S T A T E O F N E W Y O R K
________________________________________________________________________
8563
2025-2026 Regular Sessions
I N A S S E M B L Y
May 20, 2025
___________
Introduced by M. of A. RAJKUMAR -- read once and referred to the Commit-
tee on Local Governments
AN ACT to amend the general municipal law, in relation to authorizing
cities, towns, villages, school districts, boards of cooperative
educational services, library districts, fire districts, improvement
districts and special districts to enter into cooperative agreements
for the provision of centralized public employee administrative and
personnel services; and to amend the insurance law, in relation to
authorizing reduction of premiums for municipal cooperative health
benefit plans which offer employee wellness programs
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 92-a of the general municipal law is amended by
adding a new subdivision 8 to read as follows:
8. THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO ANY PUBLIC CORPO-
RATION WHICH PROVIDES HEALTH INSURANCE BENEFITS TO ITS OFFICERS AND
EMPLOYEES PURSUANT TO ARTICLE FORTY-SEVEN OF THE INSURANCE LAW.
§ 2. Subdivision a of section 119-n of the general municipal law, as
amended by chapter 413 of the laws of 1991, is amended to read as
follows:
a. The term "municipal corporation" means a county outside the city of
New York, a city, a town, a village, a board of cooperative educational
services, A PUBLIC LIBRARY AS DEFINED IN SECTION TWO HUNDRED FIFTY-THREE
OF THE EDUCATION LAW, A fire district or a school district.
§ 3. Subdivision 2 of section 119-o of the general municipal law is
amended by adding a new paragraph b-1 to read as follows:
B-1. THE ESTABLISHMENT OF A CENTRALIZED OFFICE TO COLLECTIVELY
PROVIDE:
(I) EMPLOYEE PAYROLL, TIME, ATTENDANCE AND PERSONNEL ADMINISTRATION
SERVICES;
(II) PARTICIPATION IN THE NEW YORK STATE HEALTH INSURANCE PROGRAM;
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD13025-01-5
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(III) A PERSONNEL OFFICE TO PROVIDE INFORMATION ON EMPLOYEE HEALTH
INSURANCE AND OTHER EMPLOYEE BENEFITS;
(IV) EMPLOYEE HEALTH INSURANCE BENEFITS FROM MORE THAN ONE HEALTH
INSURANCE CARRIER OR ORGANIZATION, WHICH GRANTS EACH EMPLOYEE THE CHOICE
OF WHICH HEALTH INSURANCE PLAN WHICH WILL PROVIDE COVERAGE;
(V) EMPLOYEE PARTICIPATION IN TAX DEFERRED RETIREMENT PLANS, HEALTH
CARE PLANS AND CHILD CARE PLANS;
(VI) MUNICIPAL COOPERATIVE HEALTH BENEFIT PLANS PURSUANT TO ARTICLE
FORTY-SEVEN OF THE INSURANCE LAW;
(VII) ADEQUATE AND ONGOING FINANCIAL CONTROLS AND SECURITY ARRANGE-
MENTS TO ENSURE THAT THE PARTICIPATING MUNICIPAL CORPORATIONS AND
DISTRICTS REMAIN SOLVENT;
(VIII) THE PREPARATION AND DISSEMINATION OF INFORMATIONAL AND SOLIC-
ITATION MATERIALS TO FACILITATE COMPARISON OF THE VARIOUS EMPLOYEE
HEALTH INSURANCE PLANS OFFERED BY THE PARTICIPATING MUNICIPAL CORPO-
RATIONS AND DISTRICTS;
(IX) FOR THE ENROLLMENT, BILLING, PREMIUM COLLECTION, PREMIUM
DISBURSEMENT AND RECONCILIATION, COMMISSION DISBURSEMENT, AND OTHER
PROCESSING SERVICES FOR HEALTH INSURANCE BENEFITS PROVIDED TO MUNICIPAL
EMPLOYEES;
(X) CONTRACTING WITH QUALIFIED THIRD PARTIES FOR THE PROVISION OF ANY
SERVICE NECESSARY TO CARRY OUT SUCH OFFICE'S POWERS AND DUTIES; AND
(XI) NEGOTIATION WITH PARTICIPATING HEALTH INSURERS AND HEALTH MAINTE-
NANCE ORGANIZATIONS WITH REGARD TO THE ADMINISTRATIVE EXPENSES PORTION
OF PREMIUM RATES CHARGED FOR HEALTH CARE COVERAGE OFFERED TO MUNICIPAL
EMPLOYEES BY SUCH OFFICE.
§ 4. Subsections (a) and (f) of section 4702 of the insurance law, as
added by chapter 689 of the laws of 1994, are amended and a new
subsection (i-1) is added to read as follows:
(a) "Community rating" means a rating methodology in which the premium
equivalent rate for all persons covered under a municipal cooperative
health benefit plan is the same, based upon the experience of the entire
pool of risks covered under the plan, without regard to age, sex, health
status or occupation and such that refunds, rebates, credits or divi-
dends based upon age, sex, health status or occupation are not
permitted; PROVIDED, HOWEVER, THAT, SUBJECT TO THE APPROVAL OF THE
SUPERINTENDENT, SUCH PLAN MAY PROVIDE AN ACTUARIALLY APPROPRIATE
REDUCTION IN PREMIUM RATES IN RETURN FOR AN ENROLLEE'S OR INSURED'S
ADHERENCE TO A BONA FIDE WELLNESS PROGRAM. A BONA FIDE WELLNESS PROGRAM
IS EITHER A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK POPULATIONS
OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT WHICH HELPS
TO PROMOTE GOOD HEALTH, HELPS TO PREVENT OR MITIGATE ACUTE OR CHRONIC
SICKNESS OR DISEASE, OR WHICH MINIMIZES ADVERSE HEALTH CONSEQUENCES DUE
TO LIFESTYLE. SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT
IT ENCOURAGES THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED
POPULATION. SUCH PLAN SHALL NOT REQUIRE SPECIFIC OUTCOMES AS A RESULT OF
AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE APPROVED WELLNESS PROGRAM.
(f) "Municipal corporation" means within the state of New York, a city
[with a population of less than one million or], a county outside the
city of New York, town, village, board of cooperative educational
services, school district, A FIRE DISTRICT, a public library, as defined
in section two hundred fifty-three of the education law, or district, as
defined in section one hundred nineteen-n of the general municipal law.
(I-1) "STOP-LOSS INSURANCE" MEANS AN INSURANCE POLICY WHEREBY THE
INSURER AGREES TO PAY CLAIMS OR INDEMNIFY A MUNICIPAL CORPORATION FOR
LOSSES INCURRED UNDER A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN IN
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EXCESS OF SPECIFIED LOSS LIMITS FOR INDIVIDUAL CLAIMS AND/OR FOR ALL
CLAIMS COMBINED, OR ANY SIMILAR ARRANGEMENT.
§ 5. Paragraphs 2 and 3 of subsection (a) of section 4704 of the
insurance law, paragraph 2 as amended by section 3 of part A of chapter
494 of the laws of 2009 and paragraph 3 as added by chapter 689 of the
laws of 1994, are amended to read as follows:
(2) except for any plan that provided medical, surgical and hospital
services on or before January first, nineteen hundred ninety-three
pursuant to a municipal cooperation agreement, the number of municipal
corporations participating in the municipal cooperative health benefit
plan shall be at least [three] TWO;
(3) except for any plan that provided medical, surgical and hospital
services to at least three hundred fifty covered employees (including
retirees and not including dependents) on or before January first, nine-
teen hundred ninety-three pursuant to a municipal cooperation agreement,
the number of covered employees (including retirees and not including
dependents) of municipal corporations participating in the municipal
cooperative health benefit plan shall be at least [two thousand] FIVE
HUNDRED;
§ 6. Subsection (b) of section 4704 of the insurance law, as added by
chapter 689 of the laws of 1994, is amended to read as follows:
(b) The superintendent shall refuse to grant a certificate of authori-
ty to an applicant that fails to meet the requirements of this section.
Notice of refusal shall be in writing and shall set forth the basis for
the refusal. If the applicant submits a written request within [thirty]
SIXTY days after receipt of the notice of refusal, the superintendent
shall promptly conduct a hearing to give the applicant the opportunity
to show cause why the refusal should not be made final.
§ 7. Paragraphs 1, 2 and 5 of subsection (d) of section 4705 of the
insurance law, paragraphs 1 and 5 as added by chapter 689 of the laws of
1994 and paragraph 2 as amended by chapter 681 of the laws of 2002, are
amended to read as follows:
(1) shall design the plan OR PLANS of benefits provided OR OFFERED by
the municipal cooperative health benefit plan and prepare the plan docu-
ment and summary plan description in accordance with section four thou-
sand seven hundred nine of this article, AND SHALL INCLUDE A WELLNESS
PROGRAM OPTION;
(2) may enter into an agreement with a contract administrator or other
service provider, determined by the governing board to be qualified, to
receive, investigate, recommend, audit, approve or make payment of
claims under the municipal cooperative health benefit plan OR PLANS,
provided that:
(A) the charges, fees and other compensation for any contracted
services shall be clearly stated in written administrative services
contracts as required in subdivision six of section ninety-two-a of the
general municipal law;
(B) payment for contracted services shall be made only after such
services are rendered; AND
(C) no member of the plan's governing board or any member of such
member's immediate family shall be an owner, officer, director, partner,
or employee of any contract administrator retained by the plan[; and
(D) all such agreements shall comply with the requirements of subdivi-
sion six of section ninety-two-a of the general municipal law].
(5) shall prepare an annual budget for the municipal cooperative
health benefit plan to determine the premium equivalent rates for
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participating municipal corporations to be deposited in the plan's joint
fund or funds during the fiscal year, provided that:
(A) the governing board shall designate the bank or trust company in
which joint funds, including reserve funds, are to be deposited and
which shall be located in this state, duly chartered under federal law
or the laws of this state; and
(B) the governing board shall establish premium equivalent rates for
participating municipal corporations on the [bases] BASIS of a community
rating methodology filed with and approved by the superintendent and, in
determining the annual premium equivalent rates, the governing board:
(i) may contract for necessary actuarial services to estimate expected
plan expenditures during the fiscal year;
(ii) shall maintain reserves in amounts equal to or exceeding the
minimum amounts required by section four thousand seven hundred six of
this article; and
(iii) shall maintain a stop-loss policy or policies, to the extent
required by section four thousand seven hundred seven of this article;
§ 8. Subparagraphs (A) and (B) of paragraph 5 of subsection (a) of
section 4706 of the insurance law, as added by chapter 689 of the laws
of 1994, are amended to read as follows:
(A) five percent of the annualized earned premium equivalents during
the current fiscal year of a municipal cooperative health benefit plan
which consists of [five] TWO or more participating municipal corpo-
rations and covers [two thousand] FIVE HUNDRED or more employees and
retirees; or
(B) seven percent of the annualized earned premium equivalents during
the current fiscal year of the municipal cooperative health benefit plan
which consists of [four] TWO or fewer participating municipal corpo-
rations or covers fewer than [two thousand] FIVE HUNDRED employees and
retirees.
§ 9. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become a law.