S T A T E O F N E W Y O R K
________________________________________________________________________
3394
2017-2018 Regular Sessions
I N A S S E M B L Y
January 27, 2017
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Introduced by M. of A. SIMOTAS -- read once and referred to the Commit-
tee on Insurance
AN ACT to amend the insurance law and the public health law, in relation
to ensuring reproductive health care during auto enrollment
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 3242
to read as follows:
§ 3242. ENSURING REPRODUCTIVE HEALTH CARE DURING AUTO ENROLLMENT. (A)
UPON THE AUTOMATIC ENROLLMENT OF AN INDIVIDUAL BY THE DEPARTMENT INTO A
HEALTH INSURANCE PLAN PROVIDED BY A HEALTH INSURANCE COMPANY THAT
EXCLUDES COVERAGE FOR REPRODUCTIVE HEALTH CARE SERVICES THAT WERE
COVERED BY THE INDIVIDUAL'S PREVIOUS HEALTH INSURANCE PLAN, THE HEALTH
INSURANCE COMPANY WHICH PROVIDES THE PLAN IN WHICH THE INDIVIDUAL WAS
AUTOMATICALLY ENROLLED SHALL NOTIFY THE INDIVIDUAL OF THE DIFFERENCES
BETWEEN EACH OF THE FOLLOWING:
(1) REPRODUCTIVE HEALTH CARE COVERAGE THEY RECEIVED THROUGH THEIR
PREVIOUS PLAN;
(2) REPRODUCTIVE HEALTH CARE COVERAGE THEY WOULD RECEIVE UNDER THE
PLAN IN WHICH THEY WERE AUTOMATICALLY ENROLLED; AND
(3) THE REQUIREMENTS FOR REPRODUCTIVE HEALTH CARE COVERAGE UNDER THE
ESSENTIAL HEALTH BENEFITS PACKAGE.
(B) FOR THE CALENDAR YEAR TWO THOUSAND SEVENTEEN, AN INDIVIDUAL WHO
WAS AUTOMATICALLY ENROLLED IN A HEALTH INSURANCE PLAN PROVIDED BY A
HEALTH INSURANCE COMPANY THAT EXCLUDES COVERAGE FOR REPRODUCTIVE HEALTH
CARE SERVICES THAT WERE COVERED BY THEIR PREVIOUS HEALTH INSURANCE PLAN
SHALL BE NOTIFIED BY THE HEALTH INSURANCE COMPANY WHICH PROVIDES THE
PLAN IN WHICH THE INDIVIDUAL WAS AUTOMATICALLY ENROLLED OF THE DIFFER-
ENCES BETWEEN EACH OF THE FOLLOWING:
(1) REPRODUCTIVE HEALTH CARE COVERAGE THEY RECEIVED THROUGH THEIR
PREVIOUS PLAN;
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04563-01-7
A. 3394 2
(2) REPRODUCTIVE HEALTH CARE COVERAGE THEY WOULD RECEIVE UNDER THE
PLAN IN WHICH THEY WERE AUTOMATICALLY ENROLLED; AND
(3) THE REQUIREMENTS FOR REPRODUCTIVE HEALTH CARE COVERAGE UNDER THE
ESSENTIAL HEALTH BENEFITS PACKAGE.
(C) FOR INDIVIDUALS WHO WERE AUTOMATICALLY ENROLLED IN A HEALTH INSUR-
ANCE PLAN DURING THE CALENDAR YEAR TWO THOUSAND SEVENTEEN PRIOR TO THE
EFFECTIVE DATE OF THIS SECTION, THIS INFORMATION SHALL BE DELIVERED TO
THEM IN WRITING NO LATER THAN THIRTY DAYS AFTER THE EFFECTIVE DATE OF
THIS SECTION; FOR INDIVIDUALS WHO ARE AUTOMATICALLY ENROLLED IN A HEALTH
INSURANCE PLAN AFTER THE EFFECTIVE DATE OF THIS SECTION, THIS INFORMA-
TION SHALL BE DELIVERED TO THEM IN WRITING NO LATER THAN THIRTY DAYS
AFTER AUTOMATIC ENROLLMENT IN THE PLAN.
§ 2. The insurance law is amended by adding a new section 4329 to read
as follows:
§ 4329. ENSURING REPRODUCTIVE HEALTH CARE DURING AUTO ENROLLMENT. (A)
UPON THE AUTOMATIC ENROLLMENT OF AN INDIVIDUAL BY THE DEPARTMENT INTO A
HEALTH INSURANCE PLAN PROVIDED BY A HEALTH INSURANCE COMPANY THAT
EXCLUDES COVERAGE FOR REPRODUCTIVE HEALTH CARE SERVICES THAT WERE
COVERED BY THE INDIVIDUAL'S PREVIOUS HEALTH INSURANCE PLAN, THE HEALTH
INSURANCE COMPANY WHICH PROVIDES THE PLAN IN WHICH THE INDIVIDUAL WAS
AUTOMATICALLY ENROLLED SHALL NOTIFY THE INDIVIDUAL OF THE DIFFERENCES
BETWEEN EACH OF THE FOLLOWING:
(1) REPRODUCTIVE HEALTH CARE COVERAGE THEY RECEIVED THROUGH THEIR
PREVIOUS PLAN;
(2) REPRODUCTIVE HEALTH CARE COVERAGE THEY WOULD RECEIVE UNDER THE
PLAN IN WHICH THEY WERE AUTOMATICALLY ENROLLED; AND
(3) THE REQUIREMENTS FOR REPRODUCTIVE HEALTH CARE COVERAGE UNDER THE
ESSENTIAL HEALTH BENEFITS PACKAGE.
(B) FOR THE CALENDAR YEAR TWO THOUSAND SEVENTEEN, AN INDIVIDUAL WHO
WAS AUTOMATICALLY ENROLLED IN A HEALTH INSURANCE PLAN PROVIDED BY A
HEALTH INSURANCE COMPANY THAT EXCLUDES COVERAGE FOR REPRODUCTIVE HEALTH
CARE SERVICES THAT WERE COVERED BY THEIR PREVIOUS HEALTH INSURANCE PLAN
SHALL BE NOTIFIED BY THE HEALTH INSURANCE COMPANY WHICH PROVIDES THE
PLAN IN WHICH THE INDIVIDUAL WAS AUTOMATICALLY ENROLLED OF THE DIFFER-
ENCES BETWEEN EACH OF THE FOLLOWING:
(1) REPRODUCTIVE HEALTH CARE COVERAGE THEY RECEIVED THROUGH THEIR
PREVIOUS PLAN;
(2) REPRODUCTIVE HEALTH CARE COVERAGE THEY WOULD RECEIVE UNDER THE
PLAN IN WHICH THEY WERE AUTOMATICALLY ENROLLED; AND
(3) THE REQUIREMENTS FOR REPRODUCTIVE HEALTH CARE COVERAGE UNDER THE
ESSENTIAL HEALTH BENEFITS PACKAGE.
(C) FOR INDIVIDUALS WHO WERE AUTOMATICALLY ENROLLED IN A HEALTH INSUR-
ANCE PLAN DURING THE CALENDAR YEAR TWO THOUSAND SEVENTEEN PRIOR TO THE
EFFECTIVE DATE OF THIS SECTION, THIS INFORMATION SHALL BE DELIVERED TO
THEM IN WRITING NO LATER THAN THIRTY DAYS AFTER THE EFFECTIVE DATE OF
THIS SECTION; FOR INDIVIDUALS WHO ARE AUTOMATICALLY ENROLLED IN A HEALTH
INSURANCE PLAN AFTER THE EFFECTIVE DATE OF THIS SECTION, THIS INFORMA-
TION SHALL BE DELIVERED TO THEM IN WRITING NO LATER THAN THIRTY DAYS
AFTER AUTOMATIC ENROLLMENT IN THE PLAN.
§ 3. The public health law is amended by adding a new section 4415 to
read as follows:
§ 4415. ENSURING REPRODUCTIVE HEALTH CARE DURING AUTO ENROLLMENT. 1.
UPON THE AUTOMATIC ENROLLMENT OF AN INDIVIDUAL BY THE DEPARTMENT OF
FINANCIAL SERVICES INTO A HEALTH INSURANCE PLAN PROVIDED BY A HEALTH
MAINTENANCE ORGANIZATION THAT EXCLUDES COVERAGE FOR REPRODUCTIVE HEALTH
CARE SERVICES THAT WERE COVERED BY THE INDIVIDUAL'S PREVIOUS HEALTH
A. 3394 3
INSURANCE PLAN, THE HEALTH MAINTENANCE ORGANIZATION WHICH PROVIDES THE
PLAN IN WHICH THE INDIVIDUAL WAS AUTOMATICALLY ENROLLED SHALL NOTIFY THE
INDIVIDUAL OF THE DIFFERENCES BETWEEN EACH OF THE FOLLOWING:
(A) REPRODUCTIVE HEALTH CARE COVERAGE THEY RECEIVED THROUGH THEIR
PREVIOUS PLAN;
(B) REPRODUCTIVE HEALTH CARE COVERAGE THEY WOULD RECEIVE UNDER THE
PLAN IN WHICH THEY WERE AUTOMATICALLY ENROLLED; AND
(C) THE REQUIREMENTS FOR REPRODUCTIVE HEALTH CARE COVERAGE UNDER THE
ESSENTIAL HEALTH BENEFITS PACKAGE.
2. FOR THE CALENDAR YEAR TWO THOUSAND SEVENTEEN, AN INDIVIDUAL WHO WAS
AUTOMATICALLY ENROLLED IN A HEALTH INSURANCE PLAN PROVIDED BY A HEALTH
MAINTENANCE ORGANIZATION THAT EXCLUDES COVERAGE FOR REPRODUCTIVE HEALTH
CARE SERVICES THAT WERE COVERED BY THEIR PREVIOUS HEALTH INSURANCE PLAN
SHALL BE NOTIFIED BY THE HEALTH MAINTENANCE ORGANIZATION WHICH PROVIDES
THE PLAN IN WHICH THE INDIVIDUAL WAS AUTOMATICALLY ENROLLED OF THE
DIFFERENCES BETWEEN EACH OF THE FOLLOWING:
(A) REPRODUCTIVE HEALTH CARE COVERAGE THEY RECEIVED THROUGH THEIR
PREVIOUS PLAN;
(B) REPRODUCTIVE HEALTH CARE COVERAGE THEY WOULD RECEIVE UNDER THE
PLAN IN WHICH THEY WERE AUTOMATICALLY ENROLLED; AND
(C) THE REQUIREMENTS FOR REPRODUCTIVE HEALTH CARE COVERAGE UNDER THE
ESSENTIAL HEALTH BENEFITS PACKAGE.
3. FOR INDIVIDUALS WHO WERE AUTOMATICALLY ENROLLED IN A HEALTH INSUR-
ANCE PLAN DURING THE CALENDAR YEAR TWO THOUSAND SEVENTEEN PRIOR TO THE
EFFECTIVE DATE OF THIS SECTION, THIS INFORMATION SHALL BE DELIVERED TO
THEM IN WRITING NO LATER THAN THIRTY DAYS AFTER THE EFFECTIVE DATE OF
THIS SECTION; FOR INDIVIDUALS WHO ARE AUTOMATICALLY ENROLLED IN A HEALTH
INSURANCE PLAN AFTER THE EFFECTIVE DATE OF THIS SECTION, THIS INFORMA-
TION SHALL BE DELIVERED TO THEM IN WRITING NO LATER THAN THIRTY DAYS
AFTER AUTOMATIC ENROLLMENT IN THE PLAN.
§ 4. This act shall take effect immediately.