S T A T E   O F   N E W   Y O R K
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                                  3011

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                            January 22, 2009
                               ___________

Introduced  by  M.  of  A. BARCLAY, CALHOUN, QUINN, SAYWARD, TOWNSEND --
  Multi-Sponsored by -- M.   of A.  ALFANO,  BACALLES,  BARRA,  BURLING,
  CONTE,  CROUCH, ERRIGO, FINCH, GIGLIO, HAYES, McDONOUGH, O'MARA, RAIA,
  TEDISCO, WALKER -- read once and referred to the Committee  on  Insur-
  ance

AN  ACT  to  amend  the  insurance  law, in relation to rate filings for
  health insurance

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

  Section  1.    Subparagraph  (B)  of  paragraph 2 of subsection (e) of
section 3231 of the insurance law, as added by chapter 501 of  the  laws
of  1992,  is  relettered subparagraph (C) and a new subparagraph (B) is
added to read as follows:
  (B) BEGINNING APRIL FIRST, TWO  THOUSAND  TEN,  NO  RATE  INCREASE  OR
DECREASE  MAY  BE DEEMED APPROVED UNDER THIS SUBSECTION IF THAT INCREASE
OR DECREASE, TOGETHER WITH ANY OTHER RATE INCREASES OR DECREASES IMPOSED
ON THE SAME POLICY FORM, WOULD CAUSE  THE  AGGREGATE  RATE  INCREASE  OR
DECREASE  FOR  THAT POLICY FORM TO EXCEED TEN PERCENT DURING ANY CONTIN-
UOUS TWELVE MONTH PERIOD. NO RATE INCREASE  MAY  BE  IMPOSED  UNLESS  AT
LEAST  THIRTY  DAYS  ADVANCE  WRITTEN  NOTICE  OF SUCH INCREASE HAS BEEN
PROVIDED TO EACH POLICYHOLDER, EMPLOYEE AND MEMBER.
  S 2. Paragraph 2 of subsection (g) of section 4308  of  the  insurance
law,  as added by chapter 504 of the laws of 1995, is amended to read as
follows:
  (2) [Prior to January] BEGINNING APRIL first,  two  thousand  TEN,  no
rate  increase  or decrease may be deemed approved under this subsection
if that increase or decrease, together with any other rate increases  or
decreases  imposed  on the same contract form, would cause the aggregate
rate increase or decrease for that contract form to exceed  ten  percent
during  any  continuous  twelve  month  period.  No rate increase may be

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02807-01-9

              

A. 3011                             2

imposed unless at least thirty  days  advance  written  notice  of  such
increase has been provided to each contract holder and subscriber.
  S  3.  (a)  The superintendent of insurance shall undertake a study of
existing mandated health insurance benefits. The study shall include, at
a minimum and to the extent that information is available,  the  follow-
ing:
  (1)  The  extent  to  which  the treatment or service is utilized by a
significant portion of the population;
  (2) The extent to which the treatment or service is available  to  the
population;
  (3)  The extent to which the mandated insurance coverage has increased
or decreased the cost of the treatment or service  over  the  past  five
years;
  (4)  The  extent to which the mandated insurance coverage has affected
the number and types of providers of the mandated treatment  or  service
over the past five years;
  (5)  The extent to which insurance coverage of the health care service
or provider has increased or decreased the insurance premium and  admin-
istrative expenses of policyholders;
  (6)  The impact of indirect costs, which are costs other than premiums
and administrative costs, on the question of the costs and  benefits  of
coverage;
  (7) The impact of this coverage on the total cost of health care; and
  (8) The effects on the cost of health care to employers and employees.
  (b) The superintendent of insurance shall further consider:
  (1)  The  extent to which the need for mandated benefits outweighs the
costs associated with the mandate; and
  (2) The advisability of mandating the availability of  benefits  which
are presently mandated.
  (c)  The  superintendent  of  insurance  shall forward a report of the
study to the legislature on or before December 31, 2010.
  S 4. This act shall take effect immediately.