Assembly Bill A11543

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

                                  11543

                          I N  A S S E M B L Y

                              June 23, 2010
                               ___________

Introduced  by COMMITTEE ON RULES -- (at request of M. of A. Parment) --
  read once and referred to the Committee on Insurance

AN ACT to amend the insurance law, in relation to establishing the Chau-
  tauqua County Chamber of Commerce health insurance pool  demonstration
  program;  and  providing  for  the  repeal of such provisions upon the
  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 article 42-A
to read as follows:
                              ARTICLE 42-A
                  CHAUTAUQUA COUNTY CHAMBER OF COMMERCE
               HEALTH INSURANCE POOL DEMONSTRATION PROGRAM
SECTION 4251. DEFINITIONS.
        4252. PROGRAM.
        4253. REPORTS.
  S 4251. DEFINITIONS. AS USED IN THIS ARTICLE:
  (A) "CHAMBER" MEANS THE CHAUTAUQUA COUNTY CHAMBER OF COMMERCE.
  (B) "ELIGIBLE EMPLOYEE" MEANS AN EMPLOYEE WHO IS EMPLOYED BY AN ELIGI-
BLE EMPLOYER, AND  SHALL  INCLUDE  SUCH  EMPLOYEE'S  DEPENDENTS,  SPOUSE
AND/OR DOMESTIC PARTNER.
  (C)  "ELIGIBLE  EMPLOYER"  MEANS (1) ANY INDIVIDUAL, OR PROPRIETARY OR
NOT-FOR-PROFIT FIRM, PARTNERSHIP, ASSOCIATION, LIMITED LIABILITY COMPANY
OR CORPORATION IN THE COUNTY OF CHAUTAUQUA, THAT IS ACTIVELY ENGAGED  IN
BUSINESS  IN  THIS STATE AND EMPLOYS ONE HUNDRED OR FEWER EMPLOYEES, AND
(2) ANY MUNICIPAL CORPORATION IN THE COUNTY OF CHAUTAUQUA  THAT  EMPLOYS
ONE HUNDRED OR FEWER EMPLOYEES.
  (D)  "PROGRAM"  MEANS THE CHAUTAUQUA COUNTY CHAMBER OF COMMERCE HEALTH
INSURANCE POOL DEMONSTRATION PROGRAM.
  S 4252. PROGRAM. (A) NOTWITHSTANDING ANY OTHER PROVISION OF THIS CHAP-
TER, THE CHAMBER IS HEREBY AUTHORIZED  AND  DIRECTED  TO  ESTABLISH  AND
ADMINISTER  THE  CHAUTAUQUA  COUNTY CHAMBER OF COMMERCE HEALTH INSURANCE
POOL DEMONSTRATION PROGRAM TO BE OPEN TO  ELIGIBLE  BUSINESSES  FOR  THE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD17786-01-0
              

A. 11543                            2

PURPOSE OF PROVIDING HEALTH AND ACCIDENT INSURANCE COVERAGE AND BENEFITS
TO ELIGIBLE EMPLOYEES.
  (B) THE CHAMBER SHALL:
  (1) APPOINT AN ADMINISTRATOR AND EMPLOY APPROPRIATE PERSONNEL AS NEED-
ED TO ADMINISTER AND OPERATE THE PROGRAM,
  (2)  ENTER INTO CONTRACTS WITH INSURERS TO PROVIDE HEALTH AND ACCIDENT
INSURANCE COVERAGE AND BENEFITS TO ELIGIBLE EMPLOYEES,
  (3) DEFINE THE HEALTH AND ACCIDENT  INSURANCE  COVERAGE  AND  BENEFITS
WHICH  THE CHAMBER WILL CONTRACT TO PURCHASE FROM PARTICIPATING INSURERS
AND APPROVE THE PLANS OFFERED BY INSURERS APPLYING TO PARTICIPATE IN THE
PROGRAM,
  (4) UNDERTAKE ANY ACTIVITIES  NECESSARY  TO  ADMINISTER  THE  PROGRAM,
INCLUDING  MARKETING  AND  PUBLICIZING THE PROGRAM, AND ENSURING PARTIC-
IPATING INSURER, ELIGIBLE EMPLOYEE AND ELIGIBLE EMPLOYER COMPLIANCE WITH
THE REQUIREMENTS OF THE PROGRAM,
  (5) ESTABLISH RULES, CONDITIONS AND PROCEDURES FOR ELIGIBLE  EMPLOYERS
AND PARTICIPATING INSURERS,
  (6) ESTABLISH A FINANCIAL RELATIONSHIP DIRECTLY WITH AGENTS OR BROKERS
TO PROVIDE COVERAGE AND BENEFITS PURSUANT TO THE PROGRAM, AND
  (7)  ESTABLISH A MECHANISM TO COLLECT PREMIUMS FROM ELIGIBLE EMPLOYERS
AND PAY PARTICIPATING INSURERS.
  (C) THE CHAMBER, IN CONSULTATION AND COOPERATION WITH THE  SUPERINTEN-
DENT,  SHALL CONTRACT WITH HEALTH AND ACCIDENT INSURERS FOR THE COVERAGE
AND BENEFITS TO BE PROVIDED UNDER THE PROGRAM. SUCH COVERAGE  AND  BENE-
FITS  SHALL  INCLUDE,  BUT  NOT  BE  LIMITED  TO, HOSPITAL AND PHYSICIAN
VISITS, PRESCRIPTION DRUG BENEFITS, MENTAL HEALTH SERVICES  AND  DURABLE
MEDICAL  EQUIPMENT.  SUCH  COVERAGE SHALL, SUBJECT TO THE SUPERVISION OF
THE SUPERINTENDENT, BE ISSUED ON AN EXPERIENCE RATED BASIS WITH A COMMU-
NITY RATING BASED ON FIVE THOUSAND LIVES INSURED.
  (D) THE PREMIUMS PAID BY PARTICIPATING ELIGIBLE EMPLOYERS AND ELIGIBLE
EMPLOYEES SHALL INCLUDE A SURCHARGE SUFFICIENT TO COVER THE COSTS OF THE
PROGRAM, BUT NOT TO EXCEED ONE PERCENT OF THE PREMIUM.
  (E) NEITHER THE CHAMBER OR ANY PARTICIPATING ELIGIBLE  EMPLOYER  SHALL
BE  DEEMED TO BE INELIGIBLE FOR ANY FEDERAL SUBSIDY OR TAX CREDIT ESTAB-
LISHED PURSUANT TO THE PATIENT PROTECTION AND  AFFORDABLE  CARE  ACT  OF
2010.
  S  4253.  REPORTS.  (A) ANNUALLY, ON OR BEFORE NOVEMBER FIFTEENTH, THE
CHAMBER SHALL SUBMIT A REPORT ON THE PROGRAM TO THE SUPERINTENDENT. SUCH
REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO DATA TRENDS INCLUDING  BUSI-
NESS  AND MUNICIPAL CORPORATION PARTICIPATION, AND ANY SUCH OTHER INFOR-
MATION AS THE SUPERINTENDENT SHALL DEEM TO BE NECESSARY.
  (B) ON OR BEFORE JUNE FIRST, TWO THOUSAND THIRTEEN, THE SUPERINTENDENT
SHALL SUBMIT A REPORT ON THE PROGRAM  TO  THE  GOVERNOR,  THE  TEMPORARY
PRESIDENT  OF  THE  SENATE AND THE SPEAKER OF THE ASSEMBLY.  SUCH REPORT
SHALL INCLUDE THE SUPERINTENDENT'S FINDINGS AND CONCLUSIONS  RELATED  TO
THE COSTS OF SAVINGS FROM AND PARTICIPATION IN THE PROGRAM.
  S 2. This act shall take effect December 1, 2010, and shall expire and
be deemed repealed December 1, 2013.