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

                                   569

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 5, 2011
                               ___________

Introduced  by  M.  of  A.  SAYWARD,  REILICH, TEDISCO, BUTLER, BARCLAY,
  AMEDORE -- Multi-Sponsored by -- M. of  A.  BOYLE,  BURLING,  CALHOUN,
  CONTE,  CROUCH,  DUPREY,  FINCH,  FITZPATRICK,  GIGLIO, HAWLEY, HAYES,
  KOLB,  P. LOPEZ,  McDONOUGH,  McKEVITT,  J. MILLER,  MOLINARO,   OAKS,
  RABBITT,  RAIA, SALADINO, THIELE, TOBACCO -- read once and referred to
  the Committee on Insurance

AN ACT to amend the insurance law, in relation  to  standardized  health
  insurance contracts for qualifying small employers and individuals

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

  Section 1. Items (i) and (iii) of subparagraph (A) of paragraph  1  of
subsection (c) of section 4326 of the insurance law, item (i) as amended
and  item (iii) as added by chapter 419 of the laws of 2000, are amended
to read as follows:
  (i) without health insurance which provides  benefits  on  an  expense
reimbursed  or  prepaid  basis  in  effect during the [twelve] SIX month
period prior to application for  a  qualifying  group  health  insurance
contract under the program established by this section; and
  (iii)  except  that  the  requirements  set  forth in item (i) of this
subparagraph shall not be applicable where an individual proprietor  had
health  insurance  coverage  during the previous [twelve] SIX months and
such coverage terminated due to one of the reasons set  forth  in  items
(i)  through  (viii)  of  subparagraph  (C)  of  paragraph three of THIS
subsection [(c) of this section]; or
  S 2. Item (ii) of 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:
  (ii)  no  group health insurance which provides benefits on an expense
reimbursed or prepaid basis covering  employees  in  effect  during  the
[twelve]  SIX  month  period prior to application for a qualifying group

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

                                                           LBD01326-01-1

A. 569                              2

health insurance contract under the program established by this section;
and
  S 3. Subparagraph (D) 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:
  (D) The [twelve] SIX month period set forth in item  (i)  of  subpara-
graph (A) of this paragraph and in item (ii) of subparagraph (B) of this
paragraph may be adjusted by the superintendent from [twelve] SIX months
to [eighteen] TWELVE months if he determines that the [twelve] SIX month
period  is  insufficient  to prevent inappropriate substitution of other
health  insurance  contracts  for  qualifying  group  health   insurance
contracts.
  S  4.  Items  (i)  and  (ii)  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, are amended to read as follows:
  (i) who does not have and has not had health insurance  with  benefits
on  an expense reimbursed or prepaid basis during the [twelve] SIX month
period prior to the individual's application for health insurance  under
the program established by this section;
  (ii)  whose  employer  does not provide group health insurance and has
not provided group health insurance with benefits on  an  expense  reim-
bursed or prepaid basis covering employees in effect during the [twelve]
SIX month period prior to the individual's application for health insur-
ance under the program established by this section;
  S  5.  The  opening  paragraph  of  subparagraph (C) of paragraph 3 of
subsection (c) of section 4326 of the insurance law, as amended by chap-
ter 419 of the laws of 2000, is amended to read as follows:
  The requirements set forth in items (i) and (ii) of  subparagraph  (A)
of this paragraph shall not be applicable where an individual had health
insurance  coverage  during  the  previous  [twelve] SIX months and such
coverage terminated due to:
  S 6. Subparagraph (D) 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:
  (D)  The  [twelve] SIX month period set forth in items (i) and (ii) of
subparagraph (A) of this paragraph may be adjusted by the superintendent
from [twelve] SIX months to [eighteen] TWELVE months  if  he  determines
that  the  [twelve] SIX month period is insufficient to prevent inappro-
priate substitution of other health insurance contracts  for  qualifying
individual health insurance contracts.
  S  7. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become a law.