2001-070-RES ELECTING PURUSANT TO 42 USC SEC 300GG-21 EXEMPTIONS FROM REQUIREMENTS OF HEALTH INSURANC EPORTABILITY AND ACCOUNTABILITY (HIPPA)
RESOLUTION NO. ?OOl-070
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS,
PARIS, TEXAS, ELECTING, PURSUANT TO 42 U.S.e. SEe. 300GG-21,
EXEMPTION FROM THE REQUIREMENTS OF THE HEALTH
INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) AND
THE PUBLIC HEALTH SERVICES ACT (PHS); AUTHORIZING THE
EXECUTION OF THE ELECTION UNDER 42 U.S.C. SEC. 300GG.21;
MAKING OTHER FINDINGS AND PROVISIONS RELATED TO THE
SUBJECT; AND PROVIDING AN EFFECTIVE DATE.
WHEREAS, the City of Paris has a uniform group benefits plan that is administered by the
Texas Municipal League Group Benefits Risk Pool (TML-GBRP); and,
WHEREAS, effective with the first plan year following July 1, 1997, the Federal Health
Insurance Portability and Accountability Act of 1996 (IDPAA), which establishes a standard
definition for what can be considered an existing condition, went into effect, with the effective date
for the City of Paris being May 1, 1998; and,
WHEREAS, in addition to IDP AA, the Federal Government has amended the Public Health
Services Act (PHS) to standardize benefits relating to mothers and newborns and to establish parity
in the application of mental health benefits; and,
WHEREAS, the City of Paris's employee health benefit plan in a non-Federal governmental
plan, and IDP AA allows such plans to elect to be exempt from any or all of this new legislation; and,
WHEREAS, the City Council of the City of Paris has acted to approved such exemptions
in the past; and,
WHEREAS, because of the severe penalties which are established in the law for non-
compliance, the City's plan administrator, TML-GBRP, recommends that the City of Paris continues
to exempt itself to avoid the potential of financial penalties, and it is deemed appropriate that such
recommendation be taken; and,
WHEREAS, the form for the Election Under 42 U.S.C. Sec. 300gg-21, attached hereto as
Exhibit A, should, in all things, be approved, and the Mayor should be authorized to execute the
same; NOW, THEREFORE,
BE IT RESOLVED BY TIlE CITY COUNCIL OF THE CITY OF PARIS, PARIS,
TEXAS:
Section 1. That the findings set out in the preamble to this resolution are hereby in all things
approved.
Section 2. That the form ofthe Election Under 42 U.S.C. Sec. 300gg-21, which exempts the
City of Paris from the requirements of the Health Insurance Portability and Accountability Act
(liP AA) and the Public Health Services Act (PHS), attached hereto as Exhibit A, be, and the same
is hereby, approved.
Section 3. That the Mayor be, and he is hereby, authorized and directed to execute, on behalf
of the City of Paris, the Election Under 42 U.S.C. Sec. 300gg-21, under the terms and conditions and
in the form shown in Exhibit A, attached hereto.
Section 4. That this resolution shall be effective from and after its date of passage.
PASSED AND APPROVED this 14th day of May, 2001.
~;~
Michael J. Pfiest , a
ATTEST:
Mattie Cunningham, City Clerk
CITY OF PARIS, PARIS, TEXAS
ELECTION UNDER 42 U.s.c. ~ 300gg-21
The CITY OF PARIS, PARIS, TEXAS, 135 1st Street S.E., Paris, Texas 75461-9037, (903)
785-7511, a Texas political subdivision employees' uniform group benefits plan administered by the
Texas Municipal League Group Benefits Risk Pool, 1821 Rutherford Lane, Suite 300, Austin, Texas
78754-515,1 (5121719-6500), pursuant to 42 D.S.C. ~ 300gg-21, hereby elects to be exempt for the
plan year beginning May 1,2001, through April 30, 2002, from the following requirements of the
Health Insurance Portability and Accountability Act of 1996: (A check in the box indicates entities
decision to be exempt)
181 Limitations on preexisting condition exclusion periods
181 Special enrollment periods for individuals (and dependents) losing other coverage.
181 Prohibitions against discriminating against indi vidual participants and beneficiaries
based on health status.
181 Standards relating to benefits for mother and newborns
181 Parity in the application of certain limits to mental health benefits.
The City of Paris Health Benefit Plan is a self-funded program and does not include health
insurance coverage.
This election is being made at a duly called open meeting of the City Council of the City of
Paris on May 14,2001, at Paris, Texas.
The attached "Notice to Plan Participants Regarding the City of Paris's Election Under 42
D.S.C. ~ 300gg-21" will be provided to all Plan participants by being prominently printed in the
Plan's summary plan document. Said notice will be given to each Plan participant at the time of
enrollment.
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It is hereby certified that Michael J. Pfiester is the Mayor of the City of Paris and is fully
authorized to execute this election form on behalf of and at the request of the City of Paris.
SIGNED this 14th day of May, 2001.
Michael J. Pfiester, Mayor
ATTEST:
Mattie Cunningham, City Clerk
APPROVED AS TO FORM:
Larry W. Schenk, City Attorney
~
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NOTICE TO PLAN PARTICIPANTS
REGARDING THE CITY OF PARIS'S ELECTION
UNDER 42 U.S.C 300 gg-21
TillS IS TO NOTIFY YOU THAT FEDERAL LAW IMPOSES UPON GROUP HEALTH PLANS CERTAIN
LIMITATIONS OF PREEXISTING CONDITION EXCLUSIONS PERIODS. SPECIAL ENROLLEMNT
PERIODS FOR INDNIDUALS (AND DEPENDENTS) LOSING OTHER COVERAGE, PROHIBITIONS
AGAINST DISCRIMINATING AGAINST INDNIDUAL PARTICIPANTS AND BENEFICIARIES BASED ON
HEALTH STATUS, STANDARDS RELATING TO BENEFITS FOR MOTHERS AND NEWBORNS, AND
PARITY IN THE APPLICATION OF CERTAIN LIMITS TO MENTAL HEALTH BENEFITS AND A
WOMAN'S RIGHT TO TREATMENT OF THE UNAFFECTED BREAST FOLLOWING A MASTECTOMY.
FEDERAL LAWALLOW A NON-FEDERAL GOVERNMENTAL PLAN (SUCH AS THE CITY OF PARIS'S
PLAN) TOEXEMPT ITS PLAN IN WHOLE OR IN PART FROM THESE REQUIREMENTS. THE CITY OF
PARIS HAS ELECTED TO BE EXEMPT FROM THE FOLLOWING REQUIREMENTS: LIMITATIONS ON
PREEXISTING CONDITION EXCLUSION PERIODS, SPECIAL ENROLLMENT PERIODS FOR
INDNIDUALS (AND DEPENDENTS) LOSING COVERAGE, PROHIBITIONS AGAINST DISCRIMINATING
AGAINST INDNIDUAL PARTICIPANTS AND BENEFICIARIES BASED ON HEALTH STATUS,
STANDARDS RELATING TO BENEFITS FOR MOTHERS AND NEWBORNS, AND THE PARITY IN THE
APPLICATION OF CERTAIN LIMITS TO MENTAL HEALTH BENEFITS. BECAUSE OF TillS ELECTION
EMPLOYEES AND DEPENDENTS WILL BE SUBJECT TO BENEFIT LIMITS EVEN IF THEY HAD 12 OR
18 MONTHS OF COVERAGE UNDER ANOTHER PLAN WITHIN THE LAST 63 DAYS, THE DURATION OF
A HOSPITAL CONFINMENT FOR A MOTHER AND NEWBORN FOLLOWING THE BIRTH OF A CHILD
WILL BE DETERMINED ON MEDICAL NECESSITY, AND MENTAL HELATH BENEFITS HAVE AN
ANNUAL MAXIMUM WInCH IS LESS THAN THE MAXIMUMS FOR OTHER MEDICAL CONDITION.
EVEN THOUGH THE PLAN IS EXEMPT, EMPLOYEES AND DEPENDENTS WILL BE ABLE TO ENROLL
IF THEY HAVE A QUALIFYING EVENT DURING THE PLAN YEAR AS SET FORTH IN TillS BOKLET
AND NO INDNIDUAL WILL BE DECLINED COVERAGE OT CHARGED A illGHER RATE BASED ON A
MEDICAL CONDITION. THE PLANS QUALIFYING EVENTS ARE MORE LffiERAL THAN THE FEDERAL
LAW THE ENTIRE PLAN IS SUBJECT TO TillS EXEMPTION.
City of Paris (rev 05/01) - Page 3