NY State Senate Bill 2023-S5639A

Senate Bill S5639A

2023-2024 Legislative Session

Clarifies that the New York state health insurance program remains subject to certain provisions of the financial services law

download bill text pdf

Current Bill Status - In Senate Committee Civil Service And Pensions Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to civil service and pensions
Mar 27, 2023	print number 5639a
Mar 27, 2023	amend and recommit to civil service and pensions
Mar 10, 2023	referred to civil service and pensions

Bill Amendments

Original

A (Active)

2023-S5639 - Details

See Assembly Version of this Bill:: A7055
Current Committee:: Senate Civil Service And Pensions
Law Section:: Civil Service Law
Laws Affected:: Amd §§162 & 161-a, Civ Serv L

2023-S5639 - Summary

Clarifies that the New York state health insurance program remains subject to certain provisions of the financial services law and coverage for usual and customary costs for out-of-network health care service.

2023-S5639 - Sponsor Memo

                                 
BILL NUMBER: S5639

SPONSOR: JACKSON
 
TITLE OF BILL:

An act to amend the civil service law, in relation to clarifying that
the New York state health insurance program remains subject to certain
provisions of the financial services law

 
PURPOSE:

The purpose of this bill is to ensure that participants in the New York
State Health Insurance Program (NYSHIP) that are not part of an approved
collective bargaining agreement will not have their health insurance
benefits diminished by order of the President of the New York State
Civil Service Commission.

 
SUMMARY OF PROVISIONS:

Section 1 amends subparagraph (iv) of paragraph (b) of subdivision 1 of
Section 162 of the Civil Service Law to provide that NYSHIP remains
subject to Department of Financial Services regulations and the New York

State Emergency and Surprise Bills Law.

Section 2 amends subparagraph (i) of paragraph (b) of subdivision 1 of
Section 162 of the Civil Service Law to provide that NYSHIP covers at
least one plan to enrollees that reimburses out-of-network clinicians at
usual, customary, and reasonable rates set at the 80th percentile of the
FAIR Health benchmark.

Section 3 amends subdivision 1 of Section 161-a of the Civil Service Law
to prevent the Department of Civil Service from automatically applying
collectively bargained health plan changes to non-union represented
employees, retirees, and union represented municipal employees that have
not specifically memorialized NYSHIP benefits in a collective bargaining
agreement if the changes would decrease coverage and/or reimbursement.

Section 4 is the effective date.

 
JUSTIFICATION:

The purpose of this bill is to ensure that participants in the New York
State Health Insurance Program/The Empire Plan that have not been
subjected to an approved collective bargaining agreement will not have
their health insurance benefits diminished by order of the President of
the New York State Civil Service Commission. This bill also clarifies
Civil Service Law to ensure that the New York State Health Insurance
Program/The Empire Plan remains subject to Department of Financial
Services regulations and the New York State Emergency and Surprise Bills
Law.

This bill ensures that New York State dedicated public employees partic-
ipating in NYSHIP are fairly and equitably provided health insurance
options and that no such participant has their health insurance dimin-
ished in any capacity without first having been represented through
collective bargaining. New York State's dedicated public employees from
the municipal to state levels are the backbone of the State's commitment
to every resident. Recruitment and retention of public employees have

become increasingly more difficult. This bill will reaffirm its commit-
ment to all public servants and their families.

 
LEGISLATIVE HISTORY:

New bill.

 
STATE AND LOCAL FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2023-S5639 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5639
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                              March 10, 2023
                                ___________
 
 Introduced  by  Sen. JACKSON -- read twice and ordered printed, and when
   printed to be committed to the Committee on Civil Service and Pensions
 
 AN ACT to amend the civil service law, in relation  to  clarifying  that
   the New York state health insurance program remains subject to certain
   provisions of the financial services law

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraph (iv) of paragraph  (b)  of  subdivision  1  of
 section 162 of the  civil service law, as amended by section 3 of part T
 of  chapter 56 of the laws of 2010 and as further amended by section 104
 of part A of chapter 62 of the laws of  2011,  is  amended  to  read  as
 follows:
   (iv)  Notwithstanding  the  provisions of this subdivision, the presi-
 dent's election to provide health benefits directly to plan participants
 shall not constitute the doing of insurance business within the  meaning
 of  article eleven of the insurance law; provided however, the provision
 of direct benefits as per this subdivision shall be subject to review by
 the superintendent of financial services for the  purposes  of  ensuring
 compliance  with  applicable  insurance  law  and any and all associated
 insurance rules and regulations as noted in this subdivision.   FURTHER,
 THE PROVISION OF DIRECT BENEFITS AS PER THIS SUBDIVISION, AND ANY ENTITY
 PROVIDING  ADMINISTRATIVE  SERVICES  REGARDING  THOSE BENEFITS, SHALL BE
 SUBJECT TO THE JURISDICTION OF THE DEPARTMENT OF FINANCIAL  SERVICES  IN
 ACCORDANCE  WITH ARTICLE THREE OF THE FINANCIAL SERVICES LAW, AS WELL AS
 THE PROVISIONS OF ARTICLE SIX OF THE FINANCIAL SERVICES LAW.
   § 2. Subparagraph (i) of paragraph (b) of subdivision 1 of section 162
 of the civil service law, as amended by section 3 of part T  of  chapter
 56 of the laws of 2010, is amended to read as follows:
   (i) Any and all health insurance coverage mandated by any law, rule or
 regulation,  including  but not limited to coverage mandated pursuant to
 article forty-three of the insurance law, applicable  to  contracts  for
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09746-01-3

 S. 5639                             2
 
 health  insurance entered into under this section shall be provided in a
 manner assuring uninterrupted continuance of coverage  for  all  covered
 persons.  HEALTH  BENEFITS  SHALL INCLUDE AT   LEAST ONE OPTION FOR PLAN
 PARTICIPANTS  FOR  COVERAGE FOR AT LEAST EIGHTY PERCENT OF THE USUAL AND
 CUSTOMARY COST OF EACH OUT-OF-NETWORK HEALTH  CARE SERVICE. AS  USED  IN
 THIS  SUBPARAGRAPH,  "USUAL AND CUSTOMARY COST" SHALL MEAN THE EIGHTIETH
 PERCENTILE OF  ALL  CHARGES  FOR  THE  PARTICULAR  HEALTH  CARE  SERVICE
 PERFORMED BY A PROVIDER IN THE SAME OR SIMILAR SPECIALTY AND PROVIDED IN
 THE  SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING DATABASE MAIN-
 TAINED BY A NONPROFIT ORGANIZATION SPECIFIED BY  THE  SUPERINTENDENT  OF
 FINANCIAL  SERVICES. For the purposes of this paragraph "coverage" shall
 include but shall not be limited  to  all  benefits,  services,  rights,
 privileges and guarantees allowed by law;
   §  3.  Subdivision  1  of  section  161-a of the civil service law, as
 amended by section 10 of part T of chapter 56 of the laws  of  2010,  is
 amended to read as follows:
   1.  Where,  and to the extent that, an agreement between the state and
 an employee organization entered into pursuant to  article  fourteen  of
 this  chapter provides for health benefits, the president, after receipt
 of written directions from the director  of  employee  relations,  shall
 implement  the  provisions  of  such agreement consistent with the terms
 thereof and to the extent necessary shall  adopt  regulations  providing
 for  the  benefits  to  be  thereunder provided. The president, with the
 approval of the director of the budget, may  extend  such  benefits,  in
 whole  or in part, PROVIDED THAT SUCH BENEFITS ARE NOT A DIMINISHMENT OF
 CURRENT EXISTING BENEFITS to employees not subject to the provisions  of
 such agreement.
   § 4. This act shall take effect immediately.

co-Sponsors

View additional co-sponsors

2023-S5639A (ACTIVE) - Details

See Assembly Version of this Bill:: A7055
Current Committee:: Senate Civil Service And Pensions
Law Section:: Civil Service Law
Laws Affected:: Amd §§162 & 161-a, Civ Serv L

2023-S5639A (ACTIVE) - Summary

2023-S5639A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S5639A

SPONSOR: JACKSON
 
TITLE OF BILL:

An act to amend the civil service law, in relation to clarifying that
the New York state health insurance program remains subject to certain
provisions of the financial services law

 
PURPOSE:

The purpose of this bill is to ensure that participants in the New York
State Health Insurance Program (NYSHIP) that are not part of an approved
collective bargaining agreement will not have their health insurance
benefits diminished by order of the President of the New York State
Civil Service Commission.

 
SUMMARY OF PROVISIONS:

Section 1 amends subparagraph (iv) of paragraph (b) of subdivision 1 of
Section 162 of the Civil Service Law to provide that NYSHIP remains
subject to Department of Financial Services regulations and the New York

State Emergency and Surprise Bills Law.

Section 2 amends subparagraph (i) of paragraph (b) of subdivision 1 of
Section 162 of the Civil Service Law to provide that NYSHIP covers at
least one plan to enrollees that reimburses out-of-network clinicians at
usual, customary, and reasonable rates set at the 80th percentile of the
FAIR Health benchmark.

Section 3 amends subdivision 1 of Section 161-a of the Civil Service Law
to prevent the Department of Civil Service from automatically applying
collectively bargained health plan changes to non-union represented
employees, retirees, and union represented municipal employees that have
not specifically memorialized NYSHIP benefits in a collective bargaining
agreement if the changes would decrease coverage and/or reimbursement.

Section 4 is the effective date.

 
JUSTIFICATION:

The purpose of this bill is to ensure that participants in the New York
State Health Insurance Program/The Empire Plan that have not been
subjected to an approved collective bargaining agreement will not have
their health insurance benefits diminished by order of the President of
the New York State Civil Service Commission. This bill also clarifies
Civil Service Law to ensure that the New York State Health Insurance
Program/The Empire Plan remains subject to Department of Financial
Services regulations and the New York State Emergency and Surprise Bills
Law.

This bill ensures that New York State dedicated public employees partic-
ipating in NYSHIP are fairly and equitably provided health insurance
options and that no such participant has their health insurance dimin-
ished in any capacity without first having been represented through
collective bargaining. New York State's dedicated public employees from
the municipal to state levels are the backbone of the State's commitment
to every resident. Recruitment and retention of public employees have

become increasingly more difficult. This bill will reaffirm its commit-
ment to all public servants and their families.

 
LEGISLATIVE HISTORY:

New bill.

 
STATE AND LOCAL FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2023-S5639A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5639--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                              March 10, 2023
                                ___________
 
 Introduced  by  Sen. JACKSON -- read twice and ordered printed, and when
   printed to be committed to the Committee on Civil Service and Pensions
   -- committee discharged, bill amended, ordered  reprinted  as  amended
   and recommitted to said committee
 
 AN  ACT  to  amend the civil service law, in relation to clarifying that
   the New York state health insurance program remains subject to certain
   provisions of the financial services law
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subparagraph  (iv)  of  paragraph (b) of subdivision 1 of
 section 162 of the  civil service law, as amended by section 3 of part T
 of chapter 56 of the laws of 2010 and as further amended by section  104
 of  part  A  of  chapter  62  of the laws of 2011, is amended to read as
 follows:
   (iv) Notwithstanding the provisions of this  subdivision,  the  presi-
 dent's election to provide health benefits directly to plan participants
 shall  not constitute the doing of insurance business within the meaning
 of article eleven of the insurance law; provided however, the  provision
 of direct benefits as per this subdivision shall be subject to review by
 the  superintendent  of  financial services for the purposes of ensuring
 compliance with applicable insurance law  and  any  and  all  associated
 insurance  rules and regulations as noted in this subdivision.  FURTHER,
 THE PROVISION OF DIRECT BENEFITS AS PER THIS SUBDIVISION, AND ANY ENTITY
 PROVIDING ADMINISTRATIVE SERVICES REGARDING  THOSE  BENEFITS,  SHALL  BE
 SUBJECT  TO  THE JURISDICTION OF THE DEPARTMENT OF FINANCIAL SERVICES IN
 ACCORDANCE WITH ARTICLE THREE OF THE FINANCIAL SERVICES LAW, AS WELL  AS
 THE PROVISIONS OF ARTICLE SIX OF THE FINANCIAL SERVICES LAW.
   § 2. Subparagraph (i) of paragraph (b) of subdivision 1 of section 162
 of  the  civil service law, as amended by section 3 of part T of chapter
 56 of the laws of 2010, is amended to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09746-02-3
 S. 5639--A                          2

 
   (i) Any and all health insurance coverage mandated by any law, rule or
 regulation, including but not limited to coverage mandated  pursuant  to
 article  forty-three  of  the insurance law, applicable to contracts for
 health insurance entered into under this section shall be provided in  a
 manner  assuring  uninterrupted  continuance of coverage for all covered
 persons. HEALTH BENEFITS SHALL INCLUDE A REQUIREMENT THAT COVERED HEALTH
 CARE SERVICES PROVIDED TO PLAN PARTICIPANTS WILL BE  REIMBURSED  AT  THE
 LEVEL OF AT LEAST EIGHTY PERCENT OF THE USUAL AND CUSTOMARY COST OF EACH
 OUT-OF-NETWORK  HEALTH    CARE  SERVICE.  AS  USED IN THIS SUBPARAGRAPH,
 "USUAL AND CUSTOMARY COST" SHALL MEAN THE EIGHTIETH  PERCENTILE  OF  ALL
 CHARGES  FOR  THE PARTICULAR HEALTH CARE SERVICE PERFORMED BY A PROVIDER
 IN THE SAME OR SIMILAR SPECIALTY AND PROVIDED IN THE  SAME  GEOGRAPHICAL
 AREA  AS  REPORTED  IN A BENCHMARKING DATABASE MAINTAINED BY A NONPROFIT
 ORGANIZATION SPECIFIED BY THE SUPERINTENDENT OF FINANCIAL SERVICES.  For
 the purposes of this paragraph "coverage" shall include but shall not be
 limited  to  all  benefits,  services, rights, privileges and guarantees
 allowed by law;
   § 3. Subdivision 1 of section 161-a  of  the  civil  service  law,  as
 amended  by  section  10 of part T of chapter 56 of the laws of 2010, is
 amended to read as follows:
   1. Where, and to the extent that, an agreement between the  state  and
 an  employee  organization  entered into pursuant to article fourteen of
 this chapter provides for health benefits, the president, after  receipt
 of  written  directions  from  the director of employee relations, shall
 implement the provisions of such agreement  consistent  with  the  terms
 thereof  and  to  the extent necessary shall adopt regulations providing
 for the benefits to be thereunder  provided.  The  president,  with  the
 approval  of  the  director  of the budget, may extend such benefits, in
 whole or in part, PROVIDED THAT SUCH BENEFITS ARE NOT A DIMINISHMENT  OF
 CURRENT  EXISTING BENEFITS to employees not subject to the provisions of
 such agreement.
   § 4. This act shall take effect immediately.

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