senate Bill S2894A

Signed By Governor
2013-2014 Legislative Session

Allows licensed insurance brokers and agents to develop, implement and administer wellness programs

download bill text pdf

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

do you support this bill?

Actions

view actions (24)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Nov 13, 2013 signed chap.496
Nov 01, 2013 delivered to governor
Jun 21, 2013 returned to senate
passed assembly
ordered to third reading cal.507
substituted for a7382a
Jun 20, 2013 referred to insurance
returned to assembly
repassed senate
Jun 17, 2013 amended on third reading 2894a
vote reconsidered - restored to third reading
Jun 14, 2013 returned to senate
recalled from assembly
Jun 13, 2013 recommitted to insurance
substitution reconsidered
Jun 10, 2013 ordered to third reading cal.507
substituted for a7382
Apr 29, 2013 referred to insurance
delivered to assembly
passed senate
Apr 24, 2013 advanced to third reading
Apr 23, 2013 2nd report cal.
Apr 22, 2013 1st report cal.355
Jan 24, 2013 referred to insurance

Votes

view votes

Apr 22, 2013 - Insurance committee Vote

S2894
19
0
committee
19
Aye
0
Nay
0
Aye with Reservations
0
Absent
0
Excused
0
Abstained
show committee vote details

Bill Amendments

Original
A (Active)
Original
A (Active)

Co-Sponsors

S2894 - Bill Details

See Assembly Version of this Bill:
A7382A
Law Section:
Insurance Law
Laws Affected:
Amd §4224, Ins L
Versions Introduced in 2011-2012 Legislative Session:
S4950, A9932

S2894 - Bill Texts

view summary

Allows licensed insurance brokers and agents to develop, implement and administer wellness programs.

view sponsor memo
BILL NUMBER:S2894

TITLE OF BILL: An act to amend the insurance law, in relation to
exceptions to the general prohibition on rebating

PURPOSE: To modernize the insurance law to allow licensed brokers,
agents and benefit consultants to assist insurers and employers in the
interpretation, management and communication of the insurance policy or
annuity contract and its resulting costs, and to assist insurers and
employers in the development and implementation of wellness programs,
disease management and care coordination services and other incidental
or ancillary programs and services.

SUMMARY OF PROVISIONS:

Section 1 of the bill would add a new subsection (c) to § 3239 of the
insurance law, to enumerate certain exceptions to the anti-rebating and
inducement laws for services that insurance producers may provide within
the scope of their licensure and as part of commissions paid or fees
earned, to insurance carriers and policyholders, such as the development
and implementation of wellness programs, disease management and care
coordination services and other programs designed to improve quality of
care and health outcomes of insured employees, subscribers or enrollees.

Section 2 of the bill would add a new subsection (f) to § 4224 of the
insurance law, to allow insurance producers, within the scope of their
licensure and as part of commissions paid or fees earned, to provide
certain services to assist insurers and policyholders in the interpreta-
tion, management and communication of insurance policies or annuity
contracts and their costs, as well as the development and implementation
of wellness programs, disease management and care coordination services,
administration of COBRA and New York State continuation of coverage
benefits, administration of flexible spending accounts (FSAs) and health
reimbursement or savings accounts (HSAs), clinical health advocacy
services, including employee, subscriber or enrollee communications,
hotlines, "help desks," and web site development, preparation of annual
benefit statements, maintenance of membership records, premium reconcil-
iation and billing services, including retiree billing, compliance
support, including completion of ERISA form 5500, and financial model-
ing.

Section 3 of the bill would provide for an immediate effective date.

JUSTIFICATION: The fast-paced and competitive insurance marketplace
continues to evolve, and insurance producers must change with it. Inte-
gral to this is the modernization of certain statutory restrictions that
are old and outmoded. Chief amongst these are the anti-rebating and
inducement laws that were originally designed to protect insurance
producers and consumers alike from offering and accepting illegal
inducements for the sale of insurance products. In today's sophisticated
health insurance market, licensed insurance brokers, agents and benefits

consultants must be able to offer a full value-added services platform,
such as providing benefits concierge, employee communications, benefits
web sites and help desks, benefits statements, compliance support, in
order to attract business and close the sale. Employer groups of all
sizes are increasingly looking not only for traditional advice in
selecting health plan benefits design and coverage options, underwriting
to reduce claims losses, and claims servicing and policyholder advocacy,
but are also demanding back-office human resources support.

The statutory exceptions and allowanced prescribed in this bill would
modernize the insurance law with respect to health insurance, and allow
insurance producers to keep abreast of the market by lawfully providing
such services within the scope of their licensure and practice and as
part of commissions paid or fees earned.

Moreover, this bill would codify many of the incidental services
excepted from the insurance anti-rebating and inducement laws listed in
NYS Insurance Department Circular Letter No. 9 (2009) -
http://www.ins.state.ny.us/circltr/2009/c109 09.htm

LEGISLATIVE HISTORY: S.4950 of 2011-12

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This act shall take effect immediately.

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

                                  2894

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 24, 2013
                               ___________

Introduced  by  Sen.  SEWARD -- 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  exceptions  to  the
  general prohibition on rebating

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

  Section 1. Section 3239 of the insurance law is amended  by  adding  a
new subsection (d) to read as follows:
  (D)  AN  INSURANCE  AGENT,  INSURANCE  BROKER  OR INSURANCE CONSULTANT
LICENSED UNDER ARTICLE TWENTY-ONE OF THIS CHAPTER, WHILE  ACTING  WITHIN
THE  SCOPE  OF  SUCH  LICENSURE AND AS PART OF COMMISSIONS PAID OR UNDER
SEPARATE FEE AGREEMENTS, SHALL BE  AUTHORIZED  TO  ASSIST  INSURERS  AND
EMPLOYERS  IN  THE  DEVELOPMENT AND IMPLEMENTATION OF WELLNESS PROGRAMS,
DISEASE MANAGEMENT  AND  CARE  COORDINATION  SERVICES,  AND  OTHER  SUCH
PROGRAMS  AND  SERVICES  DESIGNED  TO IMPROVE QUALITY OF CARE AND HEALTH
OUTCOMES OF INSURED EMPLOYEES, SUBSCRIBERS OR ENROLLEES, BASED ON  ACTU-
ARIAL  DEMONSTRATIONS  THAT SUCH PROGRAMS AND SERVICES CAN BE REASONABLY
EXPECTED TO RESULT IN THE OVERALL GOOD HEALTH  AND  WELL  BEING  OF  THE
GROUP.
  S  2.  Section  4224  of  the insurance law is amended by adding a new
subsection (f) to read as follows:
  (F) THIS SECTION SHALL NOT  PROHIBIT  AN  INSURANCE  AGENT,  INSURANCE
BROKER OR INSURANCE CONSULTANT LICENSED UNDER ARTICLE TWENTY-ONE OF THIS
CHAPTER,  WHILE ACTING WITHIN THE SCOPE OF SUCH LICENSURE AND AS PART OF
COMMISSIONS PAID OR UNDER SEPARATE FEE AGREEMENTS, FROM ASSISTING INSUR-
ERS AND EMPLOYERS IN THE INTERPRETATION, MANAGEMENT AND COMMUNICATION OF
THE INSURANCE POLICY  OR  ANNUITY  CONTRACT  AND  ITS  RESULTING  COSTS.
PERMISSIBLE  SERVICES  SHALL  INCLUDE,  BUT  NOT BE LIMITED TO: WELLNESS
PROGRAMS, DISEASE MANAGEMENT AND CARE  COORDINATION  SERVICES,  ADMINIS-
TRATION  OF  COBRA AND NEW YORK STATE CONTINUATION OF COVERAGE, ADMINIS-
TRATION OF FLEXIBLE SPENDING ACCOUNTS (FSAS)  AND  HEALTH  REIMBURSEMENT

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06650-01-3

S. 2894                             2

ACCOUNTS  (HSAS), CLINICAL HEALTH ADVOCACY SERVICES, INCLUDING EMPLOYEE,
SUBSCRIBER OR ENROLLEE COMMUNICATIONS, HOTLINES, "HELP DESKS,"  AND  WEB
SITE  DEVELOPMENT, PREPARATION OF ANNUAL BENEFIT STATEMENTS, MAINTENANCE
OF  MEMBERSHIP  RECORDS,  PREMIUM  RECONCILIATION  AND BILLING SERVICES,
INCLUDING RETIREE BILLING, COMPLIANCE SUPPORT, INCLUDING  COMPLETION  OF
ERISA FORM 5500, AND FINANCIAL MODELING.
  S 3. This act shall take effect immediately.

Co-Sponsors

S2894A (ACTIVE) - Bill Details

See Assembly Version of this Bill:
A7382A
Law Section:
Insurance Law
Laws Affected:
Amd §4224, Ins L
Versions Introduced in 2011-2012 Legislative Session:
S4950, A9932

S2894A (ACTIVE) - Bill Texts

view summary

Allows licensed insurance brokers and agents to develop, implement and administer wellness programs.

view sponsor memo
BILL NUMBER:S2894A

TITLE OF BILL: An act to amend the insurance law, in relation to
exceptions to the general prohibition on rebating

PURPOSE: To modernize the insurance law to allow licensed brokers and
agents to develop, implement, and administer wellness programs.

SUMMARY OF PROVISIONS: This bill would allow insurance agents and
brokers to, without charging a service fee or charging a reduced fee,
develop, implement, and administer wellness programs, if such programs
and services are provided in a fair and nondiscriminatory manner and
are incidental to a policy sold by the agent or broker.

JUSTIFICATION: The fast-paced and competitive insurance marketplace
continues to evolve, and insurance producers must change with it.
Integral to this is the modernization of certain statutory
restrictions that are old and outmoded. Chief amongst these are the
anti-rebating and inducement laws that were originally designed to
protect insurance producers and consumers alike from offering and
accepting illegal inducements for the sale of insurance products. In
today's health insurance market, licensed insurance brokers and agents
must be able to offer wellness programs in order to attract business
and close the sale.

With the recent issuance of federal rules giving employers greater
leeway in how they manage programs that promote healthy behavior and
reduce illness amongst employees, employer groups of all sizes are
increasingly looking not only for traditional advice in selecting
health plan benefits design and coverage options, underwriting to
reduce claims losses, and claims servicing and policyholder advocacy,
but are looking for programs and services that would improve the
health of their employees.

LEGISLATIVE HISTORY: S 4950 of 2011-12

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This act shall take effect immediately.

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

                                 2894--A
    Cal. No. 355

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 24, 2013
                               ___________

Introduced  by  Sens.  SEWARD,  LANZA, LATIMER -- read twice and ordered
  printed, and when printed to be committed to the Committee  on  Insur-
  ance  --  reported favorably from said committee, ordered to first and
  second report, ordered to a third reading, passed by Senate and deliv-
  ered 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  exceptions  to  the
  general prohibition on rebating

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

  Section 1. Subsection (c) of section 4224 of  the  insurance  law,  as
amended  by  chapter  291  of  the  laws  of 2012, is amended to read as
follows:
  (c) Except as permitted by section three thousand two hundred  thirty-
nine  of  this  chapter  OR SUBSECTION (F) OF THIS SECTION, no such life
insurance company and no such savings and insurance bank and no officer,
agent, solicitor or representative thereof and no such insurer doing  in
this state the business of accident and health insurance and no officer,
agent,  solicitor  or  representative thereof, and no licensed insurance
broker and no employee or other  representative  of  any  such  insurer,
agent  or  broker,  shall  pay, allow or give, or offer to pay, allow or
give, directly or indirectly, as an inducement to any person to  insure,
or  shall give, sell or purchase, or offer to give, sell or purchase, as
such inducement, or interdependent with any policy of life insurance  or
annuity contract or policy of accident and health insurance, any stocks,
bonds,  or  other securities, or any dividends or profits accruing or to
accrue thereon, or any valuable consideration or inducement whatever not
specified in such policy or contract other than any  valuable  consider-
ation,   including   but   not  limited  to  merchandise  or  periodical
subscriptions, not exceeding twenty-five dollars in value; nor shall any

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06650-03-3

S. 2894--A                          2

person in this state knowingly receive as such inducement, any rebate of
premium or policy fee or any special favor or advantage in the dividends
or other benefits to accrue on any such policy or contract, or knowingly
receive any paid employment or contract for services of any kind, or any
valuable  consideration or inducement whatever which is not specified in
such policy or contract.
  S 2. Section 4224 of the insurance law is  amended  by  adding  a  new
subsection (f) to read as follows:
  (F)  (1)  THIS  SUBSECTION SHALL APPLY ONLY WITH RESPECT TO A GROUP OR
BLANKET ACCIDENT AND  HEALTH  INSURANCE  POLICY  ISSUED  BY  AN  INSURER
LICENSED TO WRITE ACCIDENT AND HEALTH INSURANCE IN THIS STATE OR A GROUP
CONTRACT   ISSUED   BY  A  CORPORATION  ORGANIZED  PURSUANT  TO  ARTICLE
FORTY-THREE OF THIS CHAPTER, OR A HEALTH MAINTENANCE ORGANIZATION CERTI-
FIED PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW.
  (2) NOTWITHSTANDING SUBSECTION (C) OF THIS SECTION, A  LICENSED  AGENT
OR  INSURANCE  BROKER  MAY  DEVELOP,  IMPLEMENT, AND ADMINISTER WELLNESS
PROGRAMS ESTABLISHED IN  ACCORDANCE  WITH  SECTION  THREE  THOUSAND  TWO
HUNDRED  THIRTY-NINE  OF THIS CHAPTER WITHOUT CHARGING A SERVICE FEE OR,
IN THE CASE OF A LICENSED INSURANCE BROKER, FOR A  REDUCED  SERVICE  FEE
PURSUANT  TO A WRITTEN MEMORANDUM MADE IN ACCORDANCE WITH SUBSECTION (C)
OF SECTION TWO THOUSAND ONE HUNDRED NINETEEN OF THIS  CHAPTER,  IF  SUCH
PROGRAMS  ARE  PROVIDED IN A FAIR AND NONDISCRIMINATORY MANNER AND INCI-
DENTAL TO A GROUP OR BLANKET POLICY OR CONTRACT SOLD  BY  THE  INSURANCE
AGENT OR INSURANCE BROKER.
  S 3. This act shall take effect immediately.

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.