S T A T E O F N E W Y O R K
________________________________________________________________________
5198
2011-2012 Regular Sessions
I N A S S E M B L Y
February 14, 2011
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Introduced by M. of A. BARCLAY, CALHOUN, SAYWARD -- Multi-Sponsored by
-- M. of A. BURLING, CONTE, CROUCH, FINCH, GIGLIO, HAYES, McDONOUGH,
RAIA, TEDISCO -- read once and referred to the Committee on Insurance
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 amended by chapter 107 of the laws
of 2010, is relettered subparagraph (C) and a new subparagraph (B) is
added to read as follows:
(B) BEGINNING APRIL FIRST, TWO THOUSAND TWELVE, 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 amended by chapter 107 of the laws of 2010, is amended to read
as follows:
(2) [Prior to January] BEGINNING APRIL first, two thousand TWELVE, 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
imposed pursuant to this subsection unless at least thirty days advance
written notice of such increase has been provided to each contract hold-
er and subscriber.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD08761-01-1
A. 5198 2
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, 2012.
S 4. This act shall take effect immediately.