S T A T E O F N E W Y O R K
________________________________________________________________________
6354
2023-2024 Regular Sessions
I N A S S E M B L Y
April 5, 2023
___________
Introduced by M. of A. WEPRIN -- 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 18 to read as follows:
(18) (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.
LBD10617-01-3
A. 6354 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 (o) to read as follows:
(O) (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. 6354 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.