S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4959
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 6, 2017
                                ___________
 
 Introduced by M. of A. WEPRIN -- Multi-Sponsored by -- M. of A. PERRY --
   read once and referred to the Committee on Insurance
 
 AN ACT to amend the insurance law and the public health law, in relation
   to notification of termination of group health insurance
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subsection (a) of section 3221  of  the  insurance  law  is
 amended by adding a new paragraph 17 to read as follows:
   (17) (A) THAT THE INSURER SHALL REQUIRE THE POLICYHOLDER TO PROVIDE IT
 WITH  THE NAMES AND RESIDENTIAL ADDRESSES OF ALL INDIVIDUALS WHO BECAUSE
 OF THEIR EMPLOYEE OR MEMBERSHIP STATUS  ARE  CERTIFICATE  HOLDERS  UNDER
 SUCH  POLICY,  AND  TO UPDATE SUCH INFORMATION AT LEAST ANNUALLY; AND IN
 THE EVENT THE INSURER TERMINATES SUCH POLICY, SHALL  GIVE  EACH  CERTIF-
 ICATE HOLDER AT LEAST THIRTY DAYS PRIOR WRITTEN NOTICE OF TERMINATION OF
 COVERAGE,  BY  MAILING  SUCH  NOTICE  TO  THE  LAST PROVIDED RESIDENTIAL
 ADDRESS FOR SUCH CERTIFICATE HOLDER; PROVIDED, HOWEVER, THAT SUCH NOTICE
 SHALL NOT BE REQUIRED WHERE THE  POLICYHOLDER  HAS:  (1)  PROVIDED  SUCH
 CERTIFICATE  HOLDER  AT  LEAST  THIRTY  DAYS PRIOR WRITTEN NOTICE OF THE
 TERMINATION OF COVERAGE, BY MAILING SUCH NOTICE TO THE CERTIFICATE HOLD-
 ER'S LAST KNOWN RESIDENTIAL ADDRESS, OR, IF THE  CERTIFICATE  HOLDER  IS
 REPRESENTED BY A LABOR ORGANIZATION, PROVIDED THE REPRESENTATIVE OF SUCH
 LABOR  ORGANIZATION WITH SUCH WRITTEN NOTICE, OR (2) HAS CONTRACTED WITH
 ANOTHER INSURER TO PROVIDE SIMILAR COVERAGE  FOR  THE  SAME  CERTIFICATE
 HOLDERS,  AND  HAS  PROVIDED  CERTIFICATE  HOLDERS  WITH THE NAME OF THE
 SUBSTITUTED INSURER. NO TERMINATION OF A GROUP  POLICY  OR  CONTRACT  OF
 HEALTH,  OR  ACCIDENT  AND HEALTH INSURANCE SHALL BECOME EFFECTIVE UNTIL
 THIRTY DAYS AFTER THE MAILING OF SUCH NOTICE OF TERMINATION CONTRACT, IF
 REQUIRED.
   (B) THE INSURER SHALL INCLUDE WITH SUCH NOTICE A COMPLETE STATEMENT OF
 THE RIGHTS OF THE CERTIFICATE HOLDER UNDER THE TERMINATION OF THE POLICY
 AS TO COVERAGE FOR ILLNESS, ACCIDENT AND TREATMENT  OCCURRING  PRIOR  TO
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD06674-01-7

 A. 4959                             2
 
 AND SUBSEQUENT TO THE TERMINATION DATE, AND SUCH OTHER RIGHTS OF CERTIF-
 ICATE  HOLDERS  AS MAY EXIST UNDER THE CONTRACT OR POLICY OR PURSUANT TO
 PARAGRAPH ONE OF SUBSECTION (E) OF THIS SECTION.
   (C)  UPON  WRITTEN  REQUEST, THE HOLDER OF THE POLICY BEING TERMINATED
 SHALL REIMBURSE THE INSURER FOR ALL REASONABLE AND NECESSARY COSTS ASSO-
 CIATED WITH PROVIDING SUCH NOTICE TO CERTIFICATE HOLDERS.
   § 2. Section 4305 of the insurance law is  amended  by  adding  a  new
 subsection (n) to read as follows:
   (N) (1) A GROUP CONTRACT ISSUED PURSUANT TO THIS SECTION SHALL CONTAIN
 A  PROVISION THAT THE INSURER SHALL REQUIRE THE GROUP CONTRACT HOLDER TO
 PROVIDE IT WITH THE NAMES AND RESIDENTIAL ADDRESSES OF  ALL  INDIVIDUALS
 WHO BECAUSE OF THEIR EMPLOYEE OR MEMBERSHIP STATUS ARE CERTIFICATE HOLD-
 ERS UNDER SUCH POLICY, AND TO UPDATE SUCH INFORMATION AT LEAST ANNUALLY;
 AND  IN  THE  EVENT  THE INSURER TERMINATES SUCH POLICY, SHALL GIVE EACH
 CERTIFICATE HOLDER AT LEAST THIRTY DAYS PRIOR WRITTEN NOTICE  OF  TERMI-
 NATION OF COVERAGE, BY MAILING SUCH NOTICE TO THE LAST PROVIDED RESIDEN-
 TIAL  ADDRESS  FOR SUCH CERTIFICATE HOLDER; PROVIDED, HOWEVER, THAT SUCH
 NOTICE SHALL NOT BE REQUIRED  WHERE  THE  GROUP  POLICYHOLDER  HAS:  (A)
 PROVIDED  SUCH  CERTIFICATE  HOLDERS  AT LEAST THIRTY DAYS PRIOR WRITTEN
 NOTICE OF THE TERMINATION OF COVERAGE, BY MAILING SUCH  NOTICE  TO  SUCH
 CERTIFICATE HOLDER'S LAST KNOWN RESIDENTIAL ADDRESS, OR, IF SUCH CERTIF-
 ICATE HOLDER IS REPRESENTED BY A LABOR ORGANIZATION, PROVIDED THE REPRE-
 SENTATIVE  OF  SUCH  LABOR ORGANIZATION WITH SUCH WRITTEN NOTICE, OR (B)
 HAS CONTRACTED WITH ANOTHER INSURER TO PROVIDE SIMILAR COVERAGE FOR  THE
 SAME CERTIFICATE HOLDERS, AND HAS PROVIDED SUCH CERTIFICATE HOLDERS WITH
 THE NAME OF THE SUBSTITUTED INSURER. NO TERMINATION OF A GROUP POLICY OR
 CONTRACT OF HEALTH, OR ACCIDENT AND HEALTH INSURANCE SHALL BECOME EFFEC-
 TIVE  UNTIL  THIRTY DAYS AFTER THE MAILING OF SUCH NOTICE OF TERMINATION
 CONTRACT, IF REQUIRED.
   (2) THE INSURER SHALL INCLUDE WITH SUCH NOTICE A COMPLETE STATEMENT OF
 THE RIGHTS OF THE CERTIFICATE HOLDER UNDER THE TERMINATION OF THE POLICY
 AS TO COVERAGE FOR ILLNESS, ACCIDENT AND TREATMENT  OCCURRING  PRIOR  TO
 AND SUBSEQUENT TO THE TERMINATION DATE, AND SUCH OTHER RIGHTS OF CERTIF-
 ICATE  HOLDERS  AS MAY EXIST UNDER THE CONTRACT OR POLICY OR PURSUANT TO
 PARAGRAPH ONE OF SUBSECTION (D) OF THIS SECTION.
   (3) UPON WRITTEN REQUEST, THE HOLDER OF THE GROUP POLICY BEING  TERMI-
 NATED SHALL REIMBURSE THE INSURER FOR ALL REASONABLE AND NECESSARY COSTS
 ASSOCIATED WITH PROVIDING SUCH NOTICE TO CERTIFICATE HOLDERS.
   §  3.  The public health law is amended by adding a new section 4407-a
 to read as follows:
   § 4407-A. GROUP CONTRACTS; NOTIFICATION OF CANCELLATION  REQUIREMENTS.
 1.  A  HEALTH  MAINTENANCE  ORGANIZATION SHALL REQUIRE A POLICYHOLDER TO
 PROVIDE IT WITH THE NAMES AND RESIDENTIAL ADDRESSES OF  ALL  INDIVIDUALS
 WHO  BECAUSE  OF THEIR EMPLOYEE OR MEMBERSHIP STATUS ARE MEMBERS IN SUCH
 HEALTH MAINTENANCE ORGANIZATION, AND TO UPDATE SUCH INFORMATION AT LEAST
 ANNUALLY; AND IN THE EVENT THE HEALTH  MAINTENANCE  ORGANIZATION  TERMI-
 NATES  SUCH  POLICY,  SHALL  GIVE  EACH SUCH MEMBER AT LEAST THIRTY DAYS
 PRIOR WRITTEN NOTICE OF TERMINATION OF COVERAGE, BY MAILING SUCH  NOTICE
 TO  THE  LAST  PROVIDED  RESIDENTIAL  ADDRESS FOR SUCH MEMBER; PROVIDED,
 HOWEVER, THAT SUCH NOTICE SHALL NOT BE REQUIRED WHERE  THE  POLICYHOLDER
 HAS:  (A) PROVIDED SUCH MEMBER AT LEAST THIRTY DAYS PRIOR WRITTEN NOTICE
 OF THE TERMINATION OF COVERAGE, BY MAILING SUCH NOTICE TO SUCH  MEMBER'S
 LAST  KNOWN  RESIDENTIAL  ADDRESS, OR, IF THE MEMBER IS REPRESENTED BY A
 LABOR ORGANIZATION, PROVIDED THE REPRESENTATIVE OF SUCH LABOR  ORGANIZA-
 TION WITH SUCH WRITTEN NOTICE, OR (B) HAS CONTRACTED WITH ANOTHER HEALTH
 MAINTENANCE  ORGANIZATION OR INSURER TO PROVIDE SIMILAR COVERAGE FOR THE

 A. 4959                             3
 
 SAME MEMBERS, AND HAS PROVIDED MEMBERS WITH THE NAME OF THE  SUBSTITUTED
 HEALTH  MAINTENANCE  ORGANIZATION  OR INSURER. NO TERMINATION OF A GROUP
 POLICY OR CONTRACT OF HEALTH, OR ACCIDENT  AND  HEALTH  INSURANCE  SHALL
 BECOME  EFFECTIVE  UNTIL THIRTY DAYS AFTER THE MAILING OF SUCH NOTICE OF
 TERMINATION CONTRACT, IF REQUIRED.
   2. THE HEALTH MAINTENANCE ORGANIZATION SHALL INCLUDE WITH SUCH  NOTICE
 A  COMPLETE  STATEMENT OF THE RIGHTS OF THE MEMBER UNDER THE TERMINATION
 OF THE POLICY AS TO COVERAGE FOR ILLNESS, ACCIDENT AND TREATMENT  OCCUR-
 RING  PRIOR  TO  AND  SUBSEQUENT TO THE TERMINATION DATE, AND SUCH OTHER
 RIGHTS OF MEMBERS AS MAY EXIST UNDER THE CONTRACT OR POLICY OR  PURSUANT
 TO THIS ARTICLE AND ARTICLE FORTY-THREE OF THE INSURANCE LAW.
   3.  UPON  WRITTEN  REQUEST,  THE HOLDER OF THE POLICY BEING TERMINATED
 SHALL REIMBURSE THE HEALTH MAINTENANCE ORGANIZATION FOR  ALL  REASONABLE
 AND NECESSARY COSTS ASSOCIATED WITH PROVIDING SUCH NOTICE TO MEMBERS.
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law.