S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8850
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               June 9, 2025
                                ___________
 
 Introduced by M. of A. ROMERO -- read once and referred to the Committee
   on Insurance
 
 AN  ACT  to  amend the insurance law, in relation to circumstances under
   which a consumer may be subject to a new special open enrollment peri-
   od to choose a new health insurance plan

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraphs 4 and 5 of subsection (b) of section 3217 of the
 insurance  law  are  amended  and  a new paragraph 6 is added to read as
 follows:
   (4) elimination of provisions which may be contrary to the health care
 needs of the public, as certified to the superintendent by  the  commis-
 sioner of health; [and]
   (5) elimination of coverages which are so limited in scope as to be of
 no substantial economic value to the holders[.]; AND
   (6)  PROVISION  OF REASONABLE CIRCUMSTANCES UNDER WHICH, IF A CONTRACT
 IS SEVERED WITH ONE OR MORE OF A CONSUMER'S EXISTING HEALTH CARE PROVID-
 ERS UPON NO FAULT OF SUCH CONSUMER, THEN A NEW SPECIAL  OPEN  ENROLLMENT
 PERIOD  SHALL COMMENCE TO ALLOW SUCH CONSUMER AN OPPORTUNITY TO CHOOSE A
 NEW HEALTH INSURANCE PLAN THAT MAY ALLOW FOR CONTINUITY OF CARE WITH  AN
 EXISTING HEALTH CARE PROVIDER; PROVIDED THAT SUCH HEALTH INSURANCE POLI-
 CY  OR  CONTRACT  SHALL  NOT  IMPOSE  A FEE OR OTHER PENALTY FOR SPECIAL
 ENROLLMENT OF SUCH CONSUMER; AND PROVIDED FURTHER THAT UPON  ENROLLMENT,
 COVERAGE  SHALL  BE  EFFECTIVE  NO  LATER  THAN FOURTEEN DAYS AFTER SUCH
 CONSUMER PURCHASES SUCH NEW HEALTH INSURANCE POLICY.
   § 2. Subsections (l), (m), (n) and (o) of section 4306 of  the  insur-
 ance law, subsection (n) as added by chapter 237 of the laws of 2009 and
 subsection (o) as amended by chapter 29 of the laws of 2023, are amended
 and a new subsection (p) is added to read as follows:

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD13120-01-5
 A. 8850                             2
 
              

   (l)  if  the  contract  contains  any provision purporting to make any
 portion of the articles, constitution or by-laws of  the  corporation  a
 part of the contract, such portion shall be set forth in full; [and]
   (m)  in  every  such  contract made, issued or delivered in this state
 there shall be a brief description of the contract on its first page and
 on its filing back[.];
   (n) a statement that a health care claim from a  subscriber  shall  be
 submitted  within  one  hundred  twenty  days  from the date of service;
 provided, however, that if  it  was  not  reasonably  possible  for  the
 subscriber  to  submit  the  claim within that timeframe, then the claim
 shall be submitted as soon as reasonably possible[.];
   (o) Space shall be provided on  any  enrollment,  renewal  or  initial
 online  portal process setup forms required of a subscriber or applicant
 for coverage, except forms issued by the NY State of Health,  the  offi-
 cial  Health  Plan Marketplace, other than those specifically referenced
 in subparagraph (iv) of paragraph (a) of  subdivision  five  of  section
 forty  three hundred ten and paragraph (v) of subdivision one of section
 two hundred six of the public health law,  so  that  the  subscriber  or
 applicant  for  coverage  shall  register or decline registration in the
 donate life registry for organ, eye  and  tissue  donations  under  this
 section  of  the  enrollment,  renewal  or initial online portal process
 setup forms and that the following is stated on the form  in  clear  and
 conspicuous type:
   "You  must  fill out the following section: Would you like to be added
 to the Donate Life Registry? Check box for 'yes'  or  'skip  this  ques-
 tion'."; AND
   (P)  A  STATEMENT  THAT  IF A CONTRACT IS SEVERED UPON NO FAULT OF THE
 CONSUMER, THAT A SPECIAL OPEN ENROLLMENT PERIOD SHALL BE ALLOWED  PURSU-
 ANT  TO  PARAGRAPH  SIX  OF SUBSECTION (B) OF SECTION THIRTY-TWO HUNDRED
 SEVENTEEN OF THIS CHAPTER.
   § 3. This act shall take effect immediately; provided,  however,  that
 if  chapter  29  of  the  laws of 2023 shall not have taken effect on or
 before such date then the amendments to subsection (o) of  section  4306
 of  the  insurance law made by section two of this act shall take effect
 on the same date and in the same manner as such chapter of the  laws  of
 2023, takes effect.