Requires insurers providing family health insurance coverage to offer coverage for the domestic partner of an insured person according to qualification standards to be adopted by the superintendent.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A2807
SPONSOR: O'Donnell (MS) TITLE OF BILL: An act to amend the insurance law, in relation to
health insurance benefits for domestic partners
PURPOSE OR GENERAL IDEA OF BILL: This bill would require a health
plan to provide health insurance coverage for domestic partners, when
such coverage is requested by an employer group or individual purchasing
health insurance, but does not impose any mandates on employers.
SUMMARY OF SPECIFIC PROVISIONS: Sections one and two of the bill
amend Insurance Law §3216, which governs individual accident and health
insurance policies. Section one of the bill amends paragraph 3 of
subsection (a) by revising the definition of family and adding a defi-
nition of domestic partner. Section two of the bill requires the super-
intendent of insurance to promulgate regulations that establish quali-
fication standards for domestic partners under commercial health
insurance policies issued to individuals. Such regulations shall limit
coverage to one domestic partner and provide coverage for children of
domestic partners of the insured. The regulations shall also provide for
various forms of proof of domestic partnership as well as notification
procedures to the insurer of the termination of a domestic partnership.
Sections 3, 4, and 5 of the bill make similar changes to Insurance law
§§ 3221, 4304, and 4305 with respect to health coverage policies issued
by commercial insurers to groups, and to individual and group coverage
issued by non-profit insurers and HMOs. Section 6 of the bill is the
effective date.
JUSTIFICATION: Current law and regulations permit insurers, non-pro-
fit health plans and HMOs to offer health insurance coverage for domes-
tic partners. Many insurers and health plans, however, refuse to
provide domestic partner coverage to individuals and smaller employer
groups. This legislation would allow employer groups and individuals to
successfully request that their health plan provide benefits to quali-
fied domestic partners. The bill does not impose any mandates on employ-
ers. This legislation also includes safeguards to prevent abuse of the
new domestic partnership provisions by requiring qualification standards
for domestic partners and prohibiting coverage of more than one domestic
partner at the same time.
PRIOR LEGISLATIVE HISTORY: A.2368-B/S.960-B (2009-2010: passed Assem-
bly both years); A.3251-A/S.3873 (2007-08: passed Assembly both years;
technical amendment made in the Assembly in 2008 but not in the Senate);
A.22241S.5635 (2005-06; passed Assembly both years); Al 1464 (2004;
passed Assembly).
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
2807
2011-2012 Regular Sessions
IN ASSEMBLY
January 20, 2011
___________
Introduced by M. of A. O'DONNELL, BING, GOTTFRIED, KAVANAGH, ROSENTHAL,
MILLMAN, HEASTIE -- Multi-Sponsored by -- M. of A. GLICK, HOYT, KELL-
NER, LIFTON, McENENY, PERRY, PHEFFER, SWEENEY -- read once and
referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to health insurance bene-
fits for domestic partners
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph 3 of subsection (a) of section 3216 of the insur-
2 ance law is amended and a new paragraph 5 is added to read as follows:
3 (3) "Family" may include husband, wife, domestic partner or dependent
4 children, or any other person dependent upon the policyholder.
5 (5) "Domestic partner" shall mean a person who with respect to another
6 person:
7 (A) is formally a party in a domestic partnership or similar relation-
8 ship with the other person, entered into pursuant to the laws of the
9 United States or of any state, local or foreign jurisdiction, or regis-
10 tered as the domestic partner of the other person with any registry
11 maintained by the employer of either party or any state, municipality,
12 or foreign jurisdiction; or
13 (B) is dependent or mutually interdependent on the other person for
14 support, as evidenced by the totality of the circumstances indicating a
15 mutual intent to be domestic partners including, but not limited to:
16 common ownership or joint leasing of real or personal property; common
17 householding, shared income or shared expenses; children in common;
18 signs of intent to marry or become domestic partners; or the length of
19 the personal relationship of the persons.
20 § 2. Paragraph 4 of subsection (c) of section 3216 of the insurance
21 law is amended by adding a new subparagraph (D) to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05722-01-1
A. 2807 2
1 (D) The superintendent shall, within one hundred eighty days of the
2 effective date of this subparagraph, provide for qualification standards
3 for domestic partner benefits by regulation. Such regulations:
4 (i) shall prohibit the coverage of more than one domestic partner at
5 the same time under a family contract, or coverage of a domestic partner
6 of an insured or certificate holder who is also married, or coverage as
7 a domestic partner of anyone less than eighteen years of age or any
8 person who is related to the other person by blood in a manner that
9 would bar marriage to the other person in New York state;
10 (ii) shall provide for the coverage of a dependent child of a domestic
11 partner under the same terms and conditions as would apply to a depend-
12 ent child of the insured or certificate holder or spouse of such insured
13 or certificate holder;
14 (iii) shall include a provision which deems as qualified any person
15 who submits proof that he or she is formally a party to a domestic part-
16 nership, or similar relationship, entered into with the insured or
17 certificate holder pursuant to the laws of the United States or of any
18 state, local or foreign jurisdiction;
19 (iv) shall, as an alternative to clause (iii) of this subparagraph,
20 provide for other means of demonstrating a domestic partner relationship
21 including, but not limited to, an affidavit attesting to the relation-
22 ship;
23 (v) shall provide for reasonable procedures for notification of the
24 corporation by the insured or certificate holder of the end of the
25 domestic partner relationship;
26 (vi) may, for persons who are not deemed as qualified pursuant to
27 clause (iii) or (iv) of this subparagraph, include provisions requiring
28 prior cohabitation of the insured or certificate holder and the domestic
29 partner, provided that such period of required cohabitation may not
30 exceed six months; and
31 (vii) may, for persons who are not deemed as qualified pursuant to
32 clause (iii) or (iv) of this subparagraph, require the submission of
33 reasonable documentation of residence and financial interdependence of
34 the kind commonly available to married persons including, but not limit-
35 ed to, income tax returns, passports, drivers' licenses, utility bills,
36 leases, deeds, joint banking and credit card accounts, retirement
37 accounts and insurance policies and benefit statements.
38 § 3. Section 3221 of the insurance law is amended by adding two new
39 subsections (s) and (t) to read as follows:
40 (s) A group policy providing hospital, surgical or medical expense
41 insurance other than accident only to a family member of the policy or
42 certificate holder must, if requested by the policyholder, make avail-
43 able and, if requested by the insured or certificate holder, provide
44 coverage for the domestic partner of the insured or certificate holder.
45 For the purposes of this section, "domestic partner" shall mean a person
46 who with respect to another person:
47 (1) is formally a party in a domestic partnership or similar relation-
48 ship with the other person, entered into pursuant to the laws of the
49 United States or of any state, local or foreign jurisdiction, or regis-
50 tered as the domestic partner of the other person with any registry
51 maintained by the employer of either party or any state, municipality,
52 or foreign jurisdiction; or
53 (2) is dependent or mutually interdependent on the other person for
54 support, as evidenced by the totality of the circumstances indicating a
55 mutual intent to be domestic partners including but not limited to:
56 common ownership or joint leasing of real or personal property; common
A. 2807 3
1 householding, shared income or shared expenses; children in common;
2 signs of intent to marry or become domestic partners or the length of
3 the personal relationship of the persons.
4 (t) The superintendent shall, within one hundred eighty days of the
5 effective date of this subsection, provide for qualification standards
6 for domestic partner benefits by regulation. Such regulations:
7 (1) shall prohibit the coverage of more than one domestic partner at
8 the same time under a family contract, or coverage of a domestic partner
9 of an insured or certificate holder who is also married, or coverage as
10 a domestic partner of anyone less than eighteen years of age or any
11 person who is related to the other person by blood in a manner that
12 would bar marriage to the other person in New York state;
13 (2) shall provide for the coverage of a dependent child of a domestic
14 partner under the same terms and conditions as would apply to a depend-
15 ent child of the insured or certificate holder or spouse of such insured
16 or certificate holder;
17 (3) shall include a provision which deems as qualified any person who
18 submits proof that he or she is formally a party to a domestic partner-
19 ship, or similar relationship, entered into with the insured or certif-
20 icate holder pursuant to the laws of the United States, or of any state,
21 local or foreign jurisdiction;
22 (4) shall, as an alternative to paragraph three of this subsection,
23 provide for other means of demonstrating a domestic partner relationship
24 including, but not limited to, an affidavit attesting to the relation-
25 ship;
26 (5) shall provide for reasonable procedures for notification of the
27 insurer by the insured or certificate holder of the end of the domestic
28 partner relationship;
29 (6) may, for persons not deemed as qualified pursuant to paragraph
30 three or four of this subsection, include provisions requiring prior
31 cohabitation of the insured or certificate holder and the domestic part-
32 ner, provided that such period of required cohabitation may not exceed
33 six months; and
34 (7) may, for persons not deemed as qualified pursuant to paragraph
35 three or four of this subsection, require the submission of reasonable
36 documentation of residence and financial interdependence of the kind
37 commonly available to married persons including, but not limited to,
38 income tax returns, passports, drivers' licenses, utility bills, leases,
39 deeds, joint banking and credit card accounts, retirement accounts and
40 insurance policies and benefit statements.
41 § 4. Subparagraph (A) of paragraph 1 of subsection (d) of section 4304
42 of the insurance law, as amended by chapter 240 of the laws of 2009, is
43 amended and two new paragraphs 4 and 5 are added to read as follows:
44 (A) No contract issued pursuant to this section shall entitle more
45 than one person to benefits except that a contract issued and marked as
46 a "family contract" may provide that benefits will be furnished to a
47 husband and wife, or husband, wife or domestic partner and their depend-
48 ent child or children, or any child or children not over nineteen years
49 of age, provided that an unmarried student at an accredited institution
50 of learning may be considered a dependent until he or she becomes twen-
51 ty-three years of age, provided that the coverage of any such "family
52 contract" may include, at the option of the insurer, any unmarried child
53 until attaining age twenty-five, and provided also that the coverage of
54 any such "family contract" shall include any other unmarried child,
55 regardless of age, who is incapable of self-sustaining employment by
56 reason of mental illness, developmental disability, mental retardation,
A. 2807 4
1 as defined in the mental hygiene law, or physical handicap and who
2 became so incapable prior to attainment of the age at which dependent
3 coverage would otherwise terminate, so that such child may be considered
4 a dependent.
5 (4) A hospital service corporation or health service corporation which
6 provides a "family contract" to an individual or a group must, if
7 requested by the policyholder, make available and, if requested by the
8 insured or certificate holder, provide coverage for the domestic partner
9 of the insured or certificate holder. For the purposes of this section,
10 "domestic partner" shall mean a person who with respect to another
11 person:
12 (A) is formally a party in a domestic partnership or similar relation-
13 ship with the other person, entered into pursuant to the laws of the
14 United States or of any state, local or foreign jurisdiction, or regis-
15 tered as the domestic partner of the other person with any registry
16 maintained by the employer of either party or any state, municipality,
17 or foreign jurisdiction; or
18 (B) is dependent or mutually interdependent on the other person for
19 support, as evidenced by the totality of the circumstances indicating a
20 mutual intent to be domestic partners including but not limited to:
21 common ownership or joint leasing of real or personal property; common
22 householding, shared income or shared expenses; children in common;
23 signs of intent to marry or become domestic partners; or the length of
24 the personal relationship of the persons.
25 (5) The superintendent shall, within one hundred eighty days of the
26 effective date of this paragraph, provide for qualification standards
27 for domestic partner benefits by regulation. Such regulation:
28 (A) shall prohibit the coverage of more than one domestic partner at
29 the same time under a family contract, or coverage of a domestic partner
30 of an insured or certificate holder who is also married, or coverage as
31 a domestic partner of anyone less than eighteen years of age or any
32 person who is related to the other person by blood in a manner that
33 would bar marriage to the other person in New York state;
34 (B) shall provide for the coverage of a dependent child of a domestic
35 partner under the same terms and conditions as would apply to a depend-
36 ent child of the insured or certificate holder or spouse of such insured
37 or certificate holder;
38 (C) shall include a provision which deems as qualified any person who
39 submits proof that he or she is formally a party to a domestic partner-
40 ship, or similar relationship, entered into with the insured or certif-
41 icate holder pursuant to the laws of the United States or of any state,
42 local or foreign jurisdiction;
43 (D) shall, as an alternative to subparagraph (C) of this paragraph,
44 provide for other means of demonstrating a domestic partner relationship
45 including, but not limited to, an affidavit attesting to the relation-
46 ship;
47 (E) shall provide for reasonable procedures for notification of the
48 corporation by the insured or certificate holder of the end of the
49 domestic partner relationship;
50 (F) may, for persons not deemed as qualified pursuant to subparagraph
51 (C) or (D) of this paragraph, include provisions requiring prior cohabi-
52 tation of the insured or certificate holder and the domestic partner,
53 provided that such period of required cohabitation may not exceed six
54 months; and
55 (G) may, for persons not deemed as qualified pursuant to subparagraph
56 (C) or (D) of this paragraph, require the submission of reasonable
A. 2807 5
1 documentation of residence and financial interdependence of the kind
2 commonly available to married persons including, but not limited to,
3 income tax returns, passports, drivers' licenses, utility bills, leases,
4 deeds, joint banking and credit card accounts, retirement accounts and
5 insurance policies and benefit statements.
6 § 5. Subparagraphs (A) and (C) of paragraph 1 of subsection (c) of
7 section 4305 of the insurance law, as amended by chapter 240 of the laws
8 of 2009, are amended and two new paragraphs 3 and 4 are added to read as
9 follows:
10 (A) Any such contract may provide that benefits will be furnished to a
11 member of a covered group, for [himself, his spouse, his] such member
12 and the spouse, domestic partner, child or children of such member, or
13 other persons chiefly dependent upon him or her for support and mainte-
14 nance; provided that a contract under which coverage of a dependent of a
15 member terminates at a specified age shall, with respect to an unmarried
16 child who is incapable of self-sustaining employment by reason of mental
17 illness, developmental disability, mental retardation, as defined in the
18 mental hygiene law, or physical handicap and who became so incapable
19 prior to attainment of the age at which dependent coverage would other-
20 wise terminate and who is chiefly dependent upon such member for support
21 and maintenance, not so terminate while the contract remains in force
22 and the dependent remains in such condition, if the member has within
23 thirty-one days of such dependent's attainment of the termination age
24 submitted proof of such dependent's incapacity as described herein.
25 (C) Notwithstanding any rule, regulation or law to the contrary, any
26 contract under which a member elects coverage for [himself, his spouse,
27 his] such member and the spouse, domestic partner, children or other
28 persons chiefly dependent upon him or her for support and maintenance
29 shall provide that coverage of newborn infants, including newly born
30 infants adopted by the insured or subscriber if such insured or
31 subscriber takes physical custody of the infant upon such infant's
32 release from the hospital and files a petition pursuant to section one
33 hundred fifteen-c of the domestic relations law within thirty days of
34 birth; and provided further that no notice of revocation to the adoption
35 has been filed pursuant to section one hundred fifteen-b of the domestic
36 relations law and consent to the adoption has not been revoked, shall be
37 effective from the moment of birth for injury or sickness including the
38 necessary care and treatment of medically diagnosed congenital defects
39 and birth abnormalities including premature birth, except that in cases
40 of adoption, coverage of the initial hospital stay shall not be required
41 where a birth parent has insurance coverage available for the infant's
42 care. This provision regarding coverage of newborn infants shall not
43 apply to two person coverage. In the case of individual or two person
44 coverages the corporation must also permit the person to whom the
45 certificate is issued to elect such coverage of newborn infants from the
46 moment of birth. If notification and/or payment of an additional premium
47 or contribution is required to make coverage effective for a newborn
48 infant, the coverage may provide that such notice and/or payment be made
49 within no less than thirty days of the day of birth to make coverage
50 effective from the moment of birth. This election shall not be required
51 in the case of student insurance or where the group's plan does not
52 provide coverage for dependent children.
53 (3) A hospital service corporation or health service corporation which
54 provides a "family contract" to an individual or a group must, if
55 requested by the policyholder, make available and, if requested by the
56 insured or certificate holder, provide coverage for the domestic partner
A. 2807 6
1 of the insured or certificate holder. For the purposes of this section,
2 "domestic partner" shall mean a person who with respect to another
3 person:
4 (A) is formally a party in a domestic partnership or similar relation-
5 ship with the other person, entered into pursuant to the laws of the
6 United States or of any state, local or foreign jurisdiction, or regis-
7 tered as the domestic partner of the other person with any registry
8 maintained by the employer of either party or any state, municipality,
9 or foreign jurisdiction; or
10 (B) is dependent or mutually interdependent on the other person for
11 support, as evidenced by the totality of the circumstances indicating a
12 mutual intent to be domestic partners including, but not limited to:
13 common ownership or joint leasing of real or personal property; common
14 householding, shared income or shared expenses; children in common;
15 signs of intent to marry or become domestic partners; or the length of
16 the personal relationship of the persons.
17 (4) The superintendent shall, within one hundred eighty days of the
18 effective date of this paragraph, provide for qualification standards
19 for domestic partner benefits by regulation. Such regulations:
20 (A) shall prohibit the coverage of more than one domestic partner at
21 the same time under a family contract, or coverage of a domestic partner
22 of an insured or certificate holder who is also married, or coverage as
23 a domestic partner of anyone less than eighteen years of age or any
24 person who is related to the other person by blood in a manner that
25 would bar marriage to the other person in New York state;
26 (B) shall provide for the coverage of a dependent child of a domestic
27 partner under the same terms and conditions as would apply to a depend-
28 ent child of the insured or certificate holder or spouse of such insured
29 or certificate holder;
30 (C) shall include a provision which deems as qualified any person who
31 submits proof that he or she is formally a party to a domestic partner-
32 ship, or similar relationship, entered into with the insured or certif-
33 icate holder pursuant to the laws of the United States, or of any state,
34 local or foreign jurisdiction;
35 (D) shall, as an alternative to subparagraph (C) of this paragraph,
36 provide for other means of demonstrating a domestic partner relationship
37 including, but not limited to, an affidavit attesting to the relation-
38 ship;
39 (E) shall provide for reasonable procedures for notification of the
40 corporation by the insured or certificate holder of the end of the
41 domestic partner relationship;
42 (F) may, for persons not deemed as qualified pursuant to subparagraph
43 (C) or (D) of this paragraph, include provisions requiring prior cohabi-
44 tation of the insured or certificate holder and the domestic partner,
45 provided that such period of required cohabitation may not exceed six
46 months; and
47 (G) may, for persons not deemed as qualified pursuant to subparagraph
48 (C) or (D) of this paragraph, require the submission of reasonable
49 documentation of residence and financial interdependence of the kind
50 commonly available to married persons including, but not limited to,
51 income tax returns, passports, drivers' licenses, utility bills, leases,
52 deeds, joint banking and credit card accounts, retirement accounts and
53 insurance policies and benefit statements.
54 § 6. This act shall take effect immediately.
