senate Bill S2894

Signed by Governor Amended

Allows licensed insurance brokers and agents to develop, implement and administer wellness programs

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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

  • 24 / Jan / 2013
    • REFERRED TO INSURANCE
  • 22 / Apr / 2013
    • 1ST REPORT CAL.355
  • 23 / Apr / 2013
    • 2ND REPORT CAL.
  • 24 / Apr / 2013
    • ADVANCED TO THIRD READING
  • 29 / Apr / 2013
    • PASSED SENATE
  • 29 / Apr / 2013
    • DELIVERED TO ASSEMBLY
  • 29 / Apr / 2013
    • REFERRED TO INSURANCE
  • 10 / Jun / 2013
    • SUBSTITUTED FOR A7382
  • 10 / Jun / 2013
    • ORDERED TO THIRD READING CAL.507
  • 13 / Jun / 2013
    • SUBSTITUTION RECONSIDERED
  • 13 / Jun / 2013
    • RECOMMITTED TO INSURANCE
  • 14 / Jun / 2013
    • RECALLED FROM ASSEMBLY
  • 14 / Jun / 2013
    • RETURNED TO SENATE
  • 17 / Jun / 2013
    • VOTE RECONSIDERED - RESTORED TO THIRD READING
  • 17 / Jun / 2013
    • AMENDED ON THIRD READING 2894A
  • 20 / Jun / 2013
    • REPASSED SENATE
  • 20 / Jun / 2013
    • RETURNED TO ASSEMBLY
  • 20 / Jun / 2013
    • REFERRED TO INSURANCE
  • 21 / Jun / 2013
    • SUBSTITUTED FOR A7382A
  • 21 / Jun / 2013
    • ORDERED TO THIRD READING CAL.507
  • 21 / Jun / 2013
    • PASSED ASSEMBLY
  • 21 / Jun / 2013
    • RETURNED TO SENATE
  • 01 / Nov / 2013
    • DELIVERED TO GOVERNOR
  • 13 / Nov / 2013
    • SIGNED CHAP.496

Summary

Allows licensed insurance brokers and agents to develop, implement and administer wellness programs.

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Bill Details

See Assembly Version of this Bill:
A7382
Versions:
S2894
S2894A
Legislative Cycle:
2013-2014
Law Section:
Insurance Law
Laws Affected:
Amd §§3239 & 4224, Ins L
Versions Introduced in 2011-2012 Legislative Cycle:
S4950, A9932, S4950

Sponsor Memo

BILL NUMBER:S2894

TITLE OF BILL: An act to amend the insurance law, in relation to
exceptions to the general prohibition on rebating

PURPOSE: To modernize the insurance law to allow licensed brokers,
agents and benefit consultants to assist insurers and employers in the
interpretation, management and communication of the insurance policy or
annuity contract and its resulting costs, and to assist insurers and
employers in the development and implementation of wellness programs,
disease management and care coordination services and other incidental
or ancillary programs and services.

SUMMARY OF PROVISIONS:

Section 1 of the bill would add a new subsection (c) to § 3239 of the
insurance law, to enumerate certain exceptions to the anti-rebating and
inducement laws for services that insurance producers may provide within
the scope of their licensure and as part of commissions paid or fees
earned, to insurance carriers and policyholders, such as the development
and implementation of wellness programs, disease management and care
coordination services and other programs designed to improve quality of
care and health outcomes of insured employees, subscribers or enrollees.

Section 2 of the bill would add a new subsection (f) to § 4224 of the
insurance law, to allow insurance producers, within the scope of their
licensure and as part of commissions paid or fees earned, to provide
certain services to assist insurers and policyholders in the interpreta-
tion, management and communication of insurance policies or annuity
contracts and their costs, as well as the development and implementation
of wellness programs, disease management and care coordination services,
administration of COBRA and New York State continuation of coverage
benefits, administration of flexible spending accounts (FSAs) and health
reimbursement or savings accounts (HSAs), clinical health advocacy
services, including employee, subscriber or enrollee communications,
hotlines, "help desks," and web site development, preparation of annual
benefit statements, maintenance of membership records, premium reconcil-
iation and billing services, including retiree billing, compliance
support, including completion of ERISA form 5500, and financial model-
ing.

Section 3 of the bill would provide for an immediate effective date.

JUSTIFICATION: The fast-paced and competitive insurance marketplace
continues to evolve, and insurance producers must change with it. Inte-
gral to this is the modernization of certain statutory restrictions that
are old and outmoded. Chief amongst these are the anti-rebating and
inducement laws that were originally designed to protect insurance
producers and consumers alike from offering and accepting illegal
inducements for the sale of insurance products. In today's sophisticated
health insurance market, licensed insurance brokers, agents and benefits

consultants must be able to offer a full value-added services platform,
such as providing benefits concierge, employee communications, benefits
web sites and help desks, benefits statements, compliance support, in
order to attract business and close the sale. Employer groups of all
sizes are increasingly looking not only for traditional advice in
selecting health plan benefits design and coverage options, underwriting
to reduce claims losses, and claims servicing and policyholder advocacy,
but are also demanding back-office human resources support.

The statutory exceptions and allowanced prescribed in this bill would
modernize the insurance law with respect to health insurance, and allow
insurance producers to keep abreast of the market by lawfully providing
such services within the scope of their licensure and practice and as
part of commissions paid or fees earned.

Moreover, this bill would codify many of the incidental services
excepted from the insurance anti-rebating and inducement laws listed in
NYS Insurance Department Circular Letter No. 9 (2009) -
http://www.ins.state.ny.us/circltr/2009/c109 09.htm

LEGISLATIVE HISTORY: S.4950 of 2011-12

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This act shall take effect immediately.

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

                                  2894

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 24, 2013
                               ___________

Introduced  by  Sen.  SEWARD -- 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  exceptions  to  the
  general prohibition on rebating

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

  Section 1. Section 3239 of the insurance law is amended  by  adding  a
new subsection (d) to read as follows:
  (D)  AN  INSURANCE  AGENT,  INSURANCE  BROKER  OR INSURANCE CONSULTANT
LICENSED UNDER ARTICLE TWENTY-ONE OF THIS CHAPTER, WHILE  ACTING  WITHIN
THE  SCOPE  OF  SUCH  LICENSURE AND AS PART OF COMMISSIONS PAID OR UNDER
SEPARATE FEE AGREEMENTS, SHALL BE  AUTHORIZED  TO  ASSIST  INSURERS  AND
EMPLOYERS  IN  THE  DEVELOPMENT AND IMPLEMENTATION OF WELLNESS PROGRAMS,
DISEASE MANAGEMENT  AND  CARE  COORDINATION  SERVICES,  AND  OTHER  SUCH
PROGRAMS  AND  SERVICES  DESIGNED  TO IMPROVE QUALITY OF CARE AND HEALTH
OUTCOMES OF INSURED EMPLOYEES, SUBSCRIBERS OR ENROLLEES, BASED ON  ACTU-
ARIAL  DEMONSTRATIONS  THAT SUCH PROGRAMS AND SERVICES CAN BE REASONABLY
EXPECTED TO RESULT IN THE OVERALL GOOD HEALTH  AND  WELL  BEING  OF  THE
GROUP.
  S  2.  Section  4224  of  the insurance law is amended by adding a new
subsection (f) to read as follows:
  (F) THIS SECTION SHALL NOT  PROHIBIT  AN  INSURANCE  AGENT,  INSURANCE
BROKER OR INSURANCE CONSULTANT LICENSED UNDER ARTICLE TWENTY-ONE OF THIS
CHAPTER,  WHILE ACTING WITHIN THE SCOPE OF SUCH LICENSURE AND AS PART OF
COMMISSIONS PAID OR UNDER SEPARATE FEE AGREEMENTS, FROM ASSISTING INSUR-
ERS AND EMPLOYERS IN THE INTERPRETATION, MANAGEMENT AND COMMUNICATION OF
THE INSURANCE POLICY  OR  ANNUITY  CONTRACT  AND  ITS  RESULTING  COSTS.
PERMISSIBLE  SERVICES  SHALL  INCLUDE,  BUT  NOT BE LIMITED TO: WELLNESS
PROGRAMS, DISEASE MANAGEMENT AND CARE  COORDINATION  SERVICES,  ADMINIS-
TRATION  OF  COBRA AND NEW YORK STATE CONTINUATION OF COVERAGE, ADMINIS-
TRATION OF FLEXIBLE SPENDING ACCOUNTS (FSAS)  AND  HEALTH  REIMBURSEMENT

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06650-01-3

S. 2894                             2

ACCOUNTS  (HSAS), CLINICAL HEALTH ADVOCACY SERVICES, INCLUDING EMPLOYEE,
SUBSCRIBER OR ENROLLEE COMMUNICATIONS, HOTLINES, "HELP DESKS,"  AND  WEB
SITE  DEVELOPMENT, PREPARATION OF ANNUAL BENEFIT STATEMENTS, MAINTENANCE
OF  MEMBERSHIP  RECORDS,  PREMIUM  RECONCILIATION  AND BILLING SERVICES,
INCLUDING RETIREE BILLING, COMPLIANCE SUPPORT, INCLUDING  COMPLETION  OF
ERISA FORM 5500, AND FINANCIAL MODELING.
  S 3. This act shall take effect immediately.

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