senate Bill S6740

Signed by Governor Amended

Relates to a health insurance demonstration program for early retirees

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed by Governor
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actions

  • 15 / Mar / 2012
    • REFERRED TO INSURANCE
  • 25 / Apr / 2012
    • 1ST REPORT CAL.568
  • 26 / Apr / 2012
    • 2ND REPORT CAL.
  • 30 / Apr / 2012
    • ADVANCED TO THIRD READING
  • 08 / May / 2012
    • PASSED SENATE
  • 08 / May / 2012
    • DELIVERED TO ASSEMBLY
  • 08 / May / 2012
    • REFERRED TO INSURANCE
  • 21 / May / 2012
    • RECALLED FROM ASSEMBLY
  • 21 / May / 2012
    • RETURNED TO SENATE
  • 21 / May / 2012
    • VOTE RECONSIDERED - RESTORED TO THIRD READING
  • 21 / May / 2012
    • AMENDED ON THIRD READING 6740A
  • 04 / Jun / 2012
    • AMENDED ON THIRD READING 6740B
  • 13 / Jun / 2012
    • REPASSED SENATE
  • 13 / Jun / 2012
    • RETURNED TO ASSEMBLY
  • 13 / Jun / 2012
    • REFERRED TO INSURANCE
  • 14 / Jun / 2012
    • SUBSTITUTED FOR A9675B
  • 14 / Jun / 2012
    • ORDERED TO THIRD READING CAL.496
  • 14 / Jun / 2012
    • PASSED ASSEMBLY
  • 14 / Jun / 2012
    • RETURNED TO SENATE
  • 20 / Jul / 2012
    • DELIVERED TO GOVERNOR
  • 01 / Aug / 2012
    • SIGNED CHAP.362

Summary

Relates to a health insurance demonstration program for early retirees.

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Bill Details

Versions:
S6740
S6740A
S6740B
Legislative Cycle:
2011-2012
Law Section:
Insurance Law
Laws Affected:
Add ยง1123-a, Ins L

Sponsor Memo

BILL NUMBER:S6740

TITLE OF BILL:
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

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of the bill is to authorize the Superintendent of Financial
Services to approve a demonstration program to provide group health
insurance Coverage for former employees of a major New York-based
employer.

SUMMARY OF SPECIFIC PROVISIONS:
This bill authorizes a demonstration which would allow the Superinten-
dent of Financial Services to approve an eligible insurance company to
provide health insurance to former employees of a major New York-based
employer. The eligible insurance company would submit periodic reports
to the Superintendent to enable the Superintendent to evaluate the
effectiveness of the demonstration program.

JUSTIFICATION:
Today, an increasing number of New Yorkers are losing employer-based
health insurance coverage due to the economy. Some of these individuals
Were Promised continued coverage by their employer after retirement.
These former employees lack access to employment-sponsored health insur-
ance coverage and often Cannot afford to purchase coverage in the
private pay market.

This demonstration program seeks to create a new model of health insur-
ance that would meet the special needs of this population, at a reason-
able price, while still meeting the solvency requirements, benefit
mandates, and other obligations required by state statute and regu-
lation. Providing this program on a "pilot" basis affords the Department
of Financial Services the ability to assess the policy ramifications of
this change and the impact on other groups and the community,

LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
Immediately, but shall expire and be deemed repealed on December 31,
2013.

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

                                  6740

                            I N  S E N A T E

                             March 15, 2012
                               ___________

Introduced  by  Sen.  ROBACH -- 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  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) PURPOSE OF THE DEMONSTRATION PROGRAM. THE LEGISLATURE RECOG-
NIZES THAT FORMER EMPLOYEES WHO HAVE RELIED ON EMPLOYER-SPONSORED HEALTH
INSURANCE COVERAGE, AND IN SOME CASES, THE PROMISE OF  CONTINUED  HEALTH
INSURANCE, HAVE BEEN ADVERSELY AFFECTED BY THE ECONOMY AND THE INABILITY
OF  THEIR  FORMER  EMPLOYERS  TO  CONTINUE  TO PROVIDE HEALTH INSURANCE.
THESE INDIVIDUALS OFTEN FIND THEMSELVES WITHOUT ACCESS TO OTHER  EMPLOY-
ER-SPONSORED  COVERAGE  AND  ARE  TOO YOUNG TO ENROLL  IN MEDICARE.  THE
DIRECT PAY MARKET IS NOT ALWAYS A VIABLE OPTION  FOR  THESE  INDIVIDUALS
BECAUSE OF COST. THE DEMONSTRATION PROGRAM AUTHORIZED BY THIS SECTION IS
INTENDED  TO  PROVIDE  A MECHANISM TO ALLOW THESE INDIVIDUALS TO PARTIC-
IPATE IN THEIR OWN GROUP  HEALTH  INSURANCE  PROGRAMS  THAT  MEET  THEIR
SPECIAL NEEDS, WHILE ENSURING COMPLIANCE WITH THIS CHAPTER AND ANY REGU-
LATIONS  PROMULGATED  THEREUNDER, INCLUDING BENEFIT MANDATES. THE DEMON-
STRATION PROGRAM WILL ENABLE THE LEGISLATURE AND THE  SUPERINTENDENT  TO
ASSESS  WHETHER TO PERMIT AN ASSOCIATION OF FORMER EMPLOYEES TO CONTINUE
TO HAVE HEALTH INSURANCE COVERAGE  UNDER  SIMILAR  TERMS  AS  THEY  HAVE
ENJOYED  WHILE EMPLOYED UNTIL THEY ARE ELIGIBLE FOR COVERAGE UNDER TITLE
XVIII OF THE SOCIAL SECURITY ACT (MEDICARE) OR  UNTIL  OTHER  COMPARABLE
GROUP HEALTH INSURANCE COVERAGE BECOMES AVAILABLE.
  (B) 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-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15057-01-2

S. 6740                             2

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 A HEALTH SERVICE CORPORATION ORGANIZED
PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER THAT, AS OF  THE  EFFEC-
TIVE DATE OF THIS SECTION, HAS ITS PARENT HEADQUARTERS IN THE SAME COUN-
TY  AS  THE  ELIGIBLE  ASSOCIATION  AND  THAT  HAS A NATIONAL NETWORK OF
PROVIDERS ABLE TO PROVIDE SERVICES TO MEMBERS OF  THE  ELIGIBLE  ASSOCI-
ATION.
  (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.
  (4)  "GROUP  HEALTH  INSURANCE"  MEANS  INSURANCE  PROVIDING HOSPITAL,
SURGICAL OR MEDICAL EXPENSE  COVERAGE  OR  OTHER  SIMILAR  COMPREHENSIVE
HEALTH INSURANCE COVERAGE.
  (C)  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 THE  REQUIREMENTS
SET FORTH IN THIS SECTION; AND IDENTIFY THE GROUP HEALTH INSURANCE POLI-
CY  FORMS  THAT  THE ELIGIBLE INSURER WILL ISSUE TO THE ELIGIBLE ASSOCI-
ATION. 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

S. 6740                             3

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.

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