Assembly Bill A1766B

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1766
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2025
                                ___________
 
 Introduced  by  M.  of  A. STECK, BARRETT, BLANKENBUSH, COOK, DeSTEFANO,
   FRIEND,  HAWLEY,   HEVESI,   JONES,   LUPARDO,   McMAHON,   PALMESANO,
   PEOPLES-STOKES,  REYES,  STIRPE,  WOERNER,  BENDETT, MANKTELOW, TAGUE,
   BRABENEC -- read once and referred to the Committee on Insurance
 
 AN ACT authorizing municipalities to join a county self-funded or  self-
   insured health plan
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Notwithstanding article 44 or 47 of the  insurance  law  or
 any  other provision of law to the contrary, and subject to the require-
 ments set forth in this section, a municipality is permitted,  with  the
 consent  of  the  county and the governing body of such municipality, to
 join a county self-funded or self-insured health plan in any  county  in
 which  such municipality is located in whole or in part. Municipality is
 defined as any city, town, village or any other municipal corporation, a
 school district or any governmental entity operating  a  public  school,
 college  or  university,  a  public  improvement  or special district, a
 public authority, commission, or  public  benefit  corporation,  or  any
 other  public  corporation, agency or instrumentality or unit of govern-
 ment which exercises governmental powers under the laws of the state but
 is not a part of, nor a department of, nor an agency of  the  state.  In
 order for a municipality or municipalities to join the county self-fund-
 ed  or  self-insured  health plan, the county shall file with the super-
 intendent of financial services certification that,  with  inclusion  of
 the  lives  to be covered in the plan following admission of the munici-
 pality or municipalities, the county self-funded or self-insured  health
 plan meets the following six requirements:
   (a)  That  the  county  and any municipality or municipalities joining
 such plan have mutually consented to join such plan.
   (b) That it maintain a reserve fund, calculated  as  a  percentage  of
 total annual incurred claims, of a minimum of 12% of claims.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04716-01-5
              

 A. 1766                             2
 
   (c)  That it has a surplus account, established and maintained for the
 sole purpose of satisfying unexpected obligations of the benefit plan in
 the event of termination or abandonment of the plan, which shall not  be
 less  than  5%  of  the annualized earned premium equivalents during the
 current fiscal year of the plan.
   (d)  That  it  has in effect a specific stop loss per individual claim
 only, no aggregate,  and  with  a  minimum  deductible  of  $200,000  to
 $250,000.
   (e)  That  it has a minimum of 1,000 covered lives including retirees,
 but not including dependents.
   (f) That joint and several liability of  participating  municipalities
 for  the obligations of the plan is hereby abolished, and such liability
 shall be governed as follows:
   1. If the plan does not have admitted assets, as  defined  in  section
 107 of the insurance law, at least equal to the aggregate of its liabil-
 ities and reserves and minimum surplus as provided in subdivision (b) of
 this  section,  the  governing  board of such plan shall, within 30 days
 thereafter, order an assessment for the amount that will provide  suffi-
 cient  funds  to  remove such impairment and collect from each municipal
 corporation a pro rata share of such assessed amount.
   2. Every municipal corporation that participated in the  plan  at  any
 time  during  the  two-year period prior to the issuing of an assessment
 order by the plan's governing board shall, if notified of  such  assess-
 ment, pay its pro rata share of such assessment within 90 days after the
 issuance of that assessment order.
   3. A municipal corporation's pro rata share of any assessment shall be
 determined  by  applying  the  ratio  of (i) the total assessment to the
 total contributions or premium  equivalents  earned  during  the  period
 covered  by  the  assessment  on  all  municipal corporations subject to
 assessment to (ii) the contribution or premium equivalent earned  during
 such period attributable to such municipal corporation.
   4.  The  contingent liability of municipal corporations for additional
 premium equivalents or assessments shall not be included as an asset  in
 the financial statements of the self-funded or self-insured health plan.
   The  superintendent  of financial services shall have the authority to
 review such certification  to  determine  that  the  six  aforementioned
 requirements  have been met; provided, however, that in the absence of a
 finding of the superintendent to the contrary within a six-month  period
 following the filing of such certification, the admission of the munici-
 pality  to the county self-funded or self-insured health plan shall take
 effect. In January of every year following the initial  filing  of  such
 certification, the county shall file a subsequent certification that the
 six aforementioned requirements remain in full force and effect.
   § 2. This act shall take effect immediately.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1766--A
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2025
                                ___________
 
 Introduced  by  M.  of  A. STECK, BARRETT, BLANKENBUSH, COOK, DeSTEFANO,
   FRIEND, HAWLEY, HEVESI, LUPARDO, McMAHON,  PALMESANO,  PEOPLES-STOKES,
   REYES,  STIRPE,  WOERNER, BENDETT, MANKTELOW, TAGUE, BRABENEC, SAYEGH,
   O'PHARROW, ANGELINO, GALLAHAN, LUNSFORD, K. BROWN, SEMPOLINSKI -- read
   once  and  referred  to  the  Committee  on  Insurance  --   committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 AN  ACT authorizing municipalities to join a county self-funded or self-
   insured health plan
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. A municipality is permitted, with the consent of the county
 and the governing body of such municipality, to join a county self-fund-
 ed  or self-insured health plan in any county in which such municipality
 is located in whole or in part. Municipality is  defined  as  any  city,
 town, village or any other municipal corporation, that is not a part of,
 nor  a department of, nor an agency of the state. In order for a munici-
 pality or municipalities to join the county self-funded or  self-insured
 health  plan, the county shall file with the superintendent of financial
 services certification that, with inclusion of the lives to  be  covered
 in  the  plan,  prior  to  the  admission of the municipality or munici-
 palities, that the county self-funded or self-insured health plan  meets
 the following six requirements:
   (a)  That  the  county  and any municipality or municipalities joining
 such plan have mutually consented to join such plan.
   (b) That it maintain a reserve fund, calculated  as  a  percentage  of
 total annual incurred claims, of a minimum of 12% of claims.
   (c)  That it has a surplus account, established and maintained for the
 sole purpose of satisfying unexpected obligations of the benefit plan in
 the event of termination or abandonment of the plan, which shall not  be
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04716-02-5
 A. 1766--A                          2
              

 
 less  than  5%  of  the annualized earned premium equivalents during the
 current fiscal year of the plan.
   (d)  That  it  has in effect a specific stop loss per individual claim
 only, no aggregate,  and  with  a  minimum  deductible  of  $200,000  to
 $250,000.
   (e)  That  it has a minimum of 1,000 covered lives including retirees,
 but not including dependents.
   (f) That joint and several liability of  participating  municipalities
 for  the obligations of the plan is hereby abolished, and such liability
 shall be governed as follows:
   1. If the plan does not have admitted assets, as  defined  in  section
 107 of the insurance law, at least equal to the aggregate of its liabil-
 ities and reserves and minimum surplus as provided in subdivision (b) of
 this  section,  the  governing  board of such plan shall, within 30 days
 thereafter, order an assessment for the amount that will provide  suffi-
 cient  funds  to  remove such impairment and collect from each municipal
 corporation a pro rata share of such assessed amount.
   2. Every municipal corporation that participated in the  plan  at  any
 time  during  the  two-year period prior to the issuing of an assessment
 order by the plan's governing board shall, if notified of  such  assess-
 ment, pay its pro rata share of such assessment within 90 days after the
 issuance of that assessment order.
   3. A municipal corporation's pro rata share of any assessment shall be
 determined  by  applying  the  ratio  of (i) the total assessment to the
 total contributions or premium  equivalents  earned  during  the  period
 covered  by  the  assessment  on  all  municipal corporations subject to
 assessment to (ii) the contribution or premium equivalent earned  during
 such period attributable to such municipal corporation.
   4.  The  contingent liability of municipal corporations for additional
 premium equivalents or assessments shall not be included as an asset  in
 the financial statements of the self-funded or self-insured health plan.
   §  2.  Any county that seeks to admit a municipality or municipalities
 to its  self-insured  or  self-funded  health  plan  shall  utilize  the
 services  of  an  actuary  approved  by  the superintendent of financial
 services who shall certify that the criteria set forth above  have  been
 complied  with.  Certification by an actuary approved by the superinten-
 dent of financial services shall establish a presumption that the  muni-
 cipality  or municipalities shall be admitted to the county self-insured
 or self-funded health plan.  Provided, however, that the  superintendent
 of  financial services may, before the passage of one year from the date
 of certification, may reject  such  certification  stating  the  grounds
 therefor  and any requirements to assure that must be met to assure that
 the proposal is approved.
   § 3. This act shall take effect immediately.