S T A T E   O F   N E W   Y O R K
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                                  2528

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            January 19, 2011
                               ___________

Introduced by M. of A. JEFFRIES -- read once and referred to the Commit-
  tee on Insurance

AN  ACT  to  amend  the insurance law, in relation to the eligibility of
  small employers and individuals for participation in the  program  for
  standardized health insurance contracts

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

  Section 1. Item (ii) of subparagraph (A) of paragraph 1 of  subsection
(c)  of  section 4326 of the insurance law, as amended by chapter 419 of
the laws of 2000, is amended to read as follows:
  (ii) resides in [a household] THE COUNTIES OF BRONX, DUTCHESS,  KINGS,
NASSAU,  NEW  YORK, ORANGE, PUTNAM, QUEENS, RICHMOND, ROCKLAND, SUFFOLK,
OR WESTCHESTER IN A HOUSEHOLD HAVING A  GROSS  HOUSEHOLD  INCOME  AT  OR
BELOW  THREE  HUNDRED  PERCENT OF THE NON-FARM FEDERAL POVERTY LEVEL (AS
DEFINED AND UPDATED BY  THE  FEDERAL  DEPARTMENT  OF  HEALTH  AND  HUMAN
SERVICES),  OR  RESIDES  ELSEWHERE  IN THE STATE IN A HOUSEHOLD having a
[net] GROSS household income at  or  below  two  hundred  [eight]  FIFTY
percent of the non-farm federal poverty level (as defined and updated by
the  federal  department  of  health  and  human services) [or the gross
equivalent of such net income];
  S 2. Subparagraph (B) of paragraph 1 of subsection (c) of section 4326
of the insurance law, as added by chapter 1 of  the  laws  of  1999,  is
amended to read as follows:
  (B) An employer [with]:
  (i) WITH not more than fifty eligible employees;
  (ii)  WITH  no  group  health  insurance which provides benefits on an
expense reimbursed or prepaid basis covering employees in effect  during
the  twelve  month  period  prior  to application for a qualifying group
health insurance contract under the program established by this section;
and

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05032-01-1

              

A. 2528                             2

  (iii) FOR AN EMPLOYER LOCATED IN  THE  COUNTIES  OF  BRONX,  DUTCHESS,
KINGS,  NASSAU,  NEW  YORK,  ORANGE, PUTNAM, QUEENS, RICHMOND, ROCKLAND,
SUFFOLK, OR WESTCHESTER, at least thirty percent of its eligible employ-
ees receiving annual wages from the employer at a level equal to or less
than  [thirty]  FORTY-TWO  thousand  dollars, OR FOR AN EMPLOYER LOCATED
ELSEWHERE IN THE STATE, AT LEAST THIRTY PERCENT  OF  ELIGIBLE  EMPLOYEES
RECEIVING  ANNUAL  WAGES  FROM  THE EMPLOYER AT A LEVEL EQUAL TO OR LESS
THAN THIRTY-FIVE THOUSAND DOLLARS. The [thirty thousand]  dollar  figure
UTILIZED  IN  THIS  CLAUSE  shall  be  adjusted periodically pursuant to
subparagraph (F) of this paragraph.
  S 3. Subparagraph (F) of paragraph l of subsection (c) of section 4326
of the insurance law, as added by chapter 1 of  the  laws  of  1999,  is
amended to read as follows:
  (F)  The  wage  levels  utilized in subparagraph (B) of this paragraph
shall be adjusted annually, beginning in two thousand [two] TWELVE.  The
adjustment shall take effect on July first of each year. For July first,
two thousand [two] TWELVE, the adjustment shall be a percentage  of  the
annual wage [figure] FIGURES specified in subparagraph (B) of this para-
graph. For subsequent years, the adjustment shall be a percentage of the
annual  wage  [figure]  FIGURES  which  took effect on July first of the
prior year. The percentage adjustment shall be the  same  percentage  by
which  the current year's non-farm federal poverty level, as defined and
updated by the federal department of health and human  services,  for  a
family  unit  of  four persons for the forty-eight contiguous states and
Washington, D.C., changed from the same level established for the  prior
year.
  S  4.  Item (iii) of subparagraph (A) of paragraph 3 of subsection (c)
of section 4326 of the insurance law, as added by chapter 1 of the  laws
of 1999, is amended to read as follows:
  (iii) resides in [a household] THE COUNTIES OF BRONX, DUTCHESS, KINGS,
NASSAU,  NEW  YORK, ORANGE, PUTNAM, QUEENS, RICHMOND, ROCKLAND, SUFFOLK,
OR WESTCHESTER IN A HOUSEHOLD HAVING A  GROSS  HOUSEHOLD  INCOME  AT  OR
BELOW  THREE  HUNDRED  PERCENT OF THE NON-FARM FEDERAL POVERTY LEVEL (AS
DEFINED AND UPDATED BY  THE  FEDERAL  DEPARTMENT  OF  HEALTH  AND  HUMAN
SERVICES),  OR  RESIDES  ELSEWHERE  IN THE STATE IN A HOUSEHOLD having a
[net] GROSS household income at  or  below  two  hundred  [eight]  FIFTY
percent of the non-farm federal poverty level (as defined and updated by
the  federal  department  of  health  and  human services) [or the gross
equivalent of such net income]; and
  S 5. This act shall take effect on the ninetieth day  after  it  shall
have become a law.