Limits certain rate filings for individual and small group health insurance policies and individual and small group health insurance contracts with non-profit medical and dental indemnity, or health and hospital service corporations when such rate filing would cause a change in excess of 10% during any year.
STATE OF NEW YORK
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5198
2011-2012 Regular Sessions
IN ASSEMBLY
February 14, 2011
___________
Introduced by M. of A. BARCLAY, CALHOUN, SAYWARD -- Multi-Sponsored by
-- M. of A. BURLING, CONTE, CROUCH, FINCH, GIGLIO, HAYES, McDONOUGH,
RAIA, TEDISCO -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to rate filings for
health insurance
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subparagraph (B) of paragraph 2 of subsection (e) of
2 section 3231 of the insurance law, as amended by chapter 107 of the laws
3 of 2010, is relettered subparagraph (C) and a new subparagraph (B) is
4 added to read as follows:
5 (B) Beginning April first, two thousand twelve, no rate increase or
6 decrease may be deemed approved under this subsection if that increase
7 or decrease, together with any other rate increases or decreases imposed
8 on the same policy form, would cause the aggregate rate increase or
9 decrease for that policy form to exceed ten percent during any contin-
10 uous twelve month period. No rate increase may be imposed unless at
11 least thirty days advance written notice of such increase has been
12 provided to each policyholder, employee and member.
13 § 2. Paragraph 2 of subsection (g) of section 4308 of the insurance
14 law, as amended by chapter 107 of the laws of 2010, is amended to read
15 as follows:
16 (2) [Prior to January] Beginning April first, two thousand twelve, no
17 rate increase or decrease may be deemed approved under this subsection
18 if that increase or decrease, together with any other rate increases or
19 decreases imposed on the same contract form, would cause the aggregate
20 rate increase or decrease for that contract form to exceed ten percent
21 during any continuous twelve month period. No rate increase may be
22 imposed pursuant to this subsection unless at least thirty days advance
23 written notice of such increase has been provided to each contract hold-
24 er and subscriber.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD08761-01-1
A. 5198 2
1 § 3. (a) The superintendent of insurance shall undertake a study of
2 existing mandated health insurance benefits. The study shall include, at
3 a minimum and to the extent that information is available, the follow-
4 ing:
5 (1) The extent to which the treatment or service is utilized by a
6 significant portion of the population;
7 (2) The extent to which the treatment or service is available to the
8 population;
9 (3) The extent to which the mandated insurance coverage has increased
10 or decreased the cost of the treatment or service over the past five
11 years;
12 (4) The extent to which the mandated insurance coverage has affected
13 the number and types of providers of the mandated treatment or service
14 over the past five years;
15 (5) The extent to which insurance coverage of the health care service
16 or provider has increased or decreased the insurance premium and admin-
17 istrative expenses of policyholders;
18 (6) The impact of indirect costs, which are costs other than premiums
19 and administrative costs, on the question of the costs and benefits of
20 coverage;
21 (7) The impact of this coverage on the total cost of health care; and
22 (8) The effects on the cost of health care to employers and employees.
23 (b) The superintendent of insurance shall further consider:
24 (1) The extent to which the need for mandated benefits outweighs the
25 costs associated with the mandate; and
26 (2) The advisability of mandating the availability of benefits which
27 are presently mandated.
28 (c) The superintendent of insurance shall forward a report of the
29 study to the legislature on or before December 31, 2012.
30 § 4. This act shall take effect immediately.
