A9675B-2011 Actions

• Jun 14, 2012: substituted by s6740b
• Jun 4, 2012: amended on third reading 9675b
• May 21, 2012: amended on third reading 9675a
• Apr 26, 2012: advanced to third reading cal.496
• Apr 26, 2012: reported
• Mar 23, 2012: referred to insurance

A9675B-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 9675--B
 Cal. No. 496
 I N  ASSEMBLY
 March 23, 2012
 
 Introduced  by M. of A. MORELLE -- read once and referred to the Commit
 tee on Insurance -- advanced to a third reading, amended  and  ordered
 reprinted,  retaining its place on the order of third reading -- again
 amended on third reading, ordered reprinted, retaining  its  place  on
 the order of third reading
 AN  ACT  to  amend  the insurance law, in relation to a health insurance
 demonstration program for early retirees; and providing for the repeal
 of such provisions upon expiration thereof
 THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM
 BLY, DO ENACT AS FOLLOWS:

 

Section 1. The insurance law is amended by adding a new section 1123-a
 to read as follows:

 

S  1123-A.   HEALTH INSURANCE DEMONSTRATION PROGRAM FOR FORMER EMPLOY
 EES.  (A) DEFINITIONS. IN THIS SECTION:

 (1) "ELIGIBLE ASSOCIATION" MEANS AN ENTITY THAT: (A)  IS  EXEMPT  FROM
 FEDERAL  TAXATION  UNDER  SECTION  501(C)(3)  OR  (C)(4) OF THE INTERNAL
 REVENUE CODE; (B) WAS INCORPORATED ON OR BEFORE JANUARY FIRST, TWO THOU
 SAND TEN; (C) MEETS THE CRITERIA SET FORTH IN SUBPARAGRAPH (K) OF  PARA
 GRAPH  ONE  OF SUBSECTION (C) OF SECTION FOUR THOUSAND TWO HUNDRED THIR
 TY-FIVE OF THIS CHAPTER; AND (D) HAS BEEN ESTABLISHED FOR THE BENEFIT OF
 FORMER EMPLOYEES OF A COMPANY IN THIS STATE.
 (2) "ELIGIBLE INSURER"  MEANS  ANY  HEALTH  MAINTENANCE  ORGANIZATION,
 CERTIFIED  PURSUANT  TO  ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, AN
 INSURER LICENSED TO WRITE ACCIDENT AND HEALTH  INSURANCE,  OR  A  CORPO
 RATION ORGANIZED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER.
 (3)  "FORMER  EMPLOYEE"  MEANS  AN  INDIVIDUAL:  (A)  WHO WAS FORMERLY
 EMPLOYED BY A COMPANY HEADQUARTERED IN THIS STATE AND WHICH HAS BEEN  IN
 OPERATION  FOR  OVER  ONE HUNDRED YEARS; (B) WHO HAS HERETOFORE RECEIVED
 HEALTH INSURANCE COVERAGE THROUGH THE FORMER EMPLOYER, (C) WHOSE  FORMER
 EMPLOYER  FILED  FOR  CHAPTER  ELEVEN BANKRUPTCY IN JANUARY TWO THOUSAND
 TWELVE, AND (D) WHO IS NOT ELIGIBLE FOR MEDICARE  OR  FOR  GROUP  HEALTH
 INSURANCE COVERAGE THROUGH ANOTHER EMPLOYER.
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD15057-06-2
 
       A. 9675--B                          2
 (4)  "GROUP  HEALTH  INSURANCE"  MEANS  INSURANCE  PROVIDING HOSPITAL,
 SURGICAL OR MEDICAL EXPENSE  COVERAGE  OR  OTHER  SIMILAR  COMPREHENSIVE
 HEALTH INSURANCE COVERAGE.
 (B)  DEMONSTRATION PROGRAM FOR FORMER EMPLOYEES.  (1) BOTH THE INSURER
 AND THE GROUP HEALTH INSURANCE POLICIES ISSUED TO THE  ELIGIBLE  ASSOCI
 ATION  SHALL  BE SUBJECT TO THE PROVISIONS OF THIS CHAPTER AND ANY REGU
 LATIONS PROMULGATED THEREUNDER, EXCEPT  THAT  THE  ELIGIBLE  ASSOCIATION
 SHALL NOT BE CONSIDERED A SMALL GROUP UNDER THIS CHAPTER.
 (2)  SUBJECT TO PARAGRAPH THREE OF THIS SUBSECTION, THE SUPERINTENDENT
 MAY ISSUE AN APPROVAL TO AN ELIGIBLE INSURER IF: (A) THE ELIGIBLE INSUR
 ER DEMONSTRATES THAT IT SATISFIES ALL FINANCIAL, OPERATIONAL  AND  OTHER
 REQUIREMENTS  OF  THIS  CHAPTER  AND REGULATIONS PROMULGATED THEREUNDER,
 OTHER THAN ANY REQUIREMENTS EXPRESSLY WAIVED BY THIS SECTION, AND  SHALL
 OPERATE THE DEMONSTRATION PROGRAM IN ACCORDANCE WITH THE REQUIREMENTS OF
 THIS  SECTION;  AND  (B)  THE  SUPERINTENDENT DETERMINES THAT THE DEMON
 STRATION PROGRAM FURTHERS THE PUBLIC POLICY GOALS OF THIS SECTION.
 (3) ANY ELIGIBLE INSURER SEEKING THE SUPERINTENDENT'S  APPROVAL  UNDER
 PARAGRAPH  TWO  OF THIS SUBSECTION SHALL SUBMIT A WRITTEN REQUEST TO THE
 SUPERINTENDENT WITHIN THIRTY DAYS OF THE EFFECTIVE DATE OF THIS SECTION.
 THE ELIGIBLE INSURER'S  APPLICATION  SHALL:  SPECIFY  THE  IDENTITY  AND
 COMPOSITION  OF  THE  ELIGIBLE  ASSOCIATION,  THE ELIGIBLE ASSOCIATION'S
 MEMBERSHIP RULES, AND THE TERMS UNDER WHICH THE ELIGIBLE  INSURER  SHALL
 PROVIDE  GROUP HEALTH INSURANCE TO THE ELIGIBLE ASSOCIATION; DEMONSTRATE
 THAT THE ELIGIBLE INSURER AND THE ELIGIBLE ASSOCIATION MEET THE REQUIRE
 MENTS SET FORTH IN THIS SECTION; AND IDENTIFY THE GROUP HEALTH INSURANCE
 POLICY FORMS THAT THE ELIGIBLE INSURER WILL ISSUE TO THE ELIGIBLE  ASSO
 CIATION.  THE  SUPERINTENDENT  SHALL MAKE A DETERMINATION ON ANY REQUEST
 WITHIN NINETY DAYS OF RECEIPT OF ALL NECESSARY INFORMATION.  THE  SUPER
 INTENDENT SHALL ISSUE AN APPROVAL TO ONLY ONE ELIGIBLE INSURER.
 (4)  THE  SUPERINTENDENT MAY REVOKE AN APPROVAL ISSUED UNDER PARAGRAPH
 TWO OF THIS SUBSECTION IF: THE INSURER THAT RECEIVED  SUCH  APPROVAL  NO
 LONGER  QUALIFIES  AS AN ELIGIBLE INSURER OR IS OTHERWISE OPERATING IN A
 MANNER INCONSISTENT WITH THE PROVISIONS OF THIS CHAPTER  OR  REGULATIONS
 PROMULGATED THEREUNDER; OR THE ASSOCIATION TO WHICH THE ELIGIBLE INSURER
 ISSUED  THE  GROUP  HEALTH  INSURANCE  POLICY  NO LONGER QUALIFIES AS AN
 ELIGIBLE ASSOCIATION. AN ELIGIBLE INSURER THAT RECEIVES  APPROVAL  UNDER
 PARAGRAPH  TWO  OF  THIS SUBSECTION SHALL SUBMIT PERIODIC REPORTS TO THE
 SUPERINTENDENT SUFFICIENT TO ENABLE THE SUPERINTENDENT TO  EVALUATE  THE
 EFFECTIVENESS OF THE DEMONSTRATION PROGRAM. SUCH REPORTS SHALL INCLUDE A
 COMPARISON OF THE COST OF HEALTH INSURANCE OBTAINED UNDER THE PROGRAM TO
 OTHER  AVAILABLE  INSURANCE  OPTIONS,  INCLUDING  GROUP HEALTH INSURANCE
 POLICIES DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE, DEMOGRAPHIC AND
 GEOGRAPHIC ANALYSIS OF THE ENROLLED POPULATION AND ANY OTHER INFORMATION
 REQUIRED BY THE SUPERINTENDENT.
 

S 2. This act shall take effect immediately and shall expire  December
 31,  2013 when upon such date the provisions of this act shall be deemed
 repealed.

*By contributing or voting you agree to the Terms of Participation and Privacy Policy and verify you are over 13.

Discuss!