S T A T E   O F   N E W   Y O R K
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                                  6193

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                             March 16, 2015
                               ___________

Introduced  by M. of A. ROBERTS, PEOPLES-STOKES, BARRETT, COOK -- Multi-
  Sponsored by -- M. of A. CROUCH, GOTTFRIED -- read once  and  referred
  to the Committee on Insurance

AN ACT to amend the insurance law, in relation to health insurance plans
  for long term care

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Paragraph 3 of subsection (f) of section 1117 of the insur-
ance law, as added by chapter 245 of the laws of  1986,  is  amended  to
read as follows:
  (3)  the  premium  rates  for  the  long term care plan are reasonably
related to the benefits provided, and are self-supporting, AS DETERMINED
BY THE SUPERINTENDENT PURSUANT TO SUBSECTION (H) OF THIS SECTION; and
  S 2. Section 1117 of the insurance law is  amended  by  adding  a  new
subsection (h) to read as follows:
  (H)(1)  AN INSURER DESIRING TO SET, INCREASE, OR DECREASE PREMIUMS FOR
ANY PLAN SUBJECT TO THIS SECTION SHALL SUBMIT A RATE FILING OR  APPLICA-
TION TO THE SUPERINTENDENT.
  (2)  AN INSURER SHALL SEND WRITTEN NOTICE OF THE PROPOSED RATE ADJUST-
MENT, INCLUDING THE SPECIFIC CHANGE REQUESTED, TO EACH POLICY HOLDER AND
CERTIFICATE HOLDER AFFECTED BY THE ADJUSTMENT BEFORE THE DATE  THE  RATE
FILING  OR  APPLICATION  IS SUBMITTED TO THE SUPERINTENDENT.  THE NOTICE
SHALL PROMINENTLY INCLUDE MAILING AND WEBSITE  ADDRESSES  FOR  BOTH  THE
DEPARTMENT  AND  THE  INSURER  THROUGH WHICH A PERSON MAY, WITHIN THIRTY
DAYS FROM THE DATE THE RATE FILING OR APPLICATION IS  SUBMITTED  TO  THE
SUPERINTENDENT,  CONTACT THE DEPARTMENT OR INSURER TO RECEIVE ADDITIONAL
INFORMATION OR TO SUBMIT WRITTEN COMMENTS TO THE DEPARTMENT ON THE  RATE
FILING OR APPLICATION.
  (3)  THE  SUPERINTENDENT  SHALL  ESTABLISH  A  PROCESS  TO POST ON THE
DEPARTMENT'S WEBSITE, IN A TIMELY MANNER, ALL RELEVANT WRITTEN  COMMENTS
RECEIVED PERTAINING TO RATE FILINGS OR APPLICATIONS.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09464-01-5
              

A. 6193                             2

  (4)  THE INSURER SHALL PROVIDE A COPY OF THE NOTICE TO THE SUPERINTEN-
DENT WITH THE RATE FILING OR APPLICATION. THE SUPERINTENDENT SHALL IMME-
DIATELY CAUSE THE NOTICE TO BE POSTED ON THE DEPARTMENT'S WEBSITE.
  (5)  THE SUPERINTENDENT SHALL DETERMINE WHETHER THE FILING OR APPLICA-
TION SHALL BECOME EFFECTIVE AS FILED, SHALL BECOME  EFFECTIVE  AS  MODI-
FIED,  OR  SHALL BE DISAPPROVED. THE SUPERINTENDENT MAY MODIFY OR DISAP-
PROVE THE RATE FILING OR APPLICATION IF THE  SUPERINTENDENT  FINDS  THAT
THE PREMIUMS ARE UNREASONABLE, EXCESSIVE, INADEQUATE, UNFAIRLY DISCRIMI-
NATORY,  OR NOT SELF-SUPPORTING AND MAY CONSIDER THE FINANCIAL CONDITION
OF THE INSURER WHEN APPROVING, MODIFYING  OR  DISAPPROVING  ANY  PREMIUM
ADJUSTMENT.
  (6)  THE  DETERMINATION  OF  THE  SUPERINTENDENT SHALL BE SUPPORTED BY
SOUND ACTUARIAL ASSUMPTIONS AND METHODS, AND SHALL BE RENDERED IN  WRIT-
ING  BETWEEN  THIRTY  AND  SIXTY  DAYS  FROM THE DATE THE RATE FILING OR
APPLICATION IS SUBMITTED TO THE SUPERINTENDENT.
  (7) SHOULD THE SUPERINTENDENT REQUIRE ADDITIONAL INFORMATION FROM  THE
INSURER  IN  ORDER  TO  MAKE  A  DETERMINATION, THE SUPERINTENDENT SHALL
REQUIRE THE INSURER TO FURNISH SUCH INFORMATION, AND IN SUCH EVENT,  THE
SIXTY  DAYS  SHALL BE TOLLED AND SHALL RESUME AS OF THE DATE THE INSURER
FURNISHES THE INFORMATION TO THE SUPERINTENDENT. IF  THE  SUPERINTENDENT
REQUESTS  ADDITIONAL  INFORMATION LESS THAN TEN DAYS FROM THE EXPIRATION
OF THE SIXTY DAYS (EXCLUSIVE OF TOLLING), THE SUPERINTENDENT MAY  EXTEND
THE SIXTY DAY PERIOD AN ADDITIONAL TWENTY DAYS TO MAKE A DETERMINATION.
  (8) THE APPLICATION OR RATE FILING WILL BE DEEMED APPROVED IF A DETER-
MINATION IS NOT RENDERED WITHIN THE TIME ALLOTTED UNDER THIS SUBSECTION.
  (9) AN INSURER SHALL NOT IMPLEMENT A RATE ADJUSTMENT UNLESS THE INSUR-
ER  PROVIDES  AT  LEAST SIXTY DAYS ADVANCE WRITTEN NOTICE OF THE PREMIUM
RATE ADJUSTMENT APPROVED BY THE SUPERINTENDENT TO EACH POLICY HOLDER AND
CERTIFICATE HOLDER AFFECTED BY THE RATE ADJUSTMENT.
  S 3. If any clause, sentence, paragraph, section or part of  this  act
shall  be adjudged by any court of competent jurisdiction to be invalid,
the judgment shall not affect, impair or invalidate the remainder there-
of, but shall be confined in its  operation  to  the  clause,  sentence,
paragraph,  section or part thereof directly involved in the controversy
in which such judgment shall have been rendered.
  S 4. This act shall take effect immediately.