Amendment vs bill Amendment ND27J8-1 vs Introduced

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HB323 INTRODUCED PSQFER-1 By Representatives Pettus, Treadaway, Stringer, Rehm RFD:
ND27J8-1 04/24/2023 JC (L)tgw 2023-1621 SUB HB323 COUNTY AND MUNICIPAL GOVERNMENT SUBSTITUTE TO HB323 OFFERED BY REPRESENTATIVE CRAWFORD 2 4 SYNOPSIS:
County and Municipal Government First Read:
6 Under existing workers' compensation law, an occupational disease is not considered to include a mental illness, including post-traumatic stress disorder (PTSD), unless a physical injury accompanies the mental illness.
13-Apr-23 Page 0 PSQFER-1 04/13/2023 JC (L)twg 2023-264 2 4 SYNOPSIS:
Under existing workers' compensation law, an occupational disease is not considered to include a mental illness, including post-traumatic stress disorder (PTSD), unless a physical injury accompanies the mental illness.
This bill would authorize a fund to disburse the benefits, to be established by the Alabama League of Municipalities and regulated by the Secretary of the Department of Labor.
This bill would require that a municipality employing first responders to provide supplemental insurance coverage to pay benefits for work-related PTSD.
This bill would also exempt paid benefits from state income tax liability.
it is approved by the affected entity;
it is approved by the affected Page 1 entity;
or the Page 1 HB323 INTRODUCED Legislature appropriates funds, or provides a local source of revenue, to the entity for the purpose.
or the Legislature appropriates funds, or provides a local source of revenue, to the entity for the purpose.
to make a certain leave benefit available to employed first responders;
to make certain leave benefits available to employed first responders;
to authorize the Secretary of the Department of Labor to regulate a fund established by the Alabama League of Municipalities to provide the benefits payable to first responders;
to exempt benefit payments from the fund from state income tax;
Page 2 HB323 INTRODUCED Section 1.
Section 1.
(1) AUTHORIZED TREATING PHYSICIAN.
Page 2 (1) BENEFITS.
A licensed clinical psychologist or board-certified psychiatrist licensed to practice in this state and with experience diagnosing PTSD, utilizing an evaluation that includes symptom validity testing and other procedures to rule out the presence of malingering PTSD by using established guidelines and criteria.
The coverage provided under this act as described in Section 3.
(2) BENEFITS.
(2) COVERED PARTICIPANT.
The coverage provided under this act as described in Section 3(b) through (d).
A first responder whose annual premium has been paid as provided in this act.
(3) COVERED PARTICIPANT.
(3) EMPLOYER.
A first responder whose annual premium has been paid in full into the fund.
The employing municipality or fire district entity which employs first responders.
(4) EMPLOYER.
(4) FIRST RESPONDER:
The employing municipality or fire district entity which employs participants.
(5) FIRST RESPONDER:
Page 3 HB323 INTRODUCED c.
c.
(6) FUND.
(5) POST-TRAUMATIC STRESS DISORDER (PTSD).
A legal entity established by the Alabama League of Municipalities to administer the benefits provided for in this act, subject to rules adopted by the Department of Labor.
(7) GOVERNING BODY.
The board, authority, or individuals designated by the Alabama League of Municipalities to administer the fund.
(8) POST-TRAUMATIC STRESS DISORDER (PTSD).
(9) QUALIFYING EVENT.
(6) QUALIFIED TREATING PHYSICIAN.
A licensed clinical Page 3 psychologist or board-certified psychiatrist licensed to practice in this state and with experience diagnosing PTSD, utilizing an evaluation that includes symptom validity testing and other procedures to rule out the presence of malingering PTSD by using established guidelines and criteria.
(7) QUALIFYING EVENT.
Page 4 HB323 INTRODUCED (10) SECRETARY.
(8) VOLUNTEER FIRE DEPARTMENT.
The Secretary of the Department of Labor.
(11) VOLUNTEER FIRE DEPARTMENT.
(12) VOLUNTEER PARTICIPANT.
(9) VOLUNTEER PARTICIPANT.
A first responder whose annual premium has been paid in full into the fund.
A first responder whose annual premium has been paid as provided in this act.
The secretary shall be responsible for the regulation of the fund as it relates to the requirements of this act, and he or she shall adopt rules, including, but not limited to, investment policies for any monies held by the fund in furtherance of this act.
(a) An employer of first responders shall provide and maintain sufficient insurance coverage to pay claims for benefits required by this act.
Provided, however, nothing in this act shall limit or restrict the governing body from providing additional benefits to some or all first responders on matters outside the scope of this act.
Page 4 (b) A volunteer fire department is not required to provide coverage under this act for volunteer firefighters.
Any insurer who provides coverage under this act shall make all coverage available to any volunteer firefighter.
Coverage premiums extended to a volunteer firefighter shall be consistent with premiums for employed firefighters.
(c) Nothing in this section shall prevent a volunteer fire department, regional association of volunteer fire departments, a municipality, or any combination of these from optionally contributing in part or in whole to the premium of an individual volunteer firefighter.
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(d) In the event a first responder is employed by more than one employer simultaneously, the primary employer shall be responsible for the benefits provided for in this act.
The primary employer shall be identified as the employer who provides primary health insurance benefits to the first responder.
(e) If a covered participant leaves eligible employment or retires during a covered year, the employer is not entitled to any refund of any portion of the paid premium for that calendar year.
If a volunteer participant discontinues service with a volunteer fire department during a covered year, the volunteer participant, or in the case of a volunteer fire department that has paid or contributed to the volunteer participant's premium, is not entitled to any refund of any portion of the paid premium for that calendar year.
(f) If a covered participant transfers to other eligible employment with a different employer, the new Page 5 employer shall not be required to pay the premium on that participant until the current calendar year's coverage expires with the previous employer.
(g) A covered participant or volunteer participant is no longer entitled to any benefits if he or she resigns, is terminated, or retires from eligible employment with an employer.
A volunteer participant is no longer entitled to any benefits if he or she is no longer associated with a volunteer fire department or is otherwise ineligible to serve as a volunteer firefighter.
(h) Any funds received as premiums for the coverages provided by this act may not be subject to any premium taxes otherwise required by law.
(i) The computation of premium amounts by an insurer for the coverages under this act shall be subject to generally accepted adjustments from insurance underwriting.
The exemption from liability provided in this subdivision is based Page 5 HB323 INTRODUCED on the specific diagnosis for which the covered participant or volunteer participant elects to receive benefits.
The exemption from liability provided in this subdivision is based on the specific diagnosis for which the covered participant or Page 6 volunteer participant elects to receive benefits.
(4) Receives certification from an authorized treating physician providing both of the following:
(4) Receives certification from an qualified treating physician providing both of the following:
(5) Authorizes the governing body to communicate with the authorized treating physician for the limited and sole purpose of confirming PTSD treatment to the extent necessary to verify claims for benefits pursuant to subsections (b) through (d).
(5) Authorizes the insurer to communicate with the qualified treating physician for the limited and sole purpose of confirming PTSD treatment to the extent necessary to verify claims for benefits under this act.
(b) The fund shall reimburse a covered participant or volunteer participant currently employed by an employer or working with a volunteer fire department, respectively, for Page 6 HB323 INTRODUCED any co-payment or deductible not covered by the covered participant or volunteer participant's health insurance and paid by the covered participant or volunteer participant for the treatment of PTSD.
(b) A covered participant or volunteer participant currently employed by an employer or working with a volunteer fire department, respectively, shall be reimbursed for any co-payment or deductible not covered by the covered participant or volunteer participant's health insurance and Page 7 paid by the covered participant or volunteer participant for the treatment of PTSD.
(c)(1) The fund shall reimburse a covered participant or volunteer participant currently employed by an employer or working with a volunteer fire department for travel for PTSD treatment.
(c)(1) A covered participant or volunteer participant currently employed by an employer or working with a volunteer fire department, respectively, shall be reimbursed for travel for PTSD treatment.
The purpose is to visit an authorized treating physician for PTSD treatment.
The purpose is to visit an qualified treating physician for PTSD treatment.
The mileage, one way, between the covered or volunteer participant's residence and the authorized treating physician is at least 25 miles.
The mileage, one way, between the covered participant or volunteer participant's residence and the qualified treating physician is at least 25 miles.
(d) An employer covered by this act shall provide a covered participant who is employed full time by the employer up to an additional 80 working hours of paid leave, per claim related to a specific event, to seek treatment for PTSD.
(1) Any leave taken to seek treatment for PTSD shall be without any loss of pay, shall be in addition to all types Page 7 HB323 INTRODUCED of leave otherwise applicable under the employer's policies, including sick leave, personal leave, and annual vacation.
(2) Any leave taken to seek treatment for PTSD shall not be used by the employer as a factor in any performance evaluation given to the covered participant or any disciplinary action required under the employer's policies to be administered to the covered participant.
(a) The governing body shall establish the annual premium for each calendar year using an actuarial study and shall have these rates approved by the secretary to ensure adequate funding for the fund.
(a) An employer covered by this act shall provide a covered participant who is employed full time by the employer up to an additional 80 working hours of paid leave, per claim related to a specific event, to seek treatment for PTSD.
The computation of premium amounts shall be subject to generally accepted adjustments for insurance underwriting.
(b) Any leave taken to seek treatment for PTSD shall be without any loss of pay and shall be in addition to all types of leave otherwise applicable under the employer's policies, including sick leave, personal leave, and annual vacation.
(b) All employers shall pay the applicable annual premium into the fund for all eligible participants in their employment by December 31 of each calendar year in order to provide coverage for the following calendar year.
Page 8 (c) Any leave taken to seek treatment for PTSD shall not be used by the employer as a factor in any performance evaluation given to the covered participant or any disciplinary action required under the employer's policies to be administered to the covered participant.
(c)(1) A volunteer fire department is not required to provide coverage under this act for volunteer firefighters.
(2) A volunteer firefighter may elect to pay the premium into the fund by December 31 of each calendar year, at his or her own expense, in order to provide coverage for the following calendar year.
(3) Nothing in this subsection shall prevent a volunteer fire department, regional association of volunteer fire departments, a municipality, or any combination of these from optionally contributing in part or in whole to the premium of an individual volunteer firefighter.
Page 8 HB323 INTRODUCED (d) The annual premium paid into the fund is fully earned and is nonrefundable.
(e) If a covered participant leaves eligible employment or retires during a covered year, the employer is not entitled to any refund of any portion of the paid premium for that calendar year.
If a volunteer participant discontinues service with a volunteer fire department during a covered year, the volunteer participant, or in the case of a volunteer fire department that has paid or contributed to the volunteer participant's premium, is not entitled to any refund of any portion of the paid premium for that calendar year.
(f) If a covered participant transfers to other eligible employment with a different employer, the new employer shall not be required to pay the premium on that participant until the current calendar year's coverage expires with the previous employer.
(g) A covered participant or volunteer participant is no longer entitled to any benefits if he or she resigns, is terminated, or retires from eligible employment with an employer.
A volunteer participant is no longer entitled to any benefits if he or she is no longer associated with a volunteer fire department or is otherwise ineligible to serve as a volunteer firefighter.
(h) In the event a covered participant is employed by multiple eligible employers simultaneously, the primary employer shall be responsible for the requirements of this act.
The primary employer shall be identified as the employer Page 9 HB323 INTRODUCED who provides primary health insurance benefits to the participant.
(a) Any monies received by a covered participant or volunteer participant pursuant to this act, to any extent the amounts are included in the federal adjusted gross income of the taxpayer, shall be excluded from taxable income for state income tax purposes.
The reimbursement and benefits requirements of this act shall not apply to PTSD resulting from events occurring prior to the effective date of this act.
(b) Any monies received by the fund as premiums for the coverage provided by this act may not be subject to any premium taxes otherwise required by law.
(c) The reimbursement and benefits requirements of this act shall not apply to PTSD resulting from events occurring prior to the effective date of this act.
This act shall become effective January 1, 2024, following its passage and approval by the Governor, or its otherwise becoming law.
This act shall become effective January 1, 2025, following its passage and approval by the Governor, or its otherwise becoming law.
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