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S05928 Summary:

S05928 Actions:

S05928 Committee Votes:

S05928 Floor Votes:

S05928 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5928--A
 
                               2015-2016 Regular Sessions
 
                    IN SENATE
 
                                      June 12, 2015
                                       ___________
 
        Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
          printed to be  committed  to  the  Committee  on  Rules  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee
 
        AN  ACT to amend the insurance law, in relation to catastrophic or rein-
          surance coverage issued to certain small groups; and providing for the
          repeal of such provisions upon the expiration thereof
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraph 1 of subsection (h) of section 3231 of the insur-
     2  ance  law,  as  added  by chapter 501 of the laws of 1992, is amended to
     3  read as follows:
     4    (1) Notwithstanding any other provision of this chapter,  no  insurer,
     5  subsidiary  of  an  insurer,  or  controlled person of a holding company
     6  system may act as an administrator or claims paying agent, as opposed to
     7  an insurer, on behalf of small groups which, if  they  purchased  insur-
     8  ance,  would  be  subject  to this section. No insurer, subsidiary of an
     9  insurer, or controlled person of a  holding  company  may  provide  stop
    10  loss,  catastrophic  or  reinsurance  coverage to small groups which, if
    11  they purchased insurance, would be subject to this section.    Provided,
    12  however,  the provisions of this paragraph shall not apply to stop loss,
    13  catastrophic or reinsurance coverage issued and in effect on  or  before
    14  June  first,  two  thousand  fifteen  to  small  groups covering between
    15  fifty-one and one hundred employees or members of the group.
    16    § 2. Paragraph 1 of subsection (e) of section 4317  of  the  insurance
    17  law,  as  amended  by  section 72 of part D of chapter 56 of the laws of
    18  2013, is amended to read as follows:
    19    (1) Notwithstanding any other provision of this chapter,  no  insurer,
    20  subsidiary  of  an  insurer,  or  controlled person of a holding company
    21  system may act as an administrator or claims paying agent, as opposed to
    22  an insurer, on behalf of small groups which, if  they  purchased  insur-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11569-11-5
        S. 5928--A                          2
 
     1  ance,  would  be  subject  to this section. No insurer, subsidiary of an
     2  insurer, or controlled person of a  holding  company  may  provide  stop
     3  loss,  catastrophic  or  reinsurance  coverage to small groups which, if
     4  they  purchased  insurance,  would be subject to this section. Provided,
     5  however, the provisions of this paragraph shall not apply to stop  loss,
     6  catastrophic  or  reinsurance coverage issued and in effect on or before
     7  June first, two  thousand  fifteen  to  small  groups  covering  between
     8  fifty-one and one hundred employees or members of the group.
     9    §  3.  Paragraph  1 of subsection (g) of section 3231 of the insurance
    10  law, as amended by section 70 of part D of chapter 56  of  the  laws  of
    11  2013, is amended to read as follows:
    12    (1)  This  section  shall  also  apply  to  policies issued to a group
    13  defined in subsection (c) of section four thousand two  hundred  thirty-
    14  five  of  this  chapter,  including but not limited to an association or
    15  trust of employers, if the group includes one or more  member  employers
    16  or  other  member  groups which have fifty or fewer employees or members
    17  exclusive of spouses and dependents. For policies issued or  renewed  on
    18  or after January first, two thousand fourteen, if the group includes one
    19  or  more  member  small group employers eligible for coverage subject to
    20  this section, then such member employers shall be  classified  as  small
    21  groups  for  rating  purposes  and  the remaining members shall be rated
    22  consistent with the rating rules applicable to  such  remaining  members
    23  pursuant  to  paragraph  two  of this subsection. Provided, however this
    24  subsection shall not apply to groups which have been issued a policy  on
    25  or  before  July first, two thousand fifteen, and have member employers,
    26  who, on or after such date,  have  between  fifty-one  and  one  hundred
    27  employees, exclusive of spouses and dependents, and the group is either:
    28  (i)  organized  pursuant  to article five-G of the general municipal law
    29  and is comprised entirely of  one  or  more  municipal  corporations  or
    30  districts  (as  such terms are defined in section one hundred nineteen-n
    31  of the general municipal law); or (ii) comprised entirely  of  nonpublic
    32  schools  providing  education in any grade from pre-kindergarten through
    33  twelfth grade. For such groups which have been issued  a  policy  on  or
    34  before  July  first,  two  thousand  fifteen,  the applicability of this
    35  subsection shall continue irrespective of whether the  group  selects  a
    36  policy  from  a  different  insurer  or if the member employer selects a
    37  different group for such coverage.
    38    § 4. Paragraph 1 of subsection (d) of section 4317  of  the  insurance
    39  law,  as  amended  by  section 72 of part D of chapter 56 of the laws of
    40  2013, is amended to read as follows:
    41    (1) This section shall also apply to a  contract  issued  to  a  group
    42  defined  in  subsection (c) of section four thousand two hundred thirty-
    43  five of this chapter, including but not limited  to  an  association  or
    44  trust  of  employers, if the group includes one or more member employers
    45  or other member groups which have fifty or fewer  employees  or  members
    46  exclusive  of spouses and dependents. For contracts issued or renewed on
    47  or after January first, two thousand fourteen, if the group includes one
    48  or more member small group employers eligible for  coverage  subject  to
    49  this  section,  then  such member employers shall be classified as small
    50  groups for rating purposes and the  remaining  members  shall  be  rated
    51  consistent  with  the  rating rules applicable to such remaining members
    52  pursuant to paragraph two of this subsection.   Provided,  however  this
    53  subsection  shall not apply to groups which have been issued a policy on
    54  or before July first, two thousand fifteen, and have  member  employers,
    55  who,  on  or  after  such  date,  have between fifty-one and one hundred
    56  employees, exclusive of spouses and dependents, and the group is either:
        S. 5928--A                          3
 
     1  (i) organized pursuant to article five-G of the  general  municipal  law
     2  and  are  comprised  entirely  of  one or more municipal corporations or
     3  districts (as such terms are defined in section one  hundred  nineteen-n
     4  of  the  general municipal law); or (ii) comprised entirely of nonpublic
     5  schools providing education in any grade from  pre-kindergarten  through
     6  twelfth  grade.  For  such  groups which have been issued a policy on or
     7  before July first, two  thousand  fifteen,  the  applicability  of  this
     8  subsection  shall  continue  irrespective of whether the group selects a
     9  policy from a different insurer or if  the  member  employer  selects  a
    10  different group for such coverage.
    11    §  5.  This  act  shall  take  effect immediately; and shall be deemed
    12  repealed 5 years after it shall have become a law.