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

                                   640

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced by M. of A. WEPRIN -- read once and referred to the Committee
  on Insurance

AN ACT to amend the insurance law and the public health law, in relation
  to notification of termination of group health insurance

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

  Section 1. Subsection (a) of section 3221  of  the  insurance  law  is
amended by adding a new paragraph 17 to read as follows:
  (17) (A) THAT THE INSURER SHALL REQUIRE THE POLICYHOLDER TO PROVIDE IT
WITH  THE NAMES AND RESIDENTIAL ADDRESSES OF ALL INDIVIDUALS WHO BECAUSE
OF THEIR EMPLOYEE OR MEMBERSHIP STATUS  ARE  CERTIFICATE  HOLDERS  UNDER
SUCH  POLICY,  AND  TO UPDATE SUCH INFORMATION AT LEAST ANNUALLY; AND IN
THE EVENT THE INSURER TERMINATES SUCH POLICY, SHALL  GIVE  EACH  CERTIF-
ICATE HOLDER AT LEAST THIRTY DAYS PRIOR WRITTEN NOTICE OF TERMINATION OF
COVERAGE,  BY  MAILING  SUCH  NOTICE  TO  THE  LAST PROVIDED RESIDENTIAL
ADDRESS FOR SUCH CERTIFICATE HOLDER; PROVIDED, HOWEVER, THAT SUCH NOTICE
SHALL NOT BE REQUIRED WHERE THE  POLICYHOLDER  HAS:  (1)  PROVIDED  SUCH
CERTIFICATE  HOLDER  AT  LEAST  THIRTY  DAYS PRIOR WRITTEN NOTICE OF THE
TERMINATION OF COVERAGE, BY MAILING SUCH NOTICE TO THE CERTIFICATE HOLD-
ER'S LAST KNOWN RESIDENTIAL ADDRESS, OR, IF THE  CERTIFICATE  HOLDER  IS
REPRESENTED BY A LABOR ORGANIZATION, PROVIDED THE REPRESENTATIVE OF SUCH
LABOR  ORGANIZATION WITH SUCH WRITTEN NOTICE, OR (2) HAS CONTRACTED WITH
ANOTHER INSURER TO PROVIDE SIMILAR COVERAGE  FOR  THE  SAME  CERTIFICATE
HOLDERS,  AND  HAS  PROVIDED  CERTIFICATE  HOLDERS  WITH THE NAME OF THE
SUBSTITUTED INSURER. NO TERMINATION OF A GROUP  POLICY  OR  CONTRACT  OF
HEALTH,  OR  ACCIDENT  AND HEALTH INSURANCE SHALL BECOME EFFECTIVE UNTIL
THIRTY DAYS AFTER THE MAILING OF SUCH NOTICE OF TERMINATION CONTRACT, IF
REQUIRED.
  (B) THE INSURER SHALL INCLUDE WITH SUCH NOTICE A COMPLETE STATEMENT OF
THE RIGHTS OF THE CERTIFICATE HOLDER UNDER THE TERMINATION OF THE POLICY

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

                                                           LBD02917-01-3

A. 640                              2

AS TO COVERAGE FOR ILLNESS, ACCIDENT AND TREATMENT  OCCURRING  PRIOR  TO
AND SUBSEQUENT TO THE TERMINATION DATE, AND SUCH OTHER RIGHTS OF CERTIF-
ICATE  HOLDERS  AS MAY EXIST UNDER THE CONTRACT OR POLICY OR PURSUANT TO
PARAGRAPH ONE OF SUBSECTION (E) OF THIS SECTION.
  (C)  UPON  WRITTEN  REQUEST, THE HOLDER OF THE POLICY BEING TERMINATED
SHALL REIMBURSE THE INSURER FOR ALL REASONABLE AND NECESSARY COSTS ASSO-
CIATED WITH PROVIDING SUCH NOTICE TO CERTIFICATE HOLDERS.
  S 2. Section 4305 of the insurance law is  amended  by  adding  a  new
subsection (n) to read as follows:
  (N) (1) A GROUP CONTRACT ISSUED PURSUANT TO THIS SECTION SHALL CONTAIN
A  PROVISION THAT THE INSURER SHALL REQUIRE THE GROUP CONTRACT HOLDER TO
PROVIDE IT WITH THE NAMES AND RESIDENTIAL ADDRESSES OF  ALL  INDIVIDUALS
WHO BECAUSE OF THEIR EMPLOYEE OR MEMBERSHIP STATUS ARE CERTIFICATE HOLD-
ERS UNDER SUCH POLICY, AND TO UPDATE SUCH INFORMATION AT LEAST ANNUALLY;
AND  IN  THE  EVENT  THE INSURER TERMINATES SUCH POLICY, SHALL GIVE EACH
CERTIFICATE HOLDER AT LEAST THIRTY DAYS PRIOR WRITTEN NOTICE  OF  TERMI-
NATION OF COVERAGE, BY MAILING SUCH NOTICE TO THE LAST PROVIDED RESIDEN-
TIAL  ADDRESS  FOR SUCH CERTIFICATE HOLDER; PROVIDED, HOWEVER, THAT SUCH
NOTICE SHALL NOT BE REQUIRED  WHERE  THE  GROUP  POLICYHOLDER  HAS:  (A)
PROVIDED  SUCH  CERTIFICATE  HOLDERS  AT LEAST THIRTY DAYS PRIOR WRITTEN
NOTICE OF THE TERMINATION OF COVERAGE, BY MAILING SUCH  NOTICE  TO  SUCH
CERTIFICATE HOLDER'S LAST KNOWN RESIDENTIAL ADDRESS, OR, IF SUCH CERTIF-
ICATE HOLDER IS REPRESENTED BY A LABOR ORGANIZATION, PROVIDED THE REPRE-
SENTATIVE  OF  SUCH  LABOR ORGANIZATION WITH SUCH WRITTEN NOTICE, OR (B)
HAS CONTRACTED WITH ANOTHER INSURER TO PROVIDE SIMILAR COVERAGE FOR  THE
SAME CERTIFICATE HOLDERS, AND HAS PROVIDED SUCH CERTIFICATE HOLDERS WITH
THE NAME OF THE SUBSTITUTED INSURER. NO TERMINATION OF A GROUP POLICY OR
CONTRACT OF HEALTH, OR ACCIDENT AND HEALTH INSURANCE SHALL BECOME EFFEC-
TIVE  UNTIL  THIRTY DAYS AFTER THE MAILING OF SUCH NOTICE OF TERMINATION
CONTRACT, IF REQUIRED.
  (2) THE INSURER SHALL INCLUDE WITH SUCH NOTICE A COMPLETE STATEMENT OF
THE RIGHTS OF THE CERTIFICATE HOLDER UNDER THE TERMINATION OF THE POLICY
AS TO COVERAGE FOR ILLNESS, ACCIDENT AND TREATMENT  OCCURRING  PRIOR  TO
AND SUBSEQUENT TO THE TERMINATION DATE, AND SUCH OTHER RIGHTS OF CERTIF-
ICATE  HOLDERS  AS MAY EXIST UNDER THE CONTRACT OR POLICY OR PURSUANT TO
PARAGRAPH ONE OF SUBSECTION (D) OF THIS SECTION.
  (3) UPON WRITTEN REQUEST, THE HOLDER OF THE GROUP POLICY BEING  TERMI-
NATED SHALL REIMBURSE THE INSURER FOR ALL REASONABLE AND NECESSARY COSTS
ASSOCIATED WITH PROVIDING SUCH NOTICE TO CERTIFICATE HOLDERS.
  S  3.  The public health law is amended by adding a new section 4407-a
to read as follows:
  S 4407-A. GROUP CONTRACTS; NOTIFICATION OF CANCELLATION  REQUIREMENTS.
1.  A  HEALTH  MAINTENANCE  ORGANIZATION SHALL REQUIRE A POLICYHOLDER TO
PROVIDE IT WITH THE NAMES AND RESIDENTIAL ADDRESSES OF  ALL  INDIVIDUALS
WHO  BECAUSE  OF THEIR EMPLOYEE OR MEMBERSHIP STATUS ARE MEMBERS IN SUCH
HEALTH MAINTENANCE ORGANIZATION, AND TO UPDATE SUCH INFORMATION AT LEAST
ANNUALLY; AND IN THE EVENT THE HEALTH  MAINTENANCE  ORGANIZATION  TERMI-
NATES  SUCH  POLICY,  SHALL  GIVE  EACH SUCH MEMBER AT LEAST THIRTY DAYS
PRIOR WRITTEN NOTICE OF TERMINATION OF COVERAGE, BY MAILING SUCH  NOTICE
TO  THE  LAST  PROVIDED  RESIDENTIAL  ADDRESS FOR SUCH MEMBER; PROVIDED,
HOWEVER, THAT SUCH NOTICE SHALL NOT BE REQUIRED WHERE  THE  POLICYHOLDER
HAS:  (A) PROVIDED SUCH MEMBER AT LEAST THIRTY DAYS PRIOR WRITTEN NOTICE
OF THE TERMINATION OF COVERAGE, BY MAILING SUCH NOTICE TO SUCH  MEMBER'S
LAST  KNOWN  RESIDENTIAL  ADDRESS, OR, IF THE MEMBER IS REPRESENTED BY A
LABOR ORGANIZATION, PROVIDED THE REPRESENTATIVE OF SUCH LABOR  ORGANIZA-
TION WITH SUCH WRITTEN NOTICE, OR (B) HAS CONTRACTED WITH ANOTHER HEALTH

A. 640                              3

MAINTENANCE  ORGANIZATION OR INSURER TO PROVIDE SIMILAR COVERAGE FOR THE
SAME MEMBERS, AND HAS PROVIDED MEMBERS WITH THE NAME OF THE  SUBSTITUTED
HEALTH  MAINTENANCE  ORGANIZATION  OR INSURER. NO TERMINATION OF A GROUP
POLICY  OR  CONTRACT  OF  HEALTH, OR ACCIDENT AND HEALTH INSURANCE SHALL
BECOME EFFECTIVE UNTIL THIRTY DAYS AFTER THE MAILING OF SUCH  NOTICE  OF
TERMINATION CONTRACT, IF REQUIRED.
  2.  THE HEALTH MAINTENANCE ORGANIZATION SHALL INCLUDE WITH SUCH NOTICE
A COMPLETE STATEMENT OF THE RIGHTS OF THE MEMBER UNDER  THE  TERMINATION
OF  THE POLICY AS TO COVERAGE FOR ILLNESS, ACCIDENT AND TREATMENT OCCUR-
RING PRIOR TO AND SUBSEQUENT TO THE TERMINATION  DATE,  AND  SUCH  OTHER
RIGHTS  OF MEMBERS AS MAY EXIST UNDER THE CONTRACT OR POLICY OR PURSUANT
TO THIS ARTICLE AND ARTICLE FORTY-THREE OF THE INSURANCE LAW.
  3. UPON WRITTEN REQUEST, THE HOLDER OF  THE  POLICY  BEING  TERMINATED
SHALL  REIMBURSE  THE HEALTH MAINTENANCE ORGANIZATION FOR ALL REASONABLE
AND NECESSARY COSTS ASSOCIATED WITH PROVIDING SUCH NOTICE TO MEMBERS.
  S 4. This act shall take effect on the ninetieth day  after  it  shall
have become a law.