Assembly Bill A7291

2013-2014 Legislative Session

Requires insurance companies to disclose claims information to municipalities employing 400 or more employees

download bill text pdf

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Archive: Last Bill Status - In Assembly Committee


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

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2013-A7291 (ACTIVE) - Details

See Senate Version of this Bill:
S2056
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Add §3217-g, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A9130, S7560
2011-2012: A101, S1120
2015-2016: A2066, S1185
2017-2018: A1536, S1960
2019-2020: A2826

2013-A7291 (ACTIVE) - Summary

Requires insurance companies to disclose claims information to municipalities employing 400 or more employees to determine how their benefits are used; provides for imposition of a fine for failure to disclose such information in a timely manner.

2013-A7291 (ACTIVE) - Bill Text download pdf

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

                                  7291

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                              May 10, 2013
                               ___________

Introduced  by  M.  of  A.  ZEBROWSKI  --  read once and referred to the
  Committee on Insurance

AN ACT to amend the insurance law, in relation  to  requiring  insurance
  companies to disclose claims information to municipalities

  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 3217-g
to read as follows:
  S 3217-G. DISCLOSURE  OF  INFORMATION  TO  MUNICIPALITIES.  (A)  EVERY
INSURER  CONTRACTING  WITH MUNICIPALITIES EMPLOYING FOUR HUNDRED OR MORE
EMPLOYEES, INCLUDING MUNICIPAL COOPERATIVE HEALTH BENEFIT  PLANS  CERTI-
FIED PURSUANT TO ARTICLE FORTY-SEVEN OF THIS CHAPTER, SHALL PROVIDE UPON
REQUEST THE FOLLOWING INFORMATION TO THE INSURED MUNICIPALITY:
  (1) SPECIFIC CLAIMS EXPERIENCE COVERED BY THE INSURER UNDER A COMMUNI-
TY  RATED  OR  EXPERIENCED  RATED POLICY.   FOR PURPOSES OF THIS SECTION
"EXPERIENCE RATINGS" SHALL MEAN AND INCLUDE  ALL  QUANTITATIVE  MEASURES
USED  BY  THE  INSURANCE  CARRIER  SUCH  AS  EXPENSES PER MEMBER AND ANY
HISTORICAL DATA;
  (2) AVERAGE ANNUAL PER MEMBER COST OF CLAIMS REIMBURSEMENT;
  (3) NUMBER OF MEMBERS WHO DID NOT FILE A CLAIM WITHIN A  TWELVE  MONTH
PERIOD;
  (4)  A COMPARISON OF EMERGENCY SERVICES USED BY MEMBERS TO OUT-PATIENT
SERVICES;
  (5) A LOSS RATIO REPORT;
  (6) CLAIMS HISTORY FOR THE LAST TWELVE  MONTHS  FOR  EXPERIENCE  RATED
PLANS SEPARATED BY MEDICAL AND PRESCRIPTION;
  (7)  INFORMATION  REGARDING  COST  ON THE TOP TWENTY-FIVE PRESCRIPTION
DRUGS BEING USED BY MEMBER EMPLOYEES;
  (8) LARGE LOSS CLAIMS REPORT INDICATING DIAGNOSIS  AND  PROGNOSIS  FOR
CLAIMS GREATER THAN THIRTY THOUSAND DOLLARS;
  (9) MEDICAL LOSS RATIO REPORT; AND

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05135-01-3
              

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