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
                               ___________

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.