Requires commercial insurers to make available an option to parents/guardians purchasing family health insurance policies to cover their mentally or physically challenged dependents.
TITLE OF BILL:
An act to amend the insurance law, in relation to insurance coverage for mentally or physically disabled dependents
PURPOSE OR GENERAL IDEA OF BILL:
This bill expands access to health insurance by amending the Insurance Law to allow mentally and or physically challenged people, regardless of age, to be covered under a parent's group health insurance policy.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 Amends Section 4304(1)(A) of the Insurance Law. Requires commercial insurers to make available an option for parents/guardians purchasing family health insurance policies through their employers to cover their mentally and or physically challenged dependents. There is no age limitation for such dependent. This bill would allow parents to extend their current health insurance coverage provided by an employer for the care of a person that is dependent on a parent/guardian due to attributable disabilities. The young adult must not be eligible for coverage under their own employer sponsored insurance and they must be determined to be mentally and or physically challenged to the point where that person is unable, regardless of age, to work, live independently, and provide medical insurance for oneself. It negates limiting age of any manner when dealing with people that have been determined to meet the above mentioned criteria. The option must be extended at policy inception and at the first anniversary date following the effective date of the provisions. This approach to working with high needs people/children can also reduce state expenditures to those government funded facilities. This bill is not intended to meet the needs of all people diagnosed with specific conditions. It does not relieve Mental Health Departments from providing the necessary services to those individuals that have been deemed to have a mental condition such as depression, manic depression, and/or been diagnosed with bi-polar syndrome or any condition that can be treated, or controlled through the use of medication. In other words, people with such conditions that can and should be treated through medications that permit a person the capability to function normally, live on their own, and hold a job will not be covered by this bill.
Section 2 - Effective Date
This legislation amends existing law to require group insurance policies to provide health insurance for physically and mentally disabled children, regardless of age, under their parent's employer-sponsored health insurance.
This bill helps to mainstream disabled people into the community while insuring their health and safety. It also reduces the need for New York State to provide housing for those individuals that would be provided for by the parent or guardian. Furthermore, the longer a mentally or physically challenged person/child is allowed to stay in a familiar environment the better it is for the person/child and family. This bill allows parents an option to continue allowing their disabled child the opportunity to live at home with them and in so doing prevents placing that child in state run facilities such as group homes, hospitals, or halfway houses. Providing this type of care also keeps the family structure and support mechanisms in place.
PRIOR LEGISLATIVE HISTORY:
2010: S.6768 - Referred to Insurance/A.9408 - Referred to Insurance
No cost to the state or local governments.
This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 114 2011-2012 Regular Sessions IN SENATE (PREFILED) January 5, 2011 ___________Introduced by Sen. DIAZ -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to insurance coverage for mentally or physically disabled dependents THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subparagraph (A) of paragraph 1 of subsection (d) of section 4304 of the insurance law, as amended by chapter 240 of the laws of 2009, is amended to read as follows: (A) No contract issued pursuant to this section shall entitle more than one person to benefits except that a contract issued and marked as a "family contract"
[may]SHALL provide that benefits will be furnished to a husband and wife, or husband, wife and their dependent child or children, or any child or children not over nineteen years of age, provided that an unmarried student at an accredited institution of learning may be considered a dependent until he OR SHE becomes twenty- three years of age, provided that the coverage of any such "family contract" [may]SHALL include, at the option of the insurer, any unmar- ried child until attaining age twenty-five, and provided also that the coverage of any such "family contract" shall include any other unmarried child, regardless of age, who is incapable of self-sustaining employment by reason of mental illness, developmental disability, OR mental retar- dation, as defined in the mental hygiene law, [or physical handicap and who became so incapable prior to attainment of the age at which depend- ent coverage would otherwise terminate,]so that such child may be considered a dependent. S 2. This act shall take effect immediately.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00305-01-1