NY State Senate Bill 2009-S5471

Senate Bill S5471

Signed By Governor

2009-2010 Legislative Session

Relates to extending state continuation benefits from eighteen to thirty-six months

download bill text pdf

Archive: Last Bill Status Via A8400 - Signed by Governor

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jul 28, 2009	signed chap.236
Jul 22, 2009	delivered to governor
Jul 16, 2009	returned to assembly passed senate 3rd reading cal.860 substituted for s5471
Jul 16, 2009	substituted by a8400
Jul 15, 2009	ordered to third reading cal.860 committee discharged and committed to rules
Jun 01, 2009	reported and committed to finance
May 08, 2009	referred to insurance

Votes

- Jul 16, 2009 - Floor Vote
  A8400
  
  57
  
  Aye
  
  0
  
  Nay
  
  0
  
  Absent
  
  5
  
  Excused
  
  0
  
  Abstained
  - - Floor Vote: Jul 16, 2009
      
      aye (57)
      
      Adams
      
      Addabbo Jr.
      
      Alesi
      
      Aubertine
      
      Bonacic
      
      Breslin
      
      DeFrancisco
      
      Dilan
      
      Duane
      
      Espada
      
      Farley
      
      Flanagan
      
      Fuschillo
      
      Golden
      
      Griffo
      
      Hannon
      
      Hassell-Thompson
      
      Huntley
      
      Johnson
      
      Klein
      
      Krueger
      
      LaValle
      
      Lanza
      
      Larkin
      
      Leibell
      
      Libous
      
      Little
      
      Marcellino
      
      Maziarz
      
      McDonald
      
      Monserrate
      
      Montgomery
      
      Morahan
      
      Nozzolio
      
      Onorato
      
      Oppenheimer
      
      Padavan
      
      Parker
      
      Perkins
      
      Ranzenhofer
      
      Robach
      
      Saland
      
      Sampson
      
      Savino
      
      Schneiderman
      
      Serrano
      
      Seward
      
      Skelos
      
      Smith
      
      Stachowski
      
      Stavisky
      
      Stewart-Cousins
      
      Thompson
      
      Valesky
      
      Volker
      
      Winner
      
      Young
      
      excused (5)
      
      Diaz
      
      Foley
      
      Johnson
      
      Kruger
      
      Squadron
  Jul 15, 2009 - Rules Committee Vote
  S5471
  
  22
  
  Aye
  
  0
  
  Nay
  
  1
  
  Aye with Reservations
  
  0
  
  Absent
  
  1
  
  Excused
  
  0
  
  Abstained
  - - Rules Committee Vote: Jul 15, 2009
      
      aye (22)
      
      Dilan
      
      Duane
      
      Espada
      
      Farley
      
      Hannon
      
      Hassell-Thompson
      
      Klein
      
      Krueger
      
      LaValle
      
      Larkin
      
      Monserrate
      
      Montgomery
      
      Padavan
      
      Parker
      
      Serrano
      
      Seward
      
      Skelos
      
      Smith
      
      Stachowski
      
      Stewart-Cousins
      
      Valesky
      
      Volker
      
      aye wr (1)
      
      Saland
      
      excused (1)
      
      Johnson

co-Sponsors

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2009-S5471 (ACTIVE) - Details

See Assembly Version of this Bill:: A8400
Law Section:: Insurance Law
Laws Affected:: Amd §§3221, 4304 & 4305, Ins L

2009-S5471 (ACTIVE) - Summary

Extends the period of coverage for COBRA benefits under certain insurance contracts from eighteen to thirty-six months.

2009-S5471 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S5471

 TITLE OF BILL :

An act to amend the insurance law, in relation to extending state
continuation benefits from eighteen months to thirty-six months


 PURPOSE :

This bill would help ensure continued access to group health insurance
by extending the period of continuation coverage under a group
contract or group remittance contract from 18 months.to 36 months.

 SUMMARY OF PROVISIONS :

Section 1 of the bill would amend Insurance Law § 3221 to require
commercial insurers offering group policies to extend the period of
state continuation coverage from 18 months to 36 months for employees
or members. Section 1 of the bill would also allow an employee or
member who has otherwise exhausted federal continuation benefits under
the Consolidated Omnibus Budget Reconciliation Act ("COBRA") to
maintain coverage for up to 36 months, if the employee or member is
entitled to less than 36 months of federal COBRA benefits.

Section 2 of the bill would amend Insurance Law § 4304 to require

not-for-profit corporations and health maintenance organizations
("HMOs") offering group remittance contracts to extend continuation
benefits from 18 months to 36 months, under the same terms and
conditions as commercial insurers.

Section 3 of the bill would amend Insurance Law § 4305 to require
not-for-profit corporations and HMOs offering group contracts to
extend continuation benefits from 18 months to 36 months, under the
same terms and conditions as commercial insurers.

Section 4 of the bill would provide that the bill take effect on July
1, 2009 and apply to all contracts issued, renewed, modified, altered
or amended on or after that date.

 EXISTING LAW :

Insurance Law § 3221 (m) permits individuals covered under commercial
group or blanket accident and health insurance policies that are not
subject to federal COBRA law to elect to participate in state
continuation coverage in the event of job loss, reduction in work
hours or loss of eligibility. Such individuals must elect state
continuation coverage within 60 days of the event which qualifies them
for coverage or within 60 days of receiving notice of the right to
elect such coverage. There is no cost to the employer for continuation
coverage. The former employee or member pays the full premium, which
is capped at 102 percent of the group rate.

The period of continuation coverage for employees or members is
limited to 18 months, at which time the former employee loses their
right to continuation coverage. In cases where dependents lose
coverage due to divorce, separation, or aging off a parent's policy,
the period of continuation coverage is 36 months.

Insurance Law § 4304(k) sets forth provisions similar to those of
Insurance Law § 3221 (m), permitting the election of state
continuation coverage for group remittance contracts with a hospital
service, health service or medical expense indemnity corporation.

Insurance Law § 4305(e) sets forth provisions similar to those of
Insurance Law . 3221 (m), permitting the election of state
continuation coverage for group contracts with a hospital service,
health service or medical expense indemnity corporation.

Chapter 18 of the Employee Retirement Income Security Act, 29 D.S.C.
§ 1161, et seq., provides for continuation coverage and additional
standards for group health plans.

Chapter 6A of the Public Health Service Act, 42 D.S.C. § 300bb-1, et
seq., provides for continuation coverage under State and local group
health plans.

The American Recovery and Reinvestment Act of 2009 expanded access to
federal COBRA and state continuation benefits for laid-off workers by
providing a 9-month, 65% subsidy of premiums.

 LEGISLATIVE HISTORY :

This is a new bill.

 STATEMENT OF SUPPORT :

COBRA allows workers to continue their group health insurance coverage
for 18 months if their employment is involuntarily terminated or if
they lose their coverage due to a reduction in work hours. However,
COBRA only applies to employers with 20 or more employees. To address
this gap, the State's "Mini-COBRA" law requires small employers (with
less than 20 employees) to offer an 18-month State health insurance
continuation benefit similar to COBRA.

This bill would allow workers, regardless of the size of their
employer, to extend their health insurance continuation benefit from
18 months to 36 months, at no direct cost to the State or employers.
Currently, those who do not have access to group health insurance
(including those that exhaust their continuation benefits) must
purchase coverage on an individual basis.  New York's individual
health insurance market is standardized, with very comprehensive
benefits and prohibitively high premiums.  Continuation coverage is
available at an average cost of $400 per month for single coverage.
The average cost of individual health insurance coverage currently
exceeds $900 per month (higher in certain regions). While the Healthy
NY program offers a less expensive option, it is not available to
everyone due to eligibility requirements.

Current national unemployment rates are at a 24-year high. New York's
unemployment rate was close to eight percent as of February 2009, up
from six percent in November 2008, and climbing at a rate that exceeds
the national average. An increasing number of workers are experiencing
extended periods of job loss or being forced to work part-time. All of
these factors contribute to a loss of group health insurance coverage.
Also, as companies downsize, older workers are often offered early
retirement options as an alternative to lay-offs.  These individuals
may not have retiree health benefits, and can be years away from
Medicare.

This bill extends a more affordable private health insurance option,
at no direct cost to the State or employers. This bill would allow
individuals to maintain their existing coverage for a longer period of
time through continuation coverage. Without such option, many of these
individuals would be uninsured after 18 months.

 BUDGET IMPLICATIONS :

This bill will have not have a material impact on State finances.

 EFFECTIVE DATE :
The bill would take effect on July 1, 2009 and would apply to all
contracts issued, renewed, modified, amended or altered on or after
that date.

2009-S5471 (ACTIVE) - Bill Text download pdf

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

                                  5471

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                               May 8, 2009
                               ___________

Introduced  by  Sens.  BRESLIN,  DUANE, ESPADA, FOLEY, HASSELL-THOMPSON,
  KRUEGER, ONORATO, SAMPSON, STAVISKY, STEWART-COUSINS -- (at request of
  the Governor) -- 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 extending state
  continuation benefits from eighteen months to thirty-six months

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

  Section 1. Paragraphs 4 and 6 of subsection (m) of section 3221 of the
insurance  law,  paragraph  4  as  amended by chapter 501 of the laws of
1992, subparagraph D of paragraph 4 as amended by  chapter  661  of  the
laws  of  1997, paragraph 6 as added by chapter 210 of the laws of 1987,
are amended to read as follows:
  (4) Subject to paragraph one of this subsection, continuation of bene-
fits under the group policy for any person shall terminate at the  first
to occur of the following:
  (A)  The  date [eighteen] THIRTY-SIX months after the date the employ-
ee's or member's benefits under the policy would otherwise  have  termi-
nated because of termination of employment or membership; or
  (B) The end of the period for which premium payments were made, if the
employee  or  member  fails to make timely payment of a required premium
payment; or
  (C) In the case of an eligible dependent of an employee or member, the
date thirty-six months after the date such person's benefits  under  the
policy would otherwise have terminated by reason of:
  (i) the death of the employee or member;
  (ii)  the  divorce  or legal separation of the employee or member from
his or her spouse;
  (iii) the employee or member becoming entitled to benefits under title
XVIII of the United States Social Security Act (Medicare); or

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD12027-03-9

S. 5471                             2

  (iv) a dependent child ceasing to  be  a  dependent  child  under  the
generally applicable requirements of the policy; or
  (D)  [In  the  case  of an employee or member who is determined, under
title II or title XVI of the Social Security Act, to have been  disabled
at  the  time  of termination of employment or membership or at any time
during the first sixty days of continuation of coverage, the date  twen-
ty-nine  months after the date the employee's or member's benefits under
the policy would otherwise have terminated  because  of  termination  of
employment  or  membership;  provided, however, that if such employee or
member is no longer disabled, the benefits provided in this subparagraph
shall terminate the later of (i) the date provided by  subparagraph  (A)
of  this  paragraph,  or (ii) the month that begins more than thirty-one
days after the date of the final determination under title II  or  title
XVI of the United States Social Security Act that the employee or member
is no longer disabled; or
  (E)]  The date on which the group policy is terminated or, in the case
of an employee, the date his employer terminates participation under the
group policy. However, if this clause applies and the  coverage  ceasing
by  reason  of  such  termination  is replaced by similar coverage under
another group policy, the following shall apply:
  (i) The employee or member shall have  the  right  to  become  covered
under  that  other  group  policy, for the balance of the period that he
would have remained covered under the prior group policy  in  accordance
with  this subparagraph had a termination described in this subparagraph
not occurred, and
  (ii) The minimum level of benefits to be provided by the  other  group
policy  shall  be  the  applicable  level of benefits of the prior group
policy reduced by any benefits payable under that  prior  group  policy,
and
  (iii) The prior group policy shall continue to provide benefits to the
extent  of  its  accrued liabilities and extension of benefits as if the
replacement had not occurred.
  (6) This subsection shall not be applicable where a continuation bene-
fit is available to the employee or member pursuant to Chapter 18 of the
Employee Retirement Income Security Act, 29 U.S.C.  S  1161  et  seq  or
Chapter  6A  of the Public Health Service Act, 42 U.S.C. S 300 bb - 1 et
seq. HOWEVER, A GROUP POLICY SHALL OFFER AN INSURED  WHO  HAS  EXHAUSTED
CONTINUATION  COVERAGE PURSUANT TO CHAPTER 18 OF THE EMPLOYEE RETIREMENT
INCOME SECURITY ACT, 29 U.S.C. S 1161 ET  SEQ.  OR  CHAPTER  6A  OF  THE
PUBLIC  HEALTH  SERVICE ACT, 42 U.S.C. S 300 BB - 1 ET SEQ. THE OPPORTU-
NITY TO CONTINUE COVERAGE FOR UP TO THIRTY-SIX MONTHS FROM THE DATE  THE
EMPLOYEE'S  OR  MEMBER'S CONTINUATION COVERAGE BEGAN, IF THE EMPLOYEE OR
MEMBER IS ENTITLED TO LESS THAN THIRTY-SIX MONTHS OF CONTINUATION  BENE-
FITS UNDER FEDERAL LAW.
  S  2.  Paragraph  4 of subsection (k) of section 4304 of the insurance
law, as added by chapter 501 of the laws  of  1992,  subparagraph  D  as
amended  by  chapter 661 of the laws of 1997, is amended and a new para-
graph 5 is added to read as follows:
  (4) Subject to paragraph one of this subsection, continuation of bene-
fits under the group remittance contract for any person shall  terminate
at the first to occur of the following:
  (A)  The  date [eighteen] THIRTY-SIX months after the date the employ-
ee's or member's benefits under the contract would otherwise have termi-
nated because of termination of employment or membership; or

S. 5471                             3

  (B) The end of the period for which premium payments were made, if the
employee or member fails to make timely payment of  a  required  premium
payment; or
  (C) In the case of an eligible dependent of an employee or member, the
date  thirty-six  months after the date such person's benefits under the
contract would otherwise have terminated by reason of:
  (i) the death of the employee or member;
  (ii) the divorce or legal separation of the employee  or  member  from
his or her spouse;
  (iii) the employee or member becoming entitled to benefits under title
XVIII of the United States Social Security Act (Medicare); or
  (iv)  a  dependent  child  ceasing  to  be a dependent child under the
generally applicable requirements of the contract; or
  (D) [In the case of an employee or member  who  is  determined,  under
title  II or title XVI of the Social Security Act, to have been disabled
at the time of the termination of employment or  membership  or  at  any
time  during  the first sixty days of continuation of coverage, the date
twenty-nine months after the date the employee's  or  member's  benefits
under  the  contract  would  otherwise have terminated because of termi-
nation of employment or membership;  provided,  however,  that  if  such
employee  or member is no longer disabled, the benefits provided in this
subparagraph shall terminate the later  of  (i)  the  date  provided  by
subparagraph  (A)  of this paragraph, or (ii) the month that begins more
than thirty-one days after the date of  the  final  determination  under
title  II or title XVI of the United States Social Security Act that the
employee or member is no longer disabled; or
  (E)] The date on which the group remittance contract with that  remit-
ting  agent  is  terminated or, in the case of an employee, the date his
employer terminates participation under the group  remittance  contract.
However,  if  this  clause applies and the coverage ceasing by reason of
such termination is replaced by similar coverage under another group  or
group remittance contract, the following shall apply:
  (i)  The  employee  or  member  shall have the right to become covered
under that other group or group remittance contract, for the balance  of
the  period  that  he  would have remained covered under the prior group
remittance contract in accordance with this subparagraph  had  a  termi-
nation described in this subparagraph not occurred, and
  (ii)  The  minimum level of benefits to be provided by the other group
or group remittance contract shall be the applicable level  of  benefits
of  the  prior group remittance contract reduced by any benefits payable
under that prior group remittance contract, and
  (iii) The prior group remittance contract shall  continue  to  provide
benefits to the extent of its accrued liabilities and extension of bene-
fits as if the replacement had not occurred.
  (5)  A CONTRACT FOR WHICH PREMIUMS ARE PAID BY A REMITTING AGENT FOR A
GROUP ISSUED BY A HOSPITAL SERVICE, HEALTH SERVICE  OR  MEDICAL  EXPENSE
INDEMNITY  CORPORATION  SHALL  OFFER  AN  EMPLOYEE  OR  MEMBER  WHO  HAS
EXHAUSTED CONTINUATION COVERAGE PURSUANT TO CHAPTER 18 OF  THE  EMPLOYEE
RETIREMENT  INCOME SECURITY ACT, 29 U.S.C. S 1161 ET SEQ.  OR CHAPTER 6A
OF THE PUBLIC HEALTH SERVICE ACT, 42 U.S.C. S 300 BB -  1  ET  SEQ.  THE
OPPORTUNITY  TO  CONTINUE  COVERAGE FOR UP TO THIRTY-SIX MONTHS FROM THE
DATE THE EMPLOYEE'S OR  MEMBER'S  CONTINUATION  COVERAGE  BEGAN  IF  THE
EMPLOYEE OR MEMBER IS ENTITLED TO LESS THAN THIRTY-SIX MONTHS OF CONTIN-
UATION BENEFITS.
  S  3.  Paragraphs  4  and  7  of subsection (e) of section 4305 of the
insurance law, paragraph 4 as amended by chapter  677  of  the  laws  of

S. 5471                             4

1993,  subparagraph  D  of  paragraph 4 as amended by chapter 661 of the
laws of 1997, paragraph 7 as added by chapter 210 of the laws  of  1987,
are amended to read as follows:
  (4) Subject to paragraph one of this subsection, continuation of bene-
fits  under  the  group  contract  for any person shall terminate at the
first to occur of the following:
  (A) The date [eighteen] THIRTY-SIX months after the date  the  employ-
ee's or member's benefits under the contract would otherwise have termi-
nated because of termination of employment or membership; or
  (B) The end of the period for which premium payments were made, if the
employee  or  member  fails to make timely payment of a required premium
payment; or
  (C) In the case of an eligible dependent of an employee or member, the
date thirty-six months after the date such person's benefits  under  the
contract would otherwise have terminated by reason of:
  (i) the death of the employee or member;
  (ii)  the  divorce  or legal separation of the employee or member from
his or her spouse;
  (iii) the employee or member becoming entitled to benefits under title
XVIII of the United States Social Security Act (Medicare); or
  (iv) a dependent child ceasing to  be  a  dependent  child  under  the
generally applicable requirements of the contract; or
  (D)  [In  the  case  of an employee or member who is determined, under
title II or title XVI of the Social Security Act, to have been  disabled
at  the  time  of termination of employment or membership or at any time
during the first sixty days of continuation of coverage, the date  twen-
ty-nine  months after the date the employee's or member's benefits under
the contract would otherwise have terminated because of  termination  of
employment  or  membership;  provided, however, that if such employee or
member is no longer disabled, the benefits provided in this subparagraph
shall terminate the later of (i) the date provided by  subparagraph  (A)
of  this  paragraph,  or (ii) the month that begins more than thirty-one
days after the date of the final determination under title II  or  title
XVI of the United States Social Security Act that the employee or member
is no longer disabled; or
  (E)]  The  date  on  which the group contract is terminated or, in the
case of an employee, the  date  his  employer  terminated  participation
under the group contract. However, if this clause applies and the cover-
age  ceasing by reason of such termination is replaced by similar cover-
age under another group contract, the following shall apply:
  (i) The employee or member shall have  the  right  to  become  covered
under  that  other group contract, for the balance of the period that he
would have remained covered under the prior group contract in accordance
with this subparagraph had a termination described in this  subparagraph
not occurred, and
  (ii)  The  minimum level of benefits to be provided by the other group
contract shall be the applicable level of benefits of  the  prior  group
contract reduced by any benefits payable under the prior group contract,
and
  (iii)  The  prior group contract shall continue to provide benefits to
the extent of its accrued liabilities and extensions of benefits  as  if
the replacement had not occurred.
  (7) This subsection shall not be applicable where a continuation bene-
fit is available to the employee or member pursuant to Chapter 18 of the
Employee  Retirement  Income  Security  Act,  29 U.S.C. S 1161 et seq or
Chapter 6A of the Public Health Service Act, 42 U.S.C. S 300 bb -  1  et

S. 5471                             5

seq.    HOWEVER,  A GROUP CONTRACT SHALL OFFER AN EMPLOYEE OR MEMBER WHO
HAS EXHAUSTED CONTINUATION  COVERAGE  PURSUANT  TO  CHAPTER  18  OF  THE
EMPLOYEE  RETIREMENT  INCOME  SECURITY  ACT, 29 U.S.C. S 1161 ET SEQ. OR
CHAPTER  6A  OF THE PUBLIC HEALTH SERVICE ACT, 42 U.S.C. S 300 BB - 1 ET
SEQ. THE OPPORTUNITY TO CONTINUE COVERAGE FOR UP  TO  THIRTY-SIX  MONTHS
FROM  THE DATE THE EMPLOYEE'S OR MEMBER'S CONTINUATION COVERAGE BEGAN IF
THE EMPLOYEE OR MEMBER IS ENTITLED TO LESS  THAN  THIRTY-SIX  MONTHS  OF
CONTINUATION BENEFITS.
  S  4.  This  act  shall take effect on July 1, 2009 and shall apply to
policies and contracts issued, renewed, modified, altered or amended  on
or after such date.

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