Health Insurance; require policies to cover annual pap smear.

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To: Insurance;
Appropriations A
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representative Currie

HOUSE BILL NO. 1287

AN ACT TO REQUIRE CERTAIN INSURANCE POLICIES AND CONTRACTS 1
PROVIDE COVERAGE FOR ANNUAL PAP SMEARS; TO AMEND SECTION 25-15-9, 2
MISSISSIPPI CODE OF 1972, TO REQUIRE THE STATE AND SCHOOL 3
EMPLOYEES HEALTH INSURANCE PLAN TO INCLUDE COVERAGE FOR ANNUAL PAP 4
SMEARS; AND FOR RELATED PURPOSES. 5
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 6
SECTION 1. (1) An individual and group health insurance 7
policy providing coverage on an expense-incurred basis, individual 8
and group service or indemnity type contract issued by a nonprofit 9
corporation, individual and group service contract issued by a 10
health maintenance organization, self-insured group arrangement to 11
the extent not preempted by federal law, and a managed health care 12
delivery entity of any type or description that is delivered, 13
issued for delivery, continued or renewed on or after July 1, 14
2026, and providing coverage to a resident of this state must 15
provide coverage or benefits for an annual pap smear. The 16
coverage required under this section must meet the requirements 17
set forth in subsection (2) of this section. 18
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(2) An individual may not be required to pay an additional 19
deductible or coinsurance for an annual pap smear which is greater 20
than an annual deductible or coinsurance established for similar 21
benefits. If the program or contract does not cover a similar 22
benefit, a deductible or coinsurance may not be set at a level 23
that materially diminishes the value of the pap smear. 24
Reimbursement to a health care provider for a pap smear provided 25
under this section must be equal to or greater than reimbursement 26
to a health care provider provided under Title XVII of the Social 27
Security Act (Medicare). 28
(3) A group health plan or health insurance issuer is not 29
required under this section to provide for a referral to a 30
nonparticipating health care provider unless the plan or issuer 31
does not have an appropriate health care provider that is 32
available and accessible to perform the pap smear and that is a 33
participating health care provider with respect to that treatment. 34
(4) If a plan or issuer refers an individual to a 35
nonparticipating health care provider in accordance with this 36
section, the pap smear and resulting treatment, if any, must be 37
provided at no additional cost to the individual beyond what the 38
individual would otherwise pay the same for services received from 39
a participating health care provider. 40
SECTION 2. Section 25-15-9, Mississippi Code of 1972, is 41
amended as follows: 42
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25-15-9. (1) (a) The board shall design a plan of health 43
insurance for state employees that provides benefits for 44
semiprivate rooms in addition to other incidental coverages that 45
the board deems necessary. The amount of the coverages shall be 46
in such reasonable amount as may be determined by the board to be 47
adequate, after due consideration of current health costs in 48
Mississippi. The plan shall also include major medical benefits 49
in such amounts as the board determines. The plan shall provide 50
for coverage for telemedicine services as provided in Section 51
83-9-351. The plan also must include coverage for an annual pap 52
smear. The board is also authorized to accept bids for such 53
alternate coverage and optional benefits as the board deems 54
proper. The board is authorized to accept bids for surgical 55
services that include assistance in locating a surgeon, setting up 56
initial consultation, travel, a negotiated single case rate bundle 57
and payment for orthopedic, spine, bariatric, cardiovascular and 58
general surgeries. The surgical services may only utilize 59
surgeons and facilities located in the State of Mississippi unless 60
otherwise provided by the board. Any contract for alternative 61
coverage and optional benefits shall be awarded by the board after 62
it has carefully studied and evaluated the bids and selected the 63
best and most cost-effective bid. The board may reject all of the 64
bids; however, the board shall notify all bidders of the rejection 65
and shall actively solicit new bids if all bids are rejected. The 66
board may employ or contract for such consulting or actuarial 67
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services as may be necessary to formulate the plan, and to assist 68
the board in the preparation of specifications and in the process 69
of advertising for the bids for the plan. Those contracts shall 70
be solicited and entered into in accordance with Section 25-15-5. 71
The board shall keep a record of all persons, agents and 72
corporations who contract with or assist the board in preparing 73
and developing the plan. The board in a timely manner shall 74
provide copies of this record to the members of the advisory 75
council created in this section and those legislators, or their 76
designees, who may attend meetings of the advisory council. The 77
board shall provide copies of this record in the solicitation of 78
bids for the administration or servicing of the self-insured 79
program. Each person, agent or corporation that, during the 80
previous fiscal year, has assisted in the development of the plan 81
or employed or compensated any person who assisted in the 82
development of the plan, and that bids on the administration or 83
servicing of the plan, shall submit to the board a statement 84
accompanying the bid explaining in detail its participation with 85
the development of the plan. This statement shall include the 86
amount of compensation paid by the bidder to any such employee 87
during the previous fiscal year. The board shall make all such 88
information available to the members of the advisory council and 89
those legislators, or their designees, who may attend meetings of 90
the advisory council before any action is taken by the board on 91
the bids submitted. The failure of any bidder to fully and 92
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accurately comply with this paragraph shall result in the 93
rejection of any bid submitted by that bidder or the cancellation 94
of any contract executed when the failure is discovered after the 95
acceptance of that bid. The board is authorized to promulgate 96
rules and regulations to implement the provisions of this 97
subsection. 98
The board shall develop plans for the insurance plan 99
authorized by this section in accordance with the provisions of 100
Section 25-15-5. 101
Any corporation, association, company or individual that 102
contracts with the board for the third-party claims administration 103
of the self-insured plan shall prepare and keep on file an 104
explanation of benefits for each claim processed. The explanation 105
of benefits shall contain such information relative to each 106
processed claim that the board deems necessary, and, at a minimum, 107
each explanation shall provide the claimant's name, claim number, 108
provider number, provider name, service dates, type of services, 109
amount of charges, amount allowed to the claimant and reason 110
codes. The information contained in the explanation of benefits 111
shall be available for inspection upon request by the board. The 112
board shall have access to all claims information utilized in the 113
issuance of payments to employees and providers. 114
(b) There is created an advisory council to advise the 115
board in the formulation of the State and School Employees Health 116
Insurance Plan. The council shall be composed of the * * * 117
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Commissioner of Insurance * * *, or his designee, an 118
employee-representative of the state institutions of higher 119
learning appointed by the board of trustees thereof, an 120
employee-representative of the Mississippi Department of 121
Transportation appointed by the director thereof, an 122
employee-representative of the Department of Revenue appointed by 123
the Commissioner of Revenue, an employee-representative of 124
the * * * State Department of Health appointed by the State Health 125
Officer, an employee-representative of the Mississippi Department 126
of Corrections appointed by the Commissioner of Corrections, and 127
an employee-representative of the Department of Human Services 128
appointed by the Executive Director of Human Services, two 129
(2) * * * licensed public school administrators appointed by the 130
State Board of Education, two (2) * * * licensed classroom 131
teachers appointed by the State Board of Education, a * * * 132
nonlicensed school employee appointed by the State Board of 133
Education and a community * * * or junior college employee 134
appointed by the Mississippi Community College Board. 135
The Lieutenant Governor may designate the Secretary of the 136
Senate, the Chairman of the Senate Appropriations Committee, the 137
Chairman of the Senate Education Committee and the Chairman of the 138
Senate Insurance Committee, and the Speaker of the House of 139
Representatives may designate the Clerk of the House, the Chairman 140
of the House Appropriations Committee, the Chairman of the House 141
Education Committee and the Chairman of the House Insurance 142
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Committee, to attend any meeting of the State and School Employees 143
Insurance Advisory Council. The appointing authorities may 144
designate an alternate member from their respective houses to 145
serve when the regular designee is unable to attend the meetings 146
of the council. Those designees shall have no jurisdiction or 147
vote on any matter within the jurisdiction of the council. For 148
attending meetings of the council, the legislators shall receive 149
per diem and expenses, which shall be paid from the contingent 150
expense funds of their respective houses in the same amounts as 151
provided for committee meetings when the Legislature is not in 152
session; however, no per diem and expenses for attending meetings 153
of the council will be paid while the Legislature is in session. 154
No per diem and expenses will be paid except for attending 155
meetings of the council without prior approval of the proper 156
committee in their respective houses. 157
(c) No change in the terms of the State and School 158
Employees Health Insurance Plan may be made effective unless the 159
board, or its designee, has provided notice to the State and 160
School Employees Health Insurance Advisory Council and has called 161
a meeting of the council at least fifteen (15) days before the 162
effective date of the change. If the State and School Employees 163
Health Insurance Advisory Council does not meet to advise the 164
board on the proposed changes, the changes to the plan shall 165
become effective at such time as the board has informed the 166
council that the changes shall become effective. 167
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(d) Medical benefits for retired employees and 168
dependents under age sixty-five (65) years and not eligible for 169
Medicare benefits. For employees who retire before July 1, 2005, 170
and for employees retiring due to work-related disability under 171
the Public Employees' Retirement System, the same health insurance 172
coverage as for all other active employees and their dependents 173
shall be available to retired employees and all dependents under 174
age sixty-five (65) years who are not eligible for Medicare 175
benefits, the level of benefits to be the same level as for all 176
other active participants. For employees who retire on or after 177
July 1, 2005, and not retiring due to work-related disability 178
under the Public Employees' Retirement System, the same health 179
insurance coverage as for all other active employees and their 180
dependents shall be available to those retiring employees and all 181
dependents under age sixty-five (65) years who are not eligible 182
for Medicare benefits only if the retiring employees were 183
participants in the State and School Employees Health Insurance 184
Plan for four (4) years or more before their retirement, the level 185
of benefits to be the same level as for all other active 186
participants. This section will apply to those employees who 187
retire due to one hundred percent (100%) medical disability as 188
well as those employees electing early retirement. 189
(e) Medical benefits for retired employees and 190
dependents over age sixty-five (65) years or otherwise eligible 191
for Medicare benefits. For employees who retire before July 1, 192
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2005, and for employees retiring due to work-related disability 193
under the Public Employees' Retirement System, the health 194
insurance coverage available to retired employees over age 195
sixty-five (65) years or otherwise eligible for Medicare benefits, 196
and all dependents over age sixty-five (65) years or otherwise 197
eligible for Medicare benefits, shall be the major medical 198
coverage. For employees retiring on or after July 1, 2005, and 199
not retiring due to work-related disability under the Public 200
Employees' Retirement System, the health insurance coverage 201
described in this paragraph (e) shall be available to those 202
retiring employees only if they were participants in the State and 203
School Employees Health Insurance Plan for four (4) years or more 204
and are over age sixty-five (65) years or otherwise eligible for 205
Medicare benefits, and to all dependents over age sixty-five (65) 206
years or otherwise eligible for Medicare benefits. Benefits shall 207
be reduced by Medicare benefits as though the Medicare benefits 208
were the base plan. 209
All covered individuals shall be assumed to have full 210
Medicare coverage, Parts A and B; and any Medicare payments under 211
both Parts A and B shall be computed to reduce benefits payable 212
under this plan. 213
(f) Lifetime maximum: The lifetime maximum amount of 214
benefits payable under the health insurance plan for each 215
participant is Two Million Dollars ($2,000,000.00). 216
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(2) Nonduplication of benefits — reduction of benefits by 217
Title XIX benefits: When benefits would be payable under more 218
than one (1) group plan, benefits under those plans will be 219
coordinated to the extent that the total benefits under all plans 220
will not exceed the total expenses incurred. 221
Benefits for hospital or surgical or medical benefits shall 222
be reduced by any similar benefits payable in accordance with 223
Title XIX of the Social Security Act or under any amendments 224
thereto, or any implementing legislation. 225
Benefits for hospital or surgical or medical benefits shall 226
be reduced by any similar benefits payable by workers' 227
compensation. 228
No health care benefits under the state plan shall restrict 229
coverage for medically appropriate treatment prescribed by a 230
physician and agreed to by a fully informed insured, or if the 231
insured lacks legal capacity to consent by a person who has legal 232
authority to consent on his or her behalf, based on an insured's 233
diagnosis with a terminal condition. As used in this paragraph, 234
"terminal condition" means any aggressive malignancy, chronic 235
end-stage cardiovascular or cerebral vascular disease, or any 236
other disease, illness or condition which physician diagnoses as 237
terminal. 238
Not later than January 1, 2016, the state health plan shall 239
not require a higher co-payment, deductible or coinsurance amount 240
for patient-administered anti-cancer medications, including, but 241
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not limited to, those orally administered or self-injected, than 242
it requires for anti-cancer medications that are injected or 243
intravenously administered by a health care provider, regardless 244
of the formulation or benefit category determination by the plan. 245
For the purposes of this paragraph, the term "anti-cancer 246
medications" has the meaning as defined in Section 83-9-24. 247
(3) (a) Schedule of life insurance benefits — group term: 248
The amount of term life insurance for each active employee of a 249
department, agency or institution of the state government shall 250
not be in excess of One Hundred Thousand Dollars ($100,000.00), or 251
twice the amount of the employee's annual wage to the next highest 252
One Thousand Dollars ($1,000.00), whichever may be less, but in no 253
case less than Thirty Thousand Dollars ($30,000.00), with a like 254
amount for accidental death and dismemberment on a 255
twenty-four-hour basis. The plan will further contain a premium 256
waiver provision if a covered employee becomes totally and 257
permanently disabled before age sixty-five (65) years. Employees 258
retiring after June 30, 1999, shall be eligible to continue life 259
insurance coverage in an amount of Five Thousand Dollars 260
($5,000.00), Ten Thousand Dollars ($10,000.00) or Twenty Thousand 261
Dollars ($20,000.00) into retirement. 262
(b) Effective October 1, 1999, schedule of life 263
insurance benefits — group term: The amount of term life 264
insurance for each active employee of any school district, 265
community * * * or junior college, public library or 266
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university-based program authorized under Section 37-23-31 for 267
deaf, aphasic and emotionally disturbed children or any regular 268
nonstudent bus driver shall not be in excess of One Hundred 269
Thousand Dollars ($100,000.00), or twice the amount of the 270
employee's annual wage to the next highest One Thousand Dollars 271
($1,000.00), whichever may be less, but in no case less than 272
Thirty Thousand Dollars ($30,000.00), with a like amount for 273
accidental death and dismemberment on a twenty-four-hour basis. 274
The plan will further contain a premium waiver provision if a 275
covered employee of any school district, community * * * or junior 276
college, public library or university-based program authorized 277
under Section 37-23-31 for deaf, aphasic and emotionally disturbed 278
children or any regular nonstudent bus driver becomes totally and 279
permanently disabled before age sixty-five (65) years. Employees 280
of any school district, community * * * or junior college, public 281
library or university-based program authorized under Section 282
37-23-31 for deaf, aphasic and emotionally disturbed children or 283
any regular nonstudent bus driver retiring after September 30, 284
1999, shall be eligible to continue life insurance coverage in an 285
amount of Five Thousand Dollars ($5,000.00), Ten Thousand Dollars 286
($10,000.00) or Twenty Thousand Dollars ($20,000.00) into 287
retirement. 288
(4) Any eligible employee who on March 1, 1971, was 289
participating in a group life insurance program that has 290
provisions different from those included in this article and for 291
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which the State of Mississippi was paying a part of the premium 292
may, at his discretion, continue to participate in that plan. The 293
employee shall pay in full all additional costs, if any, above the 294
minimum program established by this article. Under no 295
circumstances shall any individual who begins employment with the 296
state after March 1, 1971, be eligible for the provisions of this 297
subsection. 298
(5) The board may offer medical savings accounts as defined 299
in Section 71-9-3 as a plan option. 300
(6) Any premium differentials, differences in coverages, 301
discounts determined by risk or by any other factors shall be 302
uniformly applied to all active employees participating in the 303
insurance plan. It is the intent of the Legislature that the 304
state contribution to the plan be the same for each employee 305
throughout the state. 306
(7) On October 1, 1999, any school district, community * * * 307
or junior college district or public library may elect to remain 308
with an existing policy or policies of group life insurance with 309
an insurance company approved by the State and School Employees 310
Health Insurance Management Board, in lieu of participation in the 311
State and School Life Insurance Plan. On or after July 1, 2004, 312
until October 1, 2004, any school district, community * * * or 313
junior college district or public library may elect to choose a 314
policy or policies of group life insurance existing on October 1, 315
1999, with an insurance company approved by the State and School 316
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Employees Health Insurance Management Board in lieu of 317
participation in the State and School Life Insurance Plan. The 318
state's contribution of up to fifty percent (50%) of the active 319
employee's premium under the State and School Life Insurance Plan 320
may be applied toward the cost of coverage for full-time employees 321
participating in the approved life insurance company group plan. 322
For purposes of this subsection (7), "life insurance company group 323
plan" means a plan administered or sold by a private insurance 324
company. After October 1, 1999, the board may assess charges in 325
addition to the existing State and School Life Insurance Plan 326
rates to such employees as a condition of enrollment in the State 327
and School Life Insurance Plan. In order for any life insurance 328
company group plan to be approved by the State and School 329
Employees Health Insurance Management Board under this subsection 330
(7), it shall meet the following criteria: 331
(a) The insurance company offering the group life 332
insurance plan shall be rated "A-" or better by A.M. Best state 333
insurance rating service and be licensed as an admitted carrier in 334
the State of Mississippi by the Mississippi Department of 335
Insurance. 336
(b) The insurance company group life insurance plan 337
shall provide the same life insurance, accidental death and 338
dismemberment insurance and waiver of premium benefits as provided 339
in the State and School Life Insurance Plan. 340
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ST: Health Insurance; require policies to cover
annual pap smear.
(c) The insurance company group life insurance plan 341
shall be fully insured, and no form of self-funding life insurance 342
by the company shall be approved. 343
(d) The insurance company group life insurance plan 344
shall have one (1) composite rate per One Thousand Dollars 345
($1,000.00) of coverage for active employees regardless of age and 346
one (1) composite rate per One Thousand Dollars ($1,000.00) of 347
coverage for all retirees regardless of age or type of retiree. 348
(e) The insurance company and its group life insurance 349
plan shall comply with any administrative requirements of the 350
State and School Employees Health Insurance Management Board. If 351
any insurance company providing group life insurance benefits to 352
employees under this subsection (7) fails to comply with any 353
requirements specified in this subsection or any administrative 354
requirements of the board, the state shall discontinue providing 355
funding for the cost of that insurance. 356
SECTION 3. This act shall take effect and be in force from 357
and after July 1, 2026. 358