senate Bill S6740B

Signed By Governor
2011-2012 Legislative Session

Relates to a health insurance demonstration program for early retirees

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Sponsored By

Archive: Last Bill Status - Signed by Governor


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Aug 01, 2012 signed chap.362
Jul 20, 2012 delivered to governor
Jun 14, 2012 returned to senate
passed assembly
ordered to third reading cal.496
substituted for a9675b
Jun 13, 2012 referred to insurance
returned to assembly
repassed senate
Jun 04, 2012 amended on third reading 6740b
May 21, 2012 amended on third reading 6740a
vote reconsidered - restored to third reading
May 21, 2012 returned to senate
recalled from assembly
May 08, 2012 referred to insurance
delivered to assembly
passed senate
Apr 30, 2012 advanced to third reading
Apr 26, 2012 2nd report cal.
Apr 25, 2012 1st report cal.568
Mar 15, 2012 referred to insurance

Votes

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Apr 25, 2012 - Insurance committee Vote

S6740
16
0
committee
16
Aye
0
Nay
0
Aye with Reservations
1
Absent
1
Excused
0
Abstained
show committee vote details

Committee Vote: Apr 25, 2012

absent (1)
excused (1)

Bill Amendments

Original
A
B (Active)
Original
A
B (Active)

S6740 - Bill Details

See Assembly Version of this Bill:
A9675B
Law Section:
Insurance Law
Laws Affected:
Add §1123-a, Ins L

S6740 - Bill Texts

view summary

Relates to a health insurance demonstration program for early retirees.

view sponsor memo
BILL NUMBER:S6740

TITLE OF BILL:
An act to amend the insurance law, in relation to a health insurance
demonstration program for early retirees; and providing for the repeal
of such provisions upon expiration thereof

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of the bill is to authorize the Superintendent of Financial
Services to approve a demonstration program to provide group health
insurance Coverage for former employees of a major New York-based
employer.

SUMMARY OF SPECIFIC PROVISIONS:
This bill authorizes a demonstration which would allow the Superinten-
dent of Financial Services to approve an eligible insurance company to
provide health insurance to former employees of a major New York-based
employer. The eligible insurance company would submit periodic reports
to the Superintendent to enable the Superintendent to evaluate the
effectiveness of the demonstration program.

JUSTIFICATION:
Today, an increasing number of New Yorkers are losing employer-based
health insurance coverage due to the economy. Some of these individuals
Were Promised continued coverage by their employer after retirement.
These former employees lack access to employment-sponsored health insur-
ance coverage and often Cannot afford to purchase coverage in the
private pay market.

This demonstration program seeks to create a new model of health insur-
ance that would meet the special needs of this population, at a reason-
able price, while still meeting the solvency requirements, benefit
mandates, and other obligations required by state statute and regu-
lation. Providing this program on a "pilot" basis affords the Department
of Financial Services the ability to assess the policy ramifications of
this change and the impact on other groups and the community,

LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
Immediately, but shall expire and be deemed repealed on December 31,
2013.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  6740

                            I N  S E N A T E

                             March 15, 2012
                               ___________

Introduced  by  Sen.  ROBACH -- 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  a  health  insurance
  demonstration program for early retirees; and providing for the repeal
  of such provisions upon 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 section 1123-a
to read as follows:
  S 1123-A.  HEALTH INSURANCE DEMONSTRATION PROGRAM FOR  FORMER  EMPLOY-
EES.    (A) PURPOSE OF THE DEMONSTRATION PROGRAM. THE LEGISLATURE RECOG-
NIZES THAT FORMER EMPLOYEES WHO HAVE RELIED ON EMPLOYER-SPONSORED HEALTH
INSURANCE COVERAGE, AND IN SOME CASES, THE PROMISE OF  CONTINUED  HEALTH
INSURANCE, HAVE BEEN ADVERSELY AFFECTED BY THE ECONOMY AND THE INABILITY
OF  THEIR  FORMER  EMPLOYERS  TO  CONTINUE  TO PROVIDE HEALTH INSURANCE.
THESE INDIVIDUALS OFTEN FIND THEMSELVES WITHOUT ACCESS TO OTHER  EMPLOY-
ER-SPONSORED  COVERAGE  AND  ARE  TOO YOUNG TO ENROLL  IN MEDICARE.  THE
DIRECT PAY MARKET IS NOT ALWAYS A VIABLE OPTION  FOR  THESE  INDIVIDUALS
BECAUSE OF COST. THE DEMONSTRATION PROGRAM AUTHORIZED BY THIS SECTION IS
INTENDED  TO  PROVIDE  A MECHANISM TO ALLOW THESE INDIVIDUALS TO PARTIC-
IPATE IN THEIR OWN GROUP  HEALTH  INSURANCE  PROGRAMS  THAT  MEET  THEIR
SPECIAL NEEDS, WHILE ENSURING COMPLIANCE WITH THIS CHAPTER AND ANY REGU-
LATIONS  PROMULGATED  THEREUNDER, INCLUDING BENEFIT MANDATES. THE DEMON-
STRATION PROGRAM WILL ENABLE THE LEGISLATURE AND THE  SUPERINTENDENT  TO
ASSESS  WHETHER TO PERMIT AN ASSOCIATION OF FORMER EMPLOYEES TO CONTINUE
TO HAVE HEALTH INSURANCE COVERAGE  UNDER  SIMILAR  TERMS  AS  THEY  HAVE
ENJOYED  WHILE EMPLOYED UNTIL THEY ARE ELIGIBLE FOR COVERAGE UNDER TITLE
XVIII OF THE SOCIAL SECURITY ACT (MEDICARE) OR  UNTIL  OTHER  COMPARABLE
GROUP HEALTH INSURANCE COVERAGE BECOMES AVAILABLE.
  (B) DEFINITIONS. IN THIS SECTION:
  (1)  "ELIGIBLE  ASSOCIATION"  MEANS AN ENTITY THAT: (A) IS EXEMPT FROM
FEDERAL TAXATION UNDER SECTION  501(C)(3)  OR  (C)(4)  OF  THE  INTERNAL
REVENUE CODE; (B) WAS INCORPORATED ON OR BEFORE JANUARY FIRST, TWO THOU-
SAND  TEN; (C) MEETS THE CRITERIA SET FORTH IN SUBPARAGRAPH (K) OF PARA-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15057-01-2

S. 6740                             2

GRAPH ONE OF SUBSECTION (C) OF SECTION FOUR THOUSAND TWO  HUNDRED  THIR-
TY-FIVE OF THIS CHAPTER; AND (D) HAS BEEN ESTABLISHED FOR THE BENEFIT OF
FORMER EMPLOYEES OF A COMPANY IN THIS STATE.
  (2)  "ELIGIBLE  INSURER"  MEANS A HEALTH SERVICE CORPORATION ORGANIZED
PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER THAT, AS OF  THE  EFFEC-
TIVE DATE OF THIS SECTION, HAS ITS PARENT HEADQUARTERS IN THE SAME COUN-
TY  AS  THE  ELIGIBLE  ASSOCIATION  AND  THAT  HAS A NATIONAL NETWORK OF
PROVIDERS ABLE TO PROVIDE SERVICES TO MEMBERS OF  THE  ELIGIBLE  ASSOCI-
ATION.
  (3)  "FORMER  EMPLOYEE"  MEANS  AN  INDIVIDUAL:  (A)  WHO WAS FORMERLY
EMPLOYED BY A COMPANY HEADQUARTERED IN THIS STATE AND WHICH HAS BEEN  IN
OPERATION  FOR  OVER  ONE HUNDRED YEARS; (B) WHO HAS HERETOFORE RECEIVED
HEALTH INSURANCE COVERAGE THROUGH THE FORMER EMPLOYER, (C) WHOSE  FORMER
EMPLOYER  FILED  FOR  CHAPTER  ELEVEN BANKRUPTCY IN JANUARY TWO THOUSAND
TWELVE, AND (D) WHO IS NOT ELIGIBLE FOR MEDICARE  OR  FOR  GROUP  HEALTH
INSURANCE COVERAGE THROUGH ANOTHER EMPLOYER.
  (4)  "GROUP  HEALTH  INSURANCE"  MEANS  INSURANCE  PROVIDING HOSPITAL,
SURGICAL OR MEDICAL EXPENSE  COVERAGE  OR  OTHER  SIMILAR  COMPREHENSIVE
HEALTH INSURANCE COVERAGE.
  (C)  DEMONSTRATION PROGRAM FOR FORMER EMPLOYEES.  (1) BOTH THE INSURER
AND THE GROUP HEALTH INSURANCE POLICIES ISSUED TO THE  ELIGIBLE  ASSOCI-
ATION  SHALL  BE SUBJECT TO THE PROVISIONS OF THIS CHAPTER AND ANY REGU-
LATIONS PROMULGATED THEREUNDER, EXCEPT  THAT  THE  ELIGIBLE  ASSOCIATION
SHALL NOT BE CONSIDERED A SMALL GROUP UNDER THIS CHAPTER.
  (2)  SUBJECT TO PARAGRAPH THREE OF THIS SUBSECTION, THE SUPERINTENDENT
MAY ISSUE AN APPROVAL TO AN ELIGIBLE INSURER IF: (A) THE ELIGIBLE INSUR-
ER DEMONSTRATES THAT IT SATISFIES ALL FINANCIAL, OPERATIONAL  AND  OTHER
REQUIREMENTS  OF  THIS  CHAPTER  AND REGULATIONS PROMULGATED THEREUNDER,
OTHER THAN ANY REQUIREMENTS EXPRESSLY WAIVED BY THIS SECTION, AND  SHALL
OPERATE THE DEMONSTRATION PROGRAM IN ACCORDANCE WITH THE REQUIREMENTS OF
THIS  SECTION;  AND  (B)  THE  SUPERINTENDENT DETERMINES THAT THE DEMON-
STRATION PROGRAM FURTHERS THE PUBLIC POLICY GOALS OF THIS SECTION.
  (3) ANY ELIGIBLE INSURER SEEKING THE SUPERINTENDENT'S  APPROVAL  UNDER
PARAGRAPH  TWO  OF THIS SUBSECTION SHALL SUBMIT A WRITTEN REQUEST TO THE
SUPERINTENDENT WITHIN THIRTY DAYS OF THE EFFECTIVE DATE OF THIS SECTION.
THE ELIGIBLE INSURER'S  APPLICATION  SHALL:  SPECIFY  THE  IDENTITY  AND
COMPOSITION  OF  THE  ELIGIBLE  ASSOCIATION,  THE ELIGIBLE ASSOCIATION'S
MEMBERSHIP RULES, AND THE TERMS UNDER WHICH THE ELIGIBLE  INSURER  SHALL
PROVIDE  GROUP HEALTH INSURANCE TO THE ELIGIBLE ASSOCIATION; DEMONSTRATE
THAT THE ELIGIBLE INSURER AND THE ELIGIBLE ASSOCIATION THE  REQUIREMENTS
SET FORTH IN THIS SECTION; AND IDENTIFY THE GROUP HEALTH INSURANCE POLI-
CY  FORMS  THAT  THE ELIGIBLE INSURER WILL ISSUE TO THE ELIGIBLE ASSOCI-
ATION. THE SUPERINTENDENT SHALL MAKE  A  DETERMINATION  ON  ANY  REQUEST
WITHIN  NINETY  DAYS OF RECEIPT OF ALL NECESSARY INFORMATION. THE SUPER-
INTENDENT SHALL ISSUE AN APPROVAL TO ONLY ONE ELIGIBLE INSURER.
  (4) THE SUPERINTENDENT MAY REVOKE AN APPROVAL ISSUED  UNDER  PARAGRAPH
TWO  OF  THIS  SUBSECTION IF: THE INSURER THAT RECEIVED SUCH APPROVAL NO
LONGER QUALIFIES AS AN ELIGIBLE INSURER OR IS OTHERWISE OPERATING  IN  A
MANNER  INCONSISTENT  WITH THE PROVISIONS OF THIS CHAPTER OR REGULATIONS
PROMULGATED THEREUNDER; OR THE ASSOCIATION TO WHICH THE ELIGIBLE INSURER
ISSUED THE GROUP HEALTH INSURANCE  POLICY  NO  LONGER  QUALIFIES  AS  AN
ELIGIBLE  ASSOCIATION.  AN ELIGIBLE INSURER THAT RECEIVES APPROVAL UNDER
PARAGRAPH TWO OF THIS SUBSECTION SHALL SUBMIT PERIODIC  REPORTS  TO  THE
SUPERINTENDENT  SUFFICIENT  TO ENABLE THE SUPERINTENDENT TO EVALUATE THE
EFFECTIVENESS OF THE DEMONSTRATION PROGRAM. SUCH REPORTS SHALL INCLUDE A
COMPARISON OF THE COST OF HEALTH INSURANCE OBTAINED UNDER THE PROGRAM TO

S. 6740                             3

OTHER AVAILABLE INSURANCE  OPTIONS,  INCLUDING  GROUP  HEALTH  INSURANCE
POLICIES DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE, DEMOGRAPHIC AND
GEOGRAPHIC ANALYSIS OF THE ENROLLED POPULATION AND ANY OTHER INFORMATION
REQUIRED BY THE SUPERINTENDENT.
  S  2. This act shall take effect immediately and shall expire December
31, 2013 when upon such date the provisions of this act shall be  deemed
repealed.

Co-Sponsors

S6740A - Bill Details

See Assembly Version of this Bill:
A9675B
Law Section:
Insurance Law
Laws Affected:
Add §1123-a, Ins L

S6740A - Bill Texts

view summary

Relates to a health insurance demonstration program for early retirees.

view sponsor memo
BILL NUMBER:S6740A

TITLE OF BILL:
An act to amend the insurance law, in relation to a health insurance
demonstration program for early retirees; and providing for the repeal
of such provisions upon expiration thereof

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of the bill is to authorize the Superintendent of Financial
Services to approve a demonstration program to provide group health
insurance Coverage for former employees of a major New York-based
employer.

SUMMARY OF SPECIFIC PROVISIONS:
This bill authorizes a demonstration which would allow the Superinten-
dent of Financial Services to approve an eligible insurance company to
provide health insurance to former employees of a major New York-based
employer. The eligible insurance company would submit periodic reports
to the Superintendent to enable the Superintendent to evaluate the
effectiveness of the demonstration program.

JUSTIFICATION:
Today, an increasing number of New Yorkers are losing employer-based
health insurance coverage due to the economy. Some of these individuals
Were Promised continued coverage by their employer after retirement.
These former employees lack access to employment-sponsored health insur-
ance coverage and often Cannot afford to purchase coverage in the
private pay market.

This demonstration program seeks to create a new model of health insur-
ance that would meet the special needs of this population, at a reason-
able price, while still meeting the solvency requirements, benefit
mandates, and other obligations required by state statute and regu-
lation. Providing this program on a "pilot" basis affords the Department
of Financial Services the ability to assess the policy ramifications of
this change and the impact on other groups and the community,

LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
Immediately, but shall expire and be deemed repealed on December 31,
2013.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 6740--A
    Cal. No. 568

                            I N  S E N A T E

                             March 15, 2012
                               ___________

Introduced  by  Sen.  ROBACH -- read twice and ordered printed, and when
  printed to be committed to the  Committee  on  Insurance  --  reported
  favorably  from  said  committee,  ordered to first and second report,
  ordered to a third reading, passed by  Senate  and  delivered  to  the
  Assembly,  recalled,  vote  reconsidered,  restored  to third reading,
  amended and ordered reprinted, retaining its place  in  the  order  of
  third reading

AN  ACT  to  amend  the insurance law, in relation to a health insurance
  demonstration program for early retirees; and providing for the repeal
  of such provisions upon 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 section 1123-a
to read as follows:
  S  1123-A.   HEALTH INSURANCE DEMONSTRATION PROGRAM FOR FORMER EMPLOY-
EES.  (A) PURPOSE OF THE DEMONSTRATION PROGRAM. THE  LEGISLATURE  RECOG-
NIZES THAT FORMER EMPLOYEES WHO HAVE RELIED ON EMPLOYER-SPONSORED HEALTH
INSURANCE  COVERAGE,  AND IN SOME CASES, THE PROMISE OF CONTINUED HEALTH
INSURANCE, HAVE BEEN ADVERSELY AFFECTED BY THE ECONOMY AND THE INABILITY
OF THEIR FORMER EMPLOYERS  TO  CONTINUE  TO  PROVIDE  HEALTH  INSURANCE.
THESE  INDIVIDUALS OFTEN FIND THEMSELVES WITHOUT ACCESS TO OTHER EMPLOY-
ER-SPONSORED COVERAGE AND ARE TOO YOUNG TO ENROLL   IN  MEDICARE.    THE
DIRECT  PAY  MARKET  IS NOT ALWAYS A VIABLE OPTION FOR THESE INDIVIDUALS
BECAUSE OF COST. THE DEMONSTRATION PROGRAM AUTHORIZED BY THIS SECTION IS
INTENDED TO PROVIDE A MECHANISM TO ALLOW THESE  INDIVIDUALS  TO  PARTIC-
IPATE  IN  THEIR  OWN  GROUP  HEALTH  INSURANCE PROGRAMS THAT MEET THEIR
SPECIAL NEEDS, WHILE ENSURING COMPLIANCE WITH THIS CHAPTER AND ANY REGU-
LATIONS PROMULGATED THEREUNDER, INCLUDING BENEFIT MANDATES.  THE  DEMON-
STRATION  PROGRAM  WILL ENABLE THE LEGISLATURE AND THE SUPERINTENDENT TO
ASSESS WHETHER TO PERMIT AN ASSOCIATION OF FORMER EMPLOYEES TO  CONTINUE
TO  HAVE  HEALTH  INSURANCE  COVERAGE  UNDER  SIMILAR TERMS AS THEY HAVE
ENJOYED WHILE EMPLOYED UNTIL THEY ARE ELIGIBLE FOR COVERAGE UNDER  TITLE
XVIII  OF  THE  SOCIAL SECURITY ACT (MEDICARE) OR UNTIL OTHER COMPARABLE
GROUP HEALTH INSURANCE COVERAGE BECOMES AVAILABLE.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15057-03-2

S. 6740--A                          2

  (B) DEFINITIONS. IN THIS SECTION:
  (1)  "ELIGIBLE  ASSOCIATION"  MEANS AN ENTITY THAT: (A) IS EXEMPT FROM
FEDERAL TAXATION UNDER SECTION  501(C)(3)  OR  (C)(4)  OF  THE  INTERNAL
REVENUE CODE; (B) WAS INCORPORATED ON OR BEFORE JANUARY FIRST, TWO THOU-
SAND  TEN; (C) MEETS THE CRITERIA SET FORTH IN SUBPARAGRAPH (K) OF PARA-
GRAPH ONE OF SUBSECTION (C) OF SECTION FOUR THOUSAND TWO  HUNDRED  THIR-
TY-FIVE OF THIS CHAPTER; AND (D) HAS BEEN ESTABLISHED FOR THE BENEFIT OF
FORMER EMPLOYEES OF A COMPANY IN THIS STATE.
  (2)  "ELIGIBLE  INSURER"  MEANS  ANY  HEALTH MAINTENANCE ORGANIZATION,
ACCIDENT AND HEALTH INSURANCE COMPANY,  OR  HEALTH  SERVICE  CORPORATION
AUTHORIZED TO ISSUE GROUP HEALTH INSURANCE IN THE STATE.
  (3)  "FORMER  EMPLOYEE"  MEANS  AN  INDIVIDUAL:  (A)  WHO WAS FORMERLY
EMPLOYED BY A COMPANY HEADQUARTERED IN THIS STATE AND WHICH HAS BEEN  IN
OPERATION  FOR  OVER  ONE HUNDRED YEARS; (B) WHO HAS HERETOFORE RECEIVED
HEALTH INSURANCE COVERAGE THROUGH THE FORMER EMPLOYER, (C) WHOSE  FORMER
EMPLOYER  FILED  FOR  CHAPTER  ELEVEN BANKRUPTCY IN JANUARY TWO THOUSAND
TWELVE, AND (D) WHO IS NOT ELIGIBLE FOR MEDICARE  OR  FOR  GROUP  HEALTH
INSURANCE COVERAGE THROUGH ANOTHER EMPLOYER.
  (4)  "GROUP  HEALTH  INSURANCE"  MEANS  INSURANCE  PROVIDING HOSPITAL,
SURGICAL OR MEDICAL EXPENSE  COVERAGE  OR  OTHER  SIMILAR  COMPREHENSIVE
HEALTH INSURANCE COVERAGE.
  (C)  DEMONSTRATION PROGRAM FOR FORMER EMPLOYEES.  (1) BOTH THE INSURER
AND THE GROUP HEALTH INSURANCE POLICIES ISSUED TO THE  ELIGIBLE  ASSOCI-
ATION  SHALL  BE SUBJECT TO THE PROVISIONS OF THIS CHAPTER AND ANY REGU-
LATIONS PROMULGATED THEREUNDER, EXCEPT  THAT  THE  ELIGIBLE  ASSOCIATION
SHALL NOT BE CONSIDERED A SMALL GROUP UNDER THIS CHAPTER.
  (2)  SUBJECT TO PARAGRAPH THREE OF THIS SUBSECTION, THE SUPERINTENDENT
MAY ISSUE AN APPROVAL TO AN ELIGIBLE INSURER IF: (A) THE ELIGIBLE INSUR-
ER DEMONSTRATES THAT IT SATISFIES ALL FINANCIAL, OPERATIONAL  AND  OTHER
REQUIREMENTS  OF  THIS  CHAPTER  AND REGULATIONS PROMULGATED THEREUNDER,
OTHER THAN ANY REQUIREMENTS EXPRESSLY WAIVED BY THIS SECTION, AND  SHALL
OPERATE THE DEMONSTRATION PROGRAM IN ACCORDANCE WITH THE REQUIREMENTS OF
THIS  SECTION;  AND  (B)  THE  SUPERINTENDENT DETERMINES THAT THE DEMON-
STRATION PROGRAM FURTHERS THE PUBLIC POLICY GOALS OF THIS SECTION.
  (3) ANY ELIGIBLE INSURER SEEKING THE SUPERINTENDENT'S  APPROVAL  UNDER
PARAGRAPH  TWO  OF THIS SUBSECTION SHALL SUBMIT A WRITTEN REQUEST TO THE
SUPERINTENDENT WITHIN THIRTY DAYS OF THE EFFECTIVE DATE OF THIS SECTION.
THE ELIGIBLE INSURER'S  APPLICATION  SHALL:  SPECIFY  THE  IDENTITY  AND
COMPOSITION  OF  THE  ELIGIBLE  ASSOCIATION,  THE ELIGIBLE ASSOCIATION'S
MEMBERSHIP RULES, AND THE TERMS UNDER WHICH THE ELIGIBLE  INSURER  SHALL
PROVIDE  GROUP HEALTH INSURANCE TO THE ELIGIBLE ASSOCIATION; DEMONSTRATE
THAT THE ELIGIBLE INSURER AND THE ELIGIBLE ASSOCIATION THE  REQUIREMENTS
SET FORTH IN THIS SECTION; AND IDENTIFY THE GROUP HEALTH INSURANCE POLI-
CY  FORMS  THAT  THE ELIGIBLE INSURER WILL ISSUE TO THE ELIGIBLE ASSOCI-
ATION. THE SUPERINTENDENT SHALL MAKE  A  DETERMINATION  ON  ANY  REQUEST
WITHIN  NINETY  DAYS OF RECEIPT OF ALL NECESSARY INFORMATION. THE SUPER-
INTENDENT SHALL ISSUE AN APPROVAL TO ONLY ONE ELIGIBLE INSURER.
  (4) THE SUPERINTENDENT MAY REVOKE AN APPROVAL ISSUED  UNDER  PARAGRAPH
TWO  OF  THIS  SUBSECTION IF: THE INSURER THAT RECEIVED SUCH APPROVAL NO
LONGER QUALIFIES AS AN ELIGIBLE INSURER OR IS OTHERWISE OPERATING  IN  A
MANNER  INCONSISTENT  WITH THE PROVISIONS OF THIS CHAPTER OR REGULATIONS
PROMULGATED THEREUNDER; OR THE ASSOCIATION TO WHICH THE ELIGIBLE INSURER
ISSUED THE GROUP HEALTH INSURANCE  POLICY  NO  LONGER  QUALIFIES  AS  AN
ELIGIBLE  ASSOCIATION.  AN ELIGIBLE INSURER THAT RECEIVES APPROVAL UNDER
PARAGRAPH TWO OF THIS SUBSECTION SHALL SUBMIT PERIODIC  REPORTS  TO  THE
SUPERINTENDENT  SUFFICIENT  TO ENABLE THE SUPERINTENDENT TO EVALUATE THE

S. 6740--A                          3

EFFECTIVENESS OF THE DEMONSTRATION PROGRAM. SUCH REPORTS SHALL INCLUDE A
COMPARISON OF THE COST OF HEALTH INSURANCE OBTAINED UNDER THE PROGRAM TO
OTHER AVAILABLE INSURANCE  OPTIONS,  INCLUDING  GROUP  HEALTH  INSURANCE
POLICIES DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE, DEMOGRAPHIC AND
GEOGRAPHIC ANALYSIS OF THE ENROLLED POPULATION AND ANY OTHER INFORMATION
REQUIRED BY THE SUPERINTENDENT.
  S  2. This act shall take effect immediately and shall expire December
31, 2013 when upon such date the provisions of this act shall be  deemed
repealed.

Co-Sponsors

S6740B (ACTIVE) - Bill Details

See Assembly Version of this Bill:
A9675B
Law Section:
Insurance Law
Laws Affected:
Add §1123-a, Ins L

S6740B (ACTIVE) - Bill Texts

view summary

Relates to a health insurance demonstration program for early retirees.

view sponsor memo
BILL NUMBER:S6740B

TITLE OF BILL:
An act to amend the insurance law, in relation to a health insurance
demonstration program for early retirees; and providing for the repeal
of such provisions upon expiration thereof

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of the bill is to authorize the Superintendent of Financial
Services to approve a demonstration program to provide group health
insurance coverage for former employees of a major New York-based
employer.

SUMMARY OF SPECIFIC PROVISIONS:
This bill authorizes a demonstration which would allow the Superinten-
dent of Financial Services to approve an eligible insurance company to
provide health insurance to former employees of a major New York-based
employer. The eligible insurance company would submit periodic reports
to the Superintendent to enable the Superintendent to evaluate the
effectiveness of the demonstration program.

JUSTIFICATION:
Today, an increasing number of New Yorkers are losing employer-based
health insurance coverage due to the economy. Some of these individuals
were promised continued coverage by their employer after retirement.
These former employees lack access to employment-sponsored health insur-
ance coverage and often cannot afford to purchase coverage in the
private pay market.

This demonstration program seeks to create a new model of health insur-
ance that would meet the special needs of this population, at a reason-
able price, while still meeting the solvency requirements, benefit
mandates, and other obligations required by state statute and regu-
lation. Providing this program on a "pilot" basis affords the Department
of Financial Services the ability to assess the policy ramifications of
this change and the impact on other groups and the community.

LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
Immediately, but shall expire and be deemed repealed on December 31,
2013.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 6740--B
    Cal. No. 568

                            I N  S E N A T E

                             March 15, 2012
                               ___________

Introduced by Sens. ROBACH, RANZENHOFER -- read twice and ordered print-
  ed,  and when printed to be committed to the Committee on Insurance --
  reported favorably from said committee, ordered to  first  and  second
  report,  ordered to a third reading, passed by Senate and delivered to
  the Assembly, recalled, vote reconsidered, restored to third  reading,
  amended  and  ordered  reprinted,  retaining its place in the order of
  third reading -- again amended and ordered  reprinted,  retaining  its
  place in the order of third reading

AN  ACT  to  amend  the insurance law, in relation to a health insurance
  demonstration program for early retirees; and providing for the repeal
  of such provisions upon 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 section 1123-a
to read as follows:
  S  1123-A.   HEALTH INSURANCE DEMONSTRATION PROGRAM FOR FORMER EMPLOY-
EES.  (A) DEFINITIONS. IN THIS SECTION:
  (1) "ELIGIBLE ASSOCIATION" MEANS AN ENTITY THAT: (A)  IS  EXEMPT  FROM
FEDERAL  TAXATION  UNDER  SECTION  501(C)(3)  OR  (C)(4) OF THE INTERNAL
REVENUE CODE; (B) WAS INCORPORATED ON OR BEFORE JANUARY FIRST, TWO THOU-
SAND TEN; (C) MEETS THE CRITERIA SET FORTH IN SUBPARAGRAPH (K) OF  PARA-
GRAPH  ONE  OF SUBSECTION (C) OF SECTION FOUR THOUSAND TWO HUNDRED THIR-
TY-FIVE OF THIS CHAPTER; AND (D) HAS BEEN ESTABLISHED FOR THE BENEFIT OF
FORMER EMPLOYEES OF A COMPANY IN THIS STATE.
  (2) "ELIGIBLE INSURER"  MEANS  ANY  HEALTH  MAINTENANCE  ORGANIZATION,
CERTIFIED  PURSUANT  TO  ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, AN
INSURER LICENSED TO WRITE ACCIDENT AND HEALTH  INSURANCE,  OR  A  CORPO-
RATION ORGANIZED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER.
  (3)  "FORMER  EMPLOYEE"  MEANS  AN  INDIVIDUAL:  (A)  WHO WAS FORMERLY
EMPLOYED BY A COMPANY HEADQUARTERED IN THIS STATE AND WHICH HAS BEEN  IN
OPERATION  FOR  OVER  ONE HUNDRED YEARS; (B) WHO HAS HERETOFORE RECEIVED
HEALTH INSURANCE COVERAGE THROUGH THE FORMER EMPLOYER, (C) WHOSE  FORMER
EMPLOYER  FILED  FOR  CHAPTER  ELEVEN BANKRUPTCY IN JANUARY TWO THOUSAND

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15057-07-2

S. 6740--B                          2

TWELVE, AND (D) WHO IS NOT ELIGIBLE FOR MEDICARE  OR  FOR  GROUP  HEALTH
INSURANCE COVERAGE THROUGH ANOTHER EMPLOYER.
  (4)  "GROUP  HEALTH  INSURANCE"  MEANS  INSURANCE  PROVIDING HOSPITAL,
SURGICAL OR MEDICAL EXPENSE  COVERAGE  OR  OTHER  SIMILAR  COMPREHENSIVE
HEALTH INSURANCE COVERAGE.
  (B)  DEMONSTRATION PROGRAM FOR FORMER EMPLOYEES.  (1) BOTH THE INSURER
AND THE GROUP HEALTH INSURANCE POLICIES ISSUED TO THE  ELIGIBLE  ASSOCI-
ATION  SHALL  BE SUBJECT TO THE PROVISIONS OF THIS CHAPTER AND ANY REGU-
LATIONS PROMULGATED THEREUNDER, EXCEPT  THAT  THE  ELIGIBLE  ASSOCIATION
SHALL NOT BE CONSIDERED A SMALL GROUP UNDER THIS CHAPTER.
  (2)  SUBJECT TO PARAGRAPH THREE OF THIS SUBSECTION, THE SUPERINTENDENT
MAY ISSUE AN APPROVAL TO AN ELIGIBLE INSURER IF: (A) THE ELIGIBLE INSUR-
ER DEMONSTRATES THAT IT SATISFIES ALL FINANCIAL, OPERATIONAL  AND  OTHER
REQUIREMENTS  OF  THIS  CHAPTER  AND REGULATIONS PROMULGATED THEREUNDER,
OTHER THAN ANY REQUIREMENTS EXPRESSLY WAIVED BY THIS SECTION, AND  SHALL
OPERATE THE DEMONSTRATION PROGRAM IN ACCORDANCE WITH THE REQUIREMENTS OF
THIS  SECTION;  AND  (B)  THE  SUPERINTENDENT DETERMINES THAT THE DEMON-
STRATION PROGRAM FURTHERS THE PUBLIC POLICY GOALS OF THIS SECTION.
  (3) ANY ELIGIBLE INSURER SEEKING THE SUPERINTENDENT'S  APPROVAL  UNDER
PARAGRAPH  TWO  OF THIS SUBSECTION SHALL SUBMIT A WRITTEN REQUEST TO THE
SUPERINTENDENT WITHIN THIRTY DAYS OF THE EFFECTIVE DATE OF THIS SECTION.
THE ELIGIBLE INSURER'S  APPLICATION  SHALL:  SPECIFY  THE  IDENTITY  AND
COMPOSITION  OF  THE  ELIGIBLE  ASSOCIATION,  THE ELIGIBLE ASSOCIATION'S
MEMBERSHIP RULES, AND THE TERMS UNDER WHICH THE ELIGIBLE  INSURER  SHALL
PROVIDE  GROUP HEALTH INSURANCE TO THE ELIGIBLE ASSOCIATION; DEMONSTRATE
THAT THE ELIGIBLE INSURER AND THE ELIGIBLE ASSOCIATION MEET THE REQUIRE-
MENTS SET FORTH IN THIS SECTION; AND IDENTIFY THE GROUP HEALTH INSURANCE
POLICY FORMS THAT THE ELIGIBLE INSURER WILL ISSUE TO THE ELIGIBLE  ASSO-
CIATION.  THE  SUPERINTENDENT  SHALL MAKE A DETERMINATION ON ANY REQUEST
WITHIN NINETY DAYS OF RECEIPT OF ALL NECESSARY INFORMATION.  THE  SUPER-
INTENDENT SHALL ISSUE AN APPROVAL TO ONLY ONE ELIGIBLE INSURER.
  (4)  THE  SUPERINTENDENT MAY REVOKE AN APPROVAL ISSUED UNDER PARAGRAPH
TWO OF THIS SUBSECTION IF: THE INSURER THAT RECEIVED  SUCH  APPROVAL  NO
LONGER  QUALIFIES  AS AN ELIGIBLE INSURER OR IS OTHERWISE OPERATING IN A
MANNER INCONSISTENT WITH THE PROVISIONS OF THIS CHAPTER  OR  REGULATIONS
PROMULGATED THEREUNDER; OR THE ASSOCIATION TO WHICH THE ELIGIBLE INSURER
ISSUED  THE  GROUP  HEALTH  INSURANCE  POLICY  NO LONGER QUALIFIES AS AN
ELIGIBLE ASSOCIATION. AN ELIGIBLE INSURER THAT RECEIVES  APPROVAL  UNDER
PARAGRAPH  TWO  OF  THIS SUBSECTION SHALL SUBMIT PERIODIC REPORTS TO THE
SUPERINTENDENT SUFFICIENT TO ENABLE THE SUPERINTENDENT TO  EVALUATE  THE
EFFECTIVENESS OF THE DEMONSTRATION PROGRAM. SUCH REPORTS SHALL INCLUDE A
COMPARISON OF THE COST OF HEALTH INSURANCE OBTAINED UNDER THE PROGRAM TO
OTHER  AVAILABLE  INSURANCE  OPTIONS,  INCLUDING  GROUP HEALTH INSURANCE
POLICIES DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE, DEMOGRAPHIC AND
GEOGRAPHIC ANALYSIS OF THE ENROLLED POPULATION AND ANY OTHER INFORMATION
REQUIRED BY THE SUPERINTENDENT.
  S 2. This act shall take effect immediately and shall expire  December
31,  2013 when upon such date the provisions of this act shall be deemed
repealed.

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