Assembly Bill A9270

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9270
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             November 21, 2025
                                ___________
 
 Introduced by M. of A. HUNTER -- read once and referred to the Committee
   on Insurance
 
 AN  ACT  to  amend the insurance law, in relation to extending dependent
   child coverage for certain individuals to age twenty-nine
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Item (iii) of subparagraph (A) of paragraph 4 of subsection
 (a)  of  section 3216 of the insurance law, as amended by chapter 219 of
 the laws of 2011, is amended and a new subparagraph  (iv)  is  added  to
 read as follows:
   (iii)  Any  married or unmarried child shall be considered a dependent
 child until attaining age twenty-six without regard to financial depend-
 ence, residency with the policyholder, student  status,  or  employment,
 for  a  policy  of  hospital,  medical,  surgical,  or prescription drug
 expense insurance[.]; OR
   (IV) ANY UNMARRIED CHILD WHO IS NOT  ELIGIBLE  FOR  EMPLOYER-SPONSORED
 HEALTH  CARE,  NOT ENROLLED IN MEDICARE, AND WHO LIVES, WORKS OR RESIDES
 IN NEW YORK STATE OR THE SERVICE AREA OF THE INSURER SHALL BE CONSIDERED
 A DEPENDENT CHILD UNTIL ATTAINING  AGE  TWENTY-NINE  WITHOUT  REGARD  TO
 FINANCIAL  DEPENDENCE,  RESIDENCY WITH THE POLICYHOLDER, STUDENT STATUS,
 OR  EMPLOYMENT,  FOR  A  POLICY  OF  HOSPITAL,  MEDICAL,  SURGICAL,   OR
 PRESCRIPTION DRUG EXPENSE INSURANCE.
   §  2.  Clause (i) of subparagraph (A) of paragraph 1 of subsection (f)
 of section 4235 of the insurance law, as amended by chapter 219  of  the
 laws  of  2011,  is  amended  and a new clause (i-a) is added to read as
 follows:
   (i) a policy of hospital,  medical,  surgical,  or  prescription  drug
 expense insurance that provides coverage for children shall provide such
 coverage  to  a married or unmarried child until attainment of age twen-
 ty-six, without regard  to  financial  dependence,  residency  with  the
 employee  or member, student status, or employment, except a policy that
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD14021-01-5
              

 A. 9270                             2
 
 is a grandfathered health plan may,  for  plan  years  beginning  before
 January first, two thousand fourteen, exclude coverage of an adult child
 under  age twenty-six who is eligible to enroll in an employer-sponsored
 health  plan other than a group health plan of a parent. For purposes of
 this [item] clause, "grandfathered health plan" means coverage  provided
 by an insurer in which an individual was enrolled on March twenty-third,
 two  thousand  ten  for  as long as the coverage maintains grandfathered
 status in accordance with section 1251(e) of the Affordable Care Act, 42
 U.S.C. § 18011(e); [and]
   (I-A) A POLICY OF HOSPITAL, MEDICAL, SURGICAL,  OR  PRESCRIPTION  DRUG
 EXPENSE INSURANCE THAT PROVIDES COVERAGE FOR CHILDREN SHALL PROVIDE SUCH
 COVERAGE  TO  AN  UNMARRIED CHILD WHO IS NOT ELIGIBLE FOR EMPLOYER-SPON-
 SORED HEALTH CARE, NOT ENROLLED IN MEDICARE, AND  WHO  LIVES,  WORKS  OR
 RESIDES  IN  NEW  YORK  STATE  OR  THE SERVICE AREA OF THE INSURER UNTIL
 ATTAINMENT OF AGE TWENTY-NINE WITHOUT REGARD  TO  FINANCIAL  DEPENDENCE,
 RESIDENCY  WITH  THE  EMPLOYEE OR MEMBER, STUDENT STATUS, OR EMPLOYMENT;
 AND
   § 3. Item (i) of subparagraph (A) of paragraph 1 of subsection (d)  of
 section 4304 of the insurance law, as amended by chapter 219 of the laws
 of 2011, is amended to read as follows:
   (i)  A "family contract" may provide coverage to any child or children
 not over nineteen years of age, provided that an unmarried student at an
 accredited institution of learning may be considered a  dependent  until
 the  child becomes twenty-three years of age, and provided also that the
 coverage of any such "family contract" may include, at the option of the
 corporation,  any  unmarried  child  until  attaining  age  twenty-five.
 However,   a  "family  contract"  of  hospital,  medical,  surgical,  or
 prescription drug expense insurance that provides coverage for dependent
 children shall provide such coverage to a  married  or  unmarried  child
 until  attainment  of age twenty-six without regard to financial depend-
 ence, residency with the contract holder, student status, or employment.
 PROVIDED FURTHER, HOWEVER, A "FAMILY  CONTRACT"  OF  HOSPITAL,  MEDICAL,
 SURGICAL,  OR PRESCRIPTION DRUG EXPENSE INSURANCE THAT PROVIDES COVERAGE
 FOR DEPENDENT CHILDREN SHALL PROVIDE SUCH COVERAGE TO AN UNMARRIED CHILD
 WHO IS NOT ELIGIBLE FOR EMPLOYER-SPONSORED HEALTH CARE, NOT ENROLLED  IN
 MEDICARE,  AND  WHO  LIVES,  WORKS  OR  RESIDES IN NEW YORK STATE OR THE
 SERVICE AREA OF THE CORPORATION  UNTIL  ATTAINMENT  OF  AGE  TWENTY-NINE
 WITHOUT  REGARD  TO  FINANCIAL  DEPENDENCE,  RESIDENCY WITH THE CONTRACT
 HOLDER, STUDENT STATUS, OR EMPLOYMENT.
   § 4. Item (i) of subparagraph (A) of paragraph 1 of subsection (c)  of
 section 4305 of the insurance law, as amended by chapter 219 of the laws
 of 2011, is amended and a new item (i-a) is added to read as follows:
   (i)  a  contract  of hospital, medical, surgical, or prescription drug
 expense insurance that provides coverage for children shall provide such
 coverage to a married or unmarried child until attainment of  age  twen-
 ty-six,  without  regard  to  financial  dependence,  residency with the
 member, student status, or employment,  except  a  contract  that  is  a
 grandfathered  health  plan may, for plan years beginning before January
 first, two thousand fourteen, exclude coverage of an adult  child  under
 age twenty-six who is eligible to enroll in an employer-sponsored health
 plan  other  than  a group health plan of a parent. For purposes of this
 item, "grandfathered health plan" means coverage provided  by  a  corpo-
 ration  in  which  an individual was enrolled on March twenty-third, two
 thousand ten for as long as the coverage maintains grandfathered  status
 in accordance with section 1251(e) of the Affordable Care Act, 42 U.S.C.
 § 18011(e); [and]
 A. 9270                             3
 
   (I-A)  A CONTRACT OF HOSPITAL, MEDICAL, SURGICAL, OR PRESCRIPTION DRUG
 EXPENSE INSURANCE THAT PROVIDES COVERAGE FOR CHILDREN SHALL PROVIDE SUCH
 COVERAGE TO AN UNMARRIED CHILD WHO IS NOT  ELIGIBLE  FOR  EMPLOYER-SPON-
 SORED  HEALTH  CARE,  NOT  ENROLLED IN MEDICARE, AND WHO LIVES, WORKS OR
 RESIDES  IN  NEW YORK STATE OR THE SERVICE AREA OF THE CORPORATION UNTIL
 ATTAINMENT OF AGE TWENTY-NINE WITHOUT REGARD  TO  FINANCIAL  DEPENDENCE,
 RESIDENCY WITH THE CONTRACT HOLDER, STUDENT STATUS, OR EMPLOYMENT; AND
   §  5.  This  act  shall take effect immediately and shall apply to all
 policies and contracts entered into, renewed, modified or amended on  or
 after such effective date.