2023 Laws of Puerto Rico › TITLE THREE - Executive (§§ 1 — 9311) › Chapter 31 - Compensation and Benefits of Government Personnel (§§ 721 — 757k) › § 729j - Public Employees Health Benefits Act—Studies and reports

(a) Respecting teachers who are members of the Teachers Association of Puerto Rico, and their relatives who are enrolled in the Medico-Hospital Service Program operated by the Association and who work at a government dependency, including the University of Puerto Rico, the Secretary of the Treasury of Puerto Rico, with the advice of the Secretary of Health and the Director of the Central Personnel Administration Office, shall execute with said Association the necessary contract or contracts for the rendering of such services to such teachers and relatives. Provided, that employees who are members of the Teachers Association and their relatives who are enrolled in the Medico-Hospital Service Program operated by the Association but do not work actively as teachers, may enroll in the plan contracted for by the Secretary of the Treasury of Puerto Rico with the Teachers Association of Puerto Rico, or in any other plan, in which case the contribution of the Government shall be made to the carrier or to the chosen entity. For such service the Association shall be paid, for each teacher or relative enrolled in same, a fee equal to that established for other employees in §§ 729a-729n of this title. The Association shall furnish the corresponding documents providing that said relatives have independent contracts whereby they make individual contributions apart from the one made by the associate teacher. The contribution of teachers in active service shall continue to be deducted from their salary in the same manner and at the same rate as it is done at present by virtue of the provisions of § 382 of Title 18. The Secretary of the Treasury shall be responsible for the effectuation of such payment to the Teachers Association.
(b) The Secretary of the Treasury shall include provisions in contracts with carriers which would require carriers to (1) furnish such reasonable reports as the Secretary of Treasury may deem necessary to enable him to carry out his functions under §§ 729a-729n of this title; and (2) permit the Secretary of the Treasury, in coordination with the Insurance Commissioner, to examine the books and records of the carrier, to the extent necessary for him to carry out his functions under §§ 729a-729n of this title.
(c) The Secretary of Health is charged with the surveillance of the services rendered by the entities and contracted for by the Secretary of the Treasury pursuant to the provisions of §§ 729a-729n of this title. The Secretary of Health and the Insurance Commissioner shall maintain appropriate statistics reflecting at all times the operating cost of the various plans for health benefits contracted for by the Secretary of the Treasury, as well as to the income obtained by each one of the insureds under the contract. The analysis of the statistics so compiled shall be taken into account by the Secretary of the Treasury at the time of renegotiating the contract rates, as provided in § 729d(f) of this title. The manner in which the Secretary of Health is to discharge the responsibilities entrusted to him by §§ 729a-729n of this title shall be contained in the regulations to be prepared by said official as provided by law. The said regulations shall provide the manner in which the Secretary of Health is to perform the pertinent investigations to determine the quality of the services and the performance of the conditions of the contracts on the part of the entities contracted with. The Secretary of Health shall report to the Secretary of the Treasury, at least once quarterly, on the result of his investigations. Whenever conclusions are reported which are adverse to a contracting entity, after formal hearing of the aggrieved party and granting it an opportunity to confront the evidence submitted against it by the Secretary of Health and to introduce such evidence as may controvert said evidence, the Secretary of the Treasury may cancel the contract or contracts. The decision of the Secretary of the Treasury in that respect shall be reviewable by the Court of First Instance, San Juan Part.
History —June 29, 1963, No. 95, p. 280, § 10; Mar. 25, 1976, No. 18, p. 40, § 2; May 30, 1976, No. 90, p. 268, eff. July 1, 1977.