LEGISLATIVE FISCAL OFFICE
Fiscal Note
Fiscal Note On: HB 253 HLS 24RS 545
Bill Text Version: ENROLLED
Opp. Chamb. Action:
Proposed Amd.:
Sub. Bill For.:
Date: May 30, 2024 4:01 PM Author: STAGNI
Dept./Agy.: Municipal and parish fire departments
Subject: Cancer screenings Analyst: Tanesha Morgan
FIRE PROTECT/FIREMEN EN INCREASE LF EX See Note Page 1 of 2
Provides relative to cancer screenings for certain firefighters and fire service employees
Proposed law requires that classified firefighters employed as full-time paid employees of municipal or parish fire
departments or fire protection districts, fire service employees employed by non profit corporations under contract with fire
protection districts be provided cancer screening examinations. Proposed law requires that the cancer screenings
examinations be conducted by a physician every three, four, or five years thereafter during the course of employment or
service. Proposed law requires that the examination include, but not be limited to the following cancers: (1) Colon (2) Lung
(3) Bladder (4) Oral (5) Thyroid. Proposed law requires that retired firefighters and fire service employees be provided
cancer screening examinations by their former employers pursuant to proposed law. Additionally requires employers and
former employers to pay for the costs of cancer screening examinations. Proposed law provides that no firefighter or fire
service employee shall be required to participate in cancer screening examinations.
EXPENDITURES 2024-25 2025-26 2026-27 2027-28 2028-29 5 -YEAR TOTAL
State Gen. Fd. $0 $0 $0 $0 $0 $0
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other $0 $0 $0 $0 $0 $0
Federal Funds $0 $0 $0 $0 $0 $0
Local Funds INCREASE INCREASE INCREASE INCREASE INCREASE
Annual Total
REVENUES 2024-25 2025-26 2026-27 2027-28 2028-29 5 -YEAR TOTAL
State Gen. Fd. $0 $0 $0 $0 $0 $0
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other $0 $0 $0 $0 $0 $0
Federal Funds $0 $0 $0 $0 $0 $0
Local Funds $0 $0 $0 $0 $0 $0
Annual Total $0 $0 $0 $0 $0 $0
EXPENDITURE EXPLANATION
The proposed bill is anticipated to have a significant ongoing expense for municipal and parish fire departments, fire
protection districts, and non-profit corporations that employ firefighters and fire service employees in Louisiana associated
with cancer screenings for certain firefighters and fire service services employees, and retirees.
The proposed bill mandates cancer screenings for an estimated 8,800 firefighters, fire service employees, and retirees in
Louisiana. The associated costs, including the full cost of screenings for uninsured individuals and co-pays, deductibles, and
increased insurance premiums for insured individuals, must be entirely covered by the employers (municipal and parish fire
departments, fire protection districts, and non-profit corporations), with no out-of-pocket expenses for the employees. This
is expected to result in significant ongoing costs for these employers. Participation in the screenings is voluntary for the
employees.
According to the actuarial analysis prepared by LDI, the proposed law is expected to increase expenditures associated with
private insurance for firefighters and fire service employees in Louisiana. The Aggregate Cost Determination section
estimates the aggregate cost of the requirement in FY 25 to range from $302,280 (low) to $452,760 (high). The aggregate
cost in FY 26-29 is projected to increase each year due to medical inflation, reaching $377,921 (low) to $566,056 (high) by
FY 29. The Premium Increase Determination section calculates the aggregate extra premium for the review procedure in FY
25, which ranges from $355,659 (low) to $532,659 (high). The aggregate extra premium in FY 26-29 is projected to
increase each year due to medical inflation, reaching $444,613 (low) to $665,949 (high) by FY 29.
On an individual policy level, the annual premium increase per policy in FY 25 ranges from $64.66 (low) to $96.85 (high).
The annual premium increase per policy in FY 26-29 is projected to increase each year due to medical inflation, reaching
$80.84 (low) to $121.08 (high) by FY 29. The percentage premium change is estimated to range from 0.38% (low) to
0.57% (high). The analysis is based on several assumptions, including approximately 5,500 firefighters and fire service
employees of local entities, a range of per employee per month (PEPM) costs for cancer screenings, a monthly health
insurance premium of $1,200, a stationary insured population, medical inflation rates of 8% in the first year and 5%
thereafter, and a premium loss ratio of 85%. See details on page 2.
REVENUE EXPLANATION
There is no anticipated direct material effect on governmental revenues as a result of this measure.
Senate Dual Referral Rules House
x 13.5.1 >= $100,000 Annual Fiscal Cost {S & H} 6.8(F)(1) >= $100,000 SGF Fiscal Cost {H & S}
13.5.2 >= $500,000 Annual Tax or Fee Patrice Thomas
6.8(G) >= $500,000 Tax or Fee Increase
Change {S & H} or a Net Fee Decrease {S} Deputy Fiscal Officer
 LEGISLATIVE FISCAL OFFICE
Fiscal Note
Fiscal Note On: HB 253 HLS 24RS 545
Bill Text Version: ENROLLED
Opp. Chamb. Action:
Proposed Amd.:
Sub. Bill For.:
Date: May 30, 2024 4:01 PM Author: STAGNI
Dept./Agy.: Municipal and parish fire departments
Subject: Cancer screenings Analyst: Tanesha Morgan
CONTINUED EXPLANATION from page one: Page 2 of 2
Aggregate Cost Determination
Aggregate cost of the requirement in FY 25
Cost = insured population x PEPM cost x 12 months
FY 25 (Low)=5,500 x $4.58 x 12= $302,280
FY 25 (High)=5,500 x $6.86 x 12=$452,760
Aggregate cost in FY 26-29
Cost = insured population x PEPM cost x 12 months x medical inflation
FY 26 (Low)=5,500x$4.58x12x1.08=$326,462
FY 26 (High)=5,500x$6.86x12x1.08=$488,981
FY 27 (Low)= $703,339 x1.05= $342,786
FY 27 (High)= $1,055,592 x1.05=$513,430
FY 28 (Low)= $738,506 x1.05= $359,925
FY 28 (High)= $1,108,372 x1.05=$539,101
FY 29 (Low)=$775,431 x1.05=$377,921
FY 29 (High)= $1,163,790x1.05)=$566,056
Premium Increase Determination
Aggregate extra premium for the review procedure in FY 25
Premium = (insured population x PEPM cost x 12 months) / loss ratio
FY 25 (Low)=(5,500x$4.58x12)/0.85=$355,659
FY 25 (High)=(5,500x$6.86x12)/0.85=$532,659
Aggregate extra premium in FY 26-29
Premium = (insured population x PEPM cost x 12 months x medical inflation) / loss ratio
FY 26 (Low)=(5,500 x $4.58 x 12 x 1.08)/0.85=$384,073
FY 26 (High)=(5,500x$6.86 x 12 x 1.08)/0.85=$575,272
FY 27 (Low)= ($827,458 x1.05)=$403,277
FY 27 (High)= ($1,241,873 x1.05)=$604,035
FY 28 (Low)=($868,831x1.05)=$423,441
FY 28 (High)=($1,303,967 x1.05)=$634,237
FY 29 (Low)=($912,272 x1.05)= $444,613
FY 29 (High)=($1,369,165 x1.05)=$665,949
Aggregate Extra Premium Determination
Annual premium increase per policy in FY 25
Premium = (PEPM cost x 12 months) / loss ratio
FY 25 (Low)=($4.58x12)/0.85= $64.66
FY 25 (High)=($6.86x12)/0.85=$96.85
Annual premium increase per policy in FY 26-29
Premium = (PEPM cost x 12 months x medical inflation) / loss ratio
FY 26 (Low)=($4.58x12x1.08)/0.85=$69.83
FY 26 (High)=($6.86x12x1.08)/0.85=$104.59
FY 27 (Low)=($92 x1.05)= $73.32
FY 27 (High)= ($138x1.05)=$109.82
FY 28 (Low)= ($97x1.05)= $76.99
FY 28 (High)= ($145x1.05)=$115.32
FY 29 (Low)= ($101x1.05)=$80.84
FY 29 (High)= ($152x1.05)=$121.08
Percentage premium change caused by the passage of this bill
Percent = PEPM cost/average monthly premium
Low=$4.58/$1,200=0.38%
High=$6.86/$1,200=0.57%
Assumptions:
The calculations are assumed to apply on a fiscal year basis
The bill is not expected to have any effect on the general Louisiana population
Louisiana's insured population of firefighters and fire service employees is approximately 5,500
Cost of cancer screening for PEPM - Low=$4.58 (Internet Research)
Cost of cancer screening for PEPM - High=$6.86 (Internet Research)
The assumed monthly health insurance premium is $1,200
The total insured population is assumed to be stationary (entries equal exits)
Medical inflation is assumed to be 8%, then 5% thereafter
The assumed premium loss ratio is 85%
Senate Dual Referral Rules House
x 13.5.1 >= $100,000 Annual Fiscal Cost {S & H} 6.8(F)(1) >= $100,000 SGF Fiscal Cost {H & S}
13.5.2 >= $500,000 Annual Tax or Fee Patrice Thomas
6.8(G) >= $500,000 Tax or Fee Increase
Change {S & H} or a Net Fee Decrease {S} Deputy Fiscal Officer