "p4  7#g7 ,second>y ,/ate ,! t]m 
second>y ,/ate means1 ) respect to gr\p 
heal? cov]age (f]$ by a local gov]nm5t  
employee heal? b5efits pool or program1 
any ,/ate t is n ! prim>y ,/ate4  4