S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8500
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               May 20, 2025
                                ___________
 
 Introduced  by  M.  of A. PHEFFER AMATO -- read once and referred to the
   Committee on Governmental Employees
 
 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 (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
 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;
   § 2. 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:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD06196-01-5
 A. 8500                             2
              

 
   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.
   § 3. This act shall take effect immediately.