This bill has been amended

Bill S5850-2011

Provides that insurance policies that cover annual physicals and well care visits shall allow one visit per calendar year

Provides that insurance policies that cover annual physicals and well care visits shall allow one visit per calendar year.

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  • Jan 4, 2012: REFERRED TO INSURANCE
  • Jun 23, 2011: REFERRED TO RULES

Memo

BILL NUMBER:S5850

TITLE OF BILL: An act to amend the insurance law, in relation to annual physicals and well care visits

PURPOSE: This legislation would provide that insurance policies that cover annual physicals and well care visits shall allow one visit per calendar year.

SUMMARY OF PROVISIONS: Sections 3216, 3221 and 4303 of the New York State Insurance Law are amended to add new paragraphs to provide that insurance policies that cover annual physicals and well care visits shall allow one visit per calendar year regardless if 365 days has passed since the previous physical or well care visit.

JUSTIFICATION: Most health care insurers in New York State allow one well-care visit or physical per year. To the insurance company that means one such visit every 365 day period. While on the surface this seems appropriate, it actually presents a unfair deterrent to care.

If an individual has a physical on August 28, 2009, that individual must wait until at least that date next year for their next covered physical or wellness visit. This creates a problem. For example, if a student needs a school required physical before the 365 day period has expired, that student may be delayed in participating in certain school activities or functions.

This legislation makes a simple change to one visit per calendar year instead of a 365 day period.

LEGISLATIVE HISTORY: S.3616-A of 2009/10

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This act shall take effect on the ninetieth day after it shall have become a law and shall apply to policies and contracts issued, renewed, modified, altered or amended on or after such date.


Text

STATE OF NEW YORK ________________________________________________________________________ 5850 2011-2012 Regular Sessions IN SENATE June 23, 2011 ___________
Introduced by Sen. MARCELLINO -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the insurance law, in relation to annual physicals and well care visits THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 28 to read as follows: (28) EVERY INDIVIDUAL POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE THAT INCLUDES COVERAGE FOR A PHYS- ICAL OR WELL CARE VISIT ONCE IN EVERY THREE HUNDRED SIXTY-FIVE DAYS SHALL BE INTERPRETED TO MEAN THAT SUCH PHYSICAL OR WELL CARE VISIT CAN BE HAD ONCE EVERY CALENDAR YEAR, REGARDLESS OF WHETHER OR NOT A PERIOD OF THREE HUNDRED SIXTY-FIVE DAYS HAS PASSED SINCE THE PREVIOUS PHYSICAL OR WELL CARE VISIT. S 2. Subsection (k) of section 3221 of the insurance law is amended by adding a new paragraph 17 to read as follows: (17) EVERY GROUP OR BLANKET POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE THAT INCLUDES COVERAGE FOR A PHYSICAL OR WELL CARE VISIT ONCE IN EVERY THREE HUNDRED SIXTY-FIVE DAYS SHALL BE INTERPRETED TO MEAN THAT SUCH PHYSICAL OR WELL CARE VISIT CAN BE HAD ONCE EVERY CALENDAR YEAR, REGARDLESS OF WHETHER OR NOT A PERIOD OF THREE HUNDRED SIXTY-FIVE DAYS HAS PASSED SINCE THE PREVIOUS PHYSICAL OR WELL CARE VISIT. S 3. Section 4303 of the insurance law is amended by adding a new subsection (hh) to read as follows: (HH) EVERY CONTRACT ISSUED BY A CORPORATION SUBJECT TO THE PROVISIONS OF THIS ARTICLE WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR COMPRE- HENSIVE-TYPE COVERAGE THAT INCLUDES COVERAGE FOR A PHYSICAL OR WELL CARE VISIT ONCE IN EVERY THREE HUNDRED SIXTY-FIVE DAYS SHALL BE INTERPRETED TO MEAN THAT SUCH PHYSICAL OR WELL CARE VISIT CAN BE HAD ONCE EVERY
CALENDAR YEAR, REGARDLESS OF WHETHER OR NOT A PERIOD OF THREE HUNDRED SIXTY-FIVE DAYS HAS PASSED SINCE THE PREVIOUS PHYSICAL OR WELL CARE VISIT. S 4. This act shall take effect on the ninetieth day after it shall have become a law and shall apply to policies and contracts issued, renewed, modified, altered or amended on or after such date.

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