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

                                  2268

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 22, 2015
                               ___________

Introduced  by  Sen.  GOLDEN -- 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  the  designation  of
  third parties to receive notification of cancellation

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

  Section 1. Paragraph 6 of subsection (b) of section 1117 of the insur-
ance law, as added by chapter 572 of the laws of  2008,  is  amended  to
read as follows:
  (6)  prior  to the earlier of the execution of a policy or certificate
in connection with a plan providing a home care benefit and/or a nursing
home benefit, or the payment of any premium or fee  related  to  such  a
policy or certificate, the authorized insurer, corporation, health main-
tenance  organization  or  fraternal  benefit  society shall provide the
prospective insured or his  or  her  representative  with  a  disclosure
statement, which contains the following:
  (A)  The  maximum  daily  and  lifetime benefit levels, if applicable,
provided by the policy or certificate for home care services and nursing
home services;
  (B) The percentage of coverage provided for  home  care  services  and
nursing  home services, if applicable, and an explanation of the method-
ology on which the reasonable  charge  used  in  conjunction  with  such
percentage amount is based;
  (C)  A  description of any inflation protection feature included in or
available for purchase under the policy or  certificate  and  the  addi-
tional premium required to purchase such option or options;
  (D)  (i)  If  available  and accessible by the insurer or other entity
from the department of  health,  the  most  recently-published  average,
statewide  rate for care in a nursing home, as well as the average rates
for care in nursing homes for both the New  York  city-metropolitan  and
upstate regions of the state; or

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00936-01-5
              

S. 2268                             2

  (ii)  If  available and accessible by the insurer or other entity from
the department of health, the most recently-published map of  the  esti-
mated  average  regional  rates in New York state for nursing home care;
[and]
  (E)  A graphic demonstration of the maximum daily nursing home benefit
level provided by the policy or certificate, and  the  impact  that  the
selection of any inflation protection options would have on such maximum
daily nursing home benefit level[.]; AND
  (F)  THE  RIGHT  OF THE PROSPECTIVE INSURED, UPON ATTAINING THE AGE OF
SIXTY-FIVE YEARS, TO DESIGNATE A THIRD PARTY WHO WILL RECEIVE A COPY  OF
ANY  NOTICES OF NONPAYMENT OF PREMIUMS DUE OR NOTICE OF CANCELLATION FOR
NONPAYMENT OF PREMIUMS THAT IS SENT TO THE PROSPECTIVE INSURED.
For the purpose of this paragraph, "home care services" shall  have  the
same meaning as defined in subdivision one of section thirty-six hundred
two  of  the  public  health law. The prospective insured, or his or her
representative, shall acknowledge that the required disclosure has  been
made  by  signing the disclosure statement prior to or contemporaneously
with the effective date of the policy or certificate.
Failure to provide information required  by  subparagraph  (D)  of  this
paragraph  shall not be construed as a violation of this section if such
information has not been made available by the department of health.
  S 2. Subsection (e) of section 3111 of the insurance law, as added  by
section  30  of  part B of chapter 58 of the laws of 2004, is amended to
read as follows:
  (e) Every insurer that has in force a long-term care insurance  policy
as defined in section one thousand one hundred seventeen of this chapter
the  premiums  for  which are paid directly to the insurer by the senior
citizen insured, except a policy that  qualifies  as  a  long-term  care
insurance  contract  as defined in Section 7702B of the Internal Revenue
Code, shall permit senior citizen insureds to designate a third party to
whom the insurer shall transmit notices of nonpayment of premiums due or
notice of cancellation for nonpayment of premiums[, as determined by the
insurer]; PROVIDED THAT NOTICE OF CANCELLATION FOR NONPAYMENT OF PREMIUM
SHALL BE SENT NO LATER THAN THIRTY DAYS BEFORE  THE  EFFECTIVE  DATE  OF
SUCH  CANCELLATION.   The senior [citizens] CITIZEN INSURED shall notify
the insurer that a third party has been so designated. Such notification
shall be delivered to the insurer EITHER IN THE  SAME  ENVELOPE  AS  THE
SENIOR  CITIZEN  INSURED'S  PREMIUM PAYMENT OR by certified mail, return
receipt requested, and shall be effective not later  than  ten  business
days  from  the  date  of  receipt by the insurer. The notification must
contain, in writing, an  acceptance  by  the  third  party  designee  to
receive  such  notices  of cancellation. Should the third party designee
desire to terminate his or her status as a third  party  designee,  such
designee shall provide written notice to both the insurer and the senior
citizen  insured.  Should the senior citizen insured desire to terminate
the third party designation, the insured shall provide written notice to
the insurer. The transmission to the third party designee  of  any  such
notice  of  cancellation shall be in addition to a copy of such document
transmitted to the senior citizen insured and when a third party  is  so
designated  all  such  notices  shall  be  mailed in an envelope clearly
marked on its face with the  following:    "IMPORTANT  INSURANCE  POLICY
INFORMATION:  OPEN  IMMEDIATELY". Designation as a third party shall not
constitute acceptance of any liability on the third party  for  services
provided  to  such  senior  citizen. The insurer shall notify its senior
citizen insureds NOT LESS THAN annually in writing of  the  availability
of  the third party designee notice procedure and provide information on

S. 2268                             3

how the insured can commence this procedure[; however, such notice  need
not  be  provided  once  a senior citizen has made a designation].  IF A
SENIOR CITIZEN INSURED HAS NOT  MADE  A  THIRD  PARTY  DESIGNATION,  THE
INSURER  SHALL  INCLUDE  A COPY OF THE THIRD PARTY DESIGNATION FORM WITH
EACH PREMIUM STATEMENT SENT TO THE SENIOR CITIZEN INSURED. IF  A  SENIOR
CITIZEN  INSURED  HAS MADE A DESIGNATION, THE INSURER SHALL CONFIRM WITH
THE SENIOR CITIZEN INSURED  THAT  THE  THIRD  PARTY  DESIGNEE'S  CONTACT
INFORMATION  IS CORRECT. UPON RECEIPT OF A DESIGNATION OR TERMINATION OF
A DESIGNATION, THE INSURER SHALL VERIFY THE DESIGNATION OR  CANCELLATION
OF  DESIGNATION  WITH THE SENIOR CITIZEN INSURED. SUCH VERIFICATION MAY,
BUT IS NOT REQUIRED TO BE, WRITTEN AND THE INSURER MAY USE TELEPHONY  TO
OBTAIN  AN  ORAL CONFIRMATION FROM THE SENIOR CITIZEN INSURED SO LONG AS
THE INSURER PROVIDES THE SENIOR CITIZEN INSURED WITH  WRITTEN  CONFIRMA-
TION OF THE ORAL VERIFICATION.
  S  3.  This  act  shall take effect on the sixtieth day after it shall
have become a law.