Senate Bill S8983A

                                
 
BILL NUMBER: S8983A

SPONSOR: O'MARA
 
TITLE OF BILL:  An act to amend the insurance law, in relation to
policies or contracts which are not included in the definition of
student accident and health insurance

 
PURPOSE:

This bill will clarify that New York State law does not prohibit the
issuance of policies offering certain "excepted benefits," such as
dental, vision, intercollegiate sports injury coverage, and travel
insurance to institutions, of higher learning.

 
SUMMARY OF PROVISIONS:

Section 1 amends clause (ii) of subparagraph (B) of paragraph 1 of
subsection (a) of § 3240 of the insurance law to clarify that New York
law does not prohibit the issuance of policies offering certain
"excepted benefits," such as dental, vision, or intercollegiate sports
injury coverage, and travel insurance to institutions of higher learn-
              

ing.

§ 2 establishes the effective date.

 
JUSTIFICATION:

New York has enacted law to conform its requirements for student health
insurance to the requirements set forth in the Affordable Care Act
("ACA"), including the ACA requirement that student health insurance
policies include a comprehensive set of "essential health benefits"
which are not subject to annual or lifetime dollar limitations. New
York's laws are aimed at traditional student health insurance policies
subject to ACA requirements. Such policies are typically offered by
institutions of higher education as a comprehensive health insurance
option for students that do not have access to health insurance through
a parent's plan. However, New York's laws do not distinguish between
traditional student health insurance policies and "excepted benefits"
policies such as accident, dental, and vision policies, which are
purchased by institutions of higher learning to address potential gaps
in coverage.

New York has interpreted its ACA compliance obligations to require all
policies issued to students of institutions of higher education to
include comprehensive essential health benefits without annual or life-
time dollar limitations. This interpretation has raised questions
regarding whether it is permissible to issue student policies in the
college market providing dental coverage, vision coverage, and other
intercollegiate sports injury coverage recognized by the ACA as
"excepted benefits." Such policies do not offer "essential health bene-
fits" without limitation. Dental policies, for example, do not typically
include maternity or mammography benefits because it falls outside of
the intended scope of the policy. However, dental policies do provide
students with important health coverage that may not be included in
their comprehensive medical plan.

Relating to travel insurance, many institutions have in the past
purchased coverage to take care of gaps in health insurance policies,
such as high out-of-network deductibles for care received outside the
United States or medical evacuation to transport a student home after
they are stabilized, but still require hospital care.

New York has interpreted its ACA conforming law to prohibit insurers
from issuing travel accident policies, as they do not provide all
comprehensive essential health benefits. These are allowable in 49 other
states.

The Department of Financial Services has directed companies to stop
selling medical evacuation polices to institutions of higher education,
making this needed coverage unavailable in NYS. DFS informed colleges
and universities that this amendment is necessary to make such policies
allowable.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

None to the state.

 
EFFECTIVE DATE:
This act shall take effect immediately.