HB 422: State employees' health insurance; include high deductible health plans

Currently Georgia's state employee health insurance program is not required to offer high deductible health plans (insurance plans with lower premiums but higher out-of-pocket costs before coverage kicks in) paired with health savings accounts, which let people set aside pretax money for medical expenses. This bill adds a new section to Georgia law requiring the state health plan's governing board to include at least two such high deductible plans, from different insurers, by January 1, 2028, as long as the bids are cost neutral to the state. By January 1, 2026, the board must also make sure covered state employees enrolled in a high deductible plan can contribute pretax money to a health savings account through payroll deductions. The State Accounting Office and state agency heads are authorized to make those payroll deductions. The bill also encourages, but does not require, other government employers such as local school boards to offer the same pretax contribution option to their employees who are in the same insurance system.

• Adds a new Code section requiring the state health insurance board to include at least two high deductible health plans from different insurers by January 1, 2028, if bids are cost neutral.
• Requires the board to ensure covered state employees in a high deductible plan can make pretax payroll contributions to a health savings account by January 1, 2026.
• Authorizes the State Accounting Office and heads of state government entities to deduct employee-designated amounts from pay for health savings account contributions.
• Encourages, without requiring, other governmental employers in the state health plan, including local school boards, to offer the same pretax contribution option to their employees.

State employees eligible for the state health insurance plan, especially those who enroll in a high deductible plan; the state board that administers the health insurance program; the State Accounting Office and state agency payroll offices; and other governmental employers, including local boards of education, that participate in the state health plan.

State employees who choose a high deductible health plan would gain a guaranteed way to save pretax money for medical costs through payroll deductions, potentially lowering their taxable income and out-of-pocket burden. The board must add qualifying plan options by set deadlines, giving employees more insurance choices within a few years.

• New Code Section 45-18-3.1(a) defines 'covered employee' and 'high deductible health plan' by reference to Section 223 of the federal Internal Revenue Code.
• Subsection (b) requires the board to include at least two cost neutral high deductible health plans from different insurers with affiliated health savings account custodians by January 1, 2028.
• Subsection (c) requires the board to ensure covered employees enrolled in such a plan can make pretax health savings account contributions through payroll deductions by January 1, 2026.
• Subsection (d) authorizes the State Accounting Office or the head of a state governmental entity to make the payroll deductions employees voluntarily designate for health savings accounts.
• Subsection (e) encourages other governmental entities in the state health plan, such as local boards of education, to offer the same pretax contribution option to their non-covered-employee participants.
• Section 2 repeals any conflicting laws.

1. 2025-05-14Effective Date 2025-07-01
2. 2025-05-14Act 267
3. 2025-05-14House Date Signed by Governor (Cámara de Representantes)
4. 2025-04-09House Sent to Governor (Cámara de Representantes)
5. 2025-04-04House Agreed Senate Amend or Sub (Cámara de Representantes)
6. 2025-04-04Senate Passed/Adopted By Substitute (Senado)
7. 2025-04-04Senate Third Read (Senado)
8. 2025-04-04Senate Taken from Table (Senado)

• Derrick McCollum (R, HD-030)Patrocinador principal
• Jan Jones (R, HD-047)
• James Burchett (R, HD-176)
• Bruce Williamson (R, HD-112)
• Shaw Blackmon (R, HD-146)
• Brad Thomas (R, HD-021)
• Jason Esteves (D, SD-035)

1. AprobadaVotación: Cámara de Representantes28 de febrero de 2025

   163 a favor, 0 en contra (7 sin votar, 10 ausentes)

   Passage: House Vote #119

2. AprobadaVotación: Cámara de Representantes4 de abril de 2025

   163 a favor, 0 en contra (4 sin votar, 13 ausentes)

   Agree To Senate Substitute: House Vote #450

3. AprobadaVotación: Senado4 de abril de 2025

   52 a favor, 1 en contra (1 sin votar, 2 ausentes)

   Passage By Substitute: Senate Vote #461

• state employee benefits
• health insurance
• health savings accounts
• payroll deductions
• high deductible health plans