Assembly Bill A4737

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4737
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 3, 2017
                                ___________
 
 Introduced by M. of A. WALTER -- read once and referred to the Committee
   on Aging
 
 AN ACT to amend the elder law and the insurance law, in relation to long
   term  care insurance education, premiums and prohibition of exclusions
   for pre-existing conditions
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  Subdivision 8 of section 203 of the elder law, as added by
 section  18  of  part B of chapter 58 of the laws of 2007, is amended to
 read as follows:
   8. The director, in consultation  with  the  commissioner  of  health,
 shall  establish  a  program to be known as the NY Connects: Choices for
 Long Term Care. The purpose of this initiative is to provide consistent,
 comprehensive, locally-based information and  assistance  on  long  term
 care  services  to  consumers, caregivers and families to help them make
 educated choices. This program shall  provide  individuals,  caregivers,
 and  families  with  objective  information  and  assistance about home,
 community-based and institutional long term care services,  AS  WELL  AS
 INFORMATION  ABOUT  LONG TERM CARE INSURANCE PRODUCTS AND PROVIDERS.  NY
 Connects will be available on a voluntary basis to consumers, caregivers
 and their families. There shall be an on-going  education  and  outreach
 campaign  to  educate the public about long term care services available
 in their community and to assist consumers in preparing for  their  long
 term care needs.
   §  2.  Section  1117 of the insurance law is amended by adding two new
 subsections (c-1) and (c-2) to read as follows:
   (C-1) THE PREMIUM RATES FOR SUCH CONTRACTS  SHALL  BE  LEVEL  FOR  THE
 DURATION  OF  THE  POLICY OR CERTIFICATE EXCEPT WHERE A RATE INCREASE IS
 GRANTED BY THE SUPERINTENDENT. NO RATE INCREASE MAY BE  DEEMED  APPROVED
 IF  THAT  INCREASE, TOGETHER WITH ANY OTHER RATE INCREASE IMPOSED ON THE
 SAME CONTRACT OR CERTIFICATE WOULD CAUSE THE AGGREGATE RATE INCREASE FOR

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

                                                            LBD04748-01-7

 A. 4737                             2
 
 THAT CONTRACT OR CERTIFICATE TO EXCEED THE LESSER OF  THREE  PERCENT  OR
 THE  PERCENTAGE CHANGE IN THE CONSUMER PRICE INDEX FOR ALL URBAN CONSUM-
 ERS PUBLISHED BY THE BUREAU OF LABOR STATISTICS  OF  THE  UNITED  STATES
 DEPARTMENT OF LABOR DURING ANY CONTINUOUS TWELVE MONTH PERIOD.
   (C-2)  THE  SUPERINTENDENT  SHALL  NOT AUTHORIZE SUCH A CONTRACT WHICH
 INCLUDES AN EXCLUSION FOR PRE-EXISTING CONDITIONS.
   § 3. Subsection (d) of section 1117 of the insurance law,  as  amended
 by chapter 446 of the laws of 1996,  is amended to read as follows:
   (d)  Contracts issued pursuant to the provisions of this section shall
 be subject to all other provisions of this chapter and  the  regulations
 promulgated  thereunder  applicable  to  the insurer, health maintenance
 organization, or fraternal benefit society which  issues  the  contract,
 provided  however  that  in order to permit the development of long term
 care plans, the superintendent may modify or suspend any such  provision
 or regulation upon making the determinations set forth in subsection (f)
 of  this  section;  AND  PROVIDED  FURTHER  THAT  TO THE EXTENT THAT THE
 PROVISIONS OF THIS SECTION ARE INCONSISTENT WITH THE PROVISIONS OF  THIS
 CHAPTER, THE PROVISIONS OF THIS SECTION SHALL PREVAIL.
   §  4.  Subsection (b) of section 3229 of the insurance law, as amended
 by chapter 572 of the laws of 2008, is amended to read as follows:
   (b) In establishing minimum  benefit  standards  for  insurance  plans
 pursuant  to  this  section, the superintendent shall seek to ensure the
 cost effectiveness of the partnership for long term care program  estab-
 lished  pursuant  to  section  three hundred sixty-seven-f of the social
 services law, and may establish minimum permissible payments under  such
 insurance  plans. The superintendent shall not approve an insurance plan
 which includes an exclusion for pre-existing  conditions  [that  exceeds
 six  months],  or which does not OTHERWISE comply with [paragraph six of
 subsection (b) of] section one thousand one hundred  seventeen  of  this
 chapter.
   §  5. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become a law.