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: A2368B
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. The A-print corrected a typographical error. The B-print
makes technical amendments to reflect, and conform to, legislation that
chaptered in 2009.
 
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.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
________________________________________________________________________
2368--B
2009-2010 Regular Sessions
IN ASSEMBLY
January 15, 2009
___________
Introduced by M. of A. O'DONNELL, BING, POWELL, GOTTFRIED, KAVANAGH,
ROSENTHAL -- Multi-Sponsored by -- M. of A. GLICK, HOYT, KELLNER,
LIFTON, McENENY, PERRY, PHEFFER, SWEENEY -- read once and referred to
the Committee on Insurance -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee --
reported from committee, advanced to a third reading, amended and
ordered reprinted, retaining its place on the order of third reading
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.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00041-06-0
A. 2368--B 2
1 § 2. Paragraph 4 of subsection (c) of section 3216 of the insurance
2 law is amended by adding a new subparagraph (D) to read as follows:
3 (D) The superintendent shall, within one hundred eighty days of the
4 effective date of this subparagraph, provide for qualification standards
5 for domestic partner benefits by regulation. Such regulations:
6 (i) shall prohibit the coverage of more than one domestic partner at
7 the same time under a family contract, or coverage of a domestic partner
8 of an insured or certificate holder who is also married, or coverage as
9 a domestic partner of anyone less than eighteen years of age or any
10 person who is related to the other person by blood in a manner that
11 would bar marriage to the other person in New York state;
12 (ii) shall provide for the coverage of a dependent child of a domestic
13 partner under the same terms and conditions as would apply to a depend-
14 ent child of the insured or certificate holder or spouse of such insured
15 or certificate holder;
16 (iii) shall include a provision which deems as qualified any person
17 who submits proof that he or she is formally a party to a domestic part-
18 nership, or similar relationship, entered into with the insured or
19 certificate holder pursuant to the laws of the United States or of any
20 state, local or foreign jurisdiction;
21 (iv) shall, as an alternative to clause (iii) of this subparagraph,
22 provide for other means of demonstrating a domestic partner relationship
23 including, but not limited to, an affidavit attesting to the relation-
24 ship;
25 (v) shall provide for reasonable procedures for notification of the
26 corporation by the insured or certificate holder of the end of the
27 domestic partner relationship;
28 (vi) may, for persons who are not deemed as qualified pursuant to
29 clause (iii) or (iv) of this subparagraph, include provisions requiring
30 prior cohabitation of the insured or certificate holder and the domestic
31 partner, provided that such period of required cohabitation may not
32 exceed six months; and
33 (vii) may, for persons who are not deemed as qualified pursuant to
34 clause (iii) or (iv) of this subparagraph, require the submission of
35 reasonable documentation of residence and financial interdependence of
36 the kind commonly available to married persons including, but not limit-
37 ed to, income tax returns, passports, drivers' licenses, utility bills,
38 leases, deeds, joint banking and credit card accounts, retirement
39 accounts and insurance policies and benefit statements.
40 § 3. Section 3221 of the insurance law is amended by adding two new
41 subsections (s) and (t) to read as follows:
42 (s) A group policy providing hospital, surgical or medical expense
43 insurance other than accident only to a family member of the policy or
44 certificate holder must, if requested by the policyholder, make avail-
45 able and, if requested by the insured or certificate holder, provide
46 coverage for the domestic partner of the insured or certificate holder.
47 For the purposes of this section, "domestic partner" shall mean a person
48 who with respect to another person:
49 (1) is formally a party in a domestic partnership or similar relation-
50 ship with the other person, entered into pursuant to the laws of the
51 United States or of any state, local or foreign jurisdiction, or regis-
52 tered as the domestic partner of the other person with any registry
53 maintained by the employer of either party or any state, municipality,
54 or foreign jurisdiction; or
55 (2) is dependent or mutually interdependent on the other person for
56 support, as evidenced by the totality of the circumstances indicating a
A. 2368--B 3
1 mutual intent to be domestic partners including but not limited to:
2 common ownership or joint leasing of real or personal property; common
3 householding, shared income or shared expenses; children in common;
4 signs of intent to marry or become domestic partners or the length of
5 the personal relationship of the persons.
6 (t) The superintendent shall, within one hundred eighty days of the
7 effective date of this subsection, provide for qualification standards
8 for domestic partner benefits by regulation. Such regulations:
9 (1) shall prohibit the coverage of more than one domestic partner at
10 the same time under a family contract, or coverage of a domestic partner
11 of an insured or certificate holder who is also married, or coverage as
12 a domestic partner of anyone less than eighteen years of age or any
13 person who is related to the other person by blood in a manner that
14 would bar marriage to the other person in New York state;
15 (2) shall provide for the coverage of a dependent child of a domestic
16 partner under the same terms and conditions as would apply to a depend-
17 ent child of the insured or certificate holder or spouse of such insured
18 or certificate holder;
19 (3) shall include a provision which deems as qualified any person who
20 submits proof that he or she is formally a party to a domestic partner-
21 ship, or similar relationship, entered into with the insured or certif-
22 icate holder pursuant to the laws of the United States, or of any state,
23 local or foreign jurisdiction;
24 (4) shall, as an alternative to paragraph three of this subsection,
25 provide for other means of demonstrating a domestic partner relationship
26 including, but not limited to, an affidavit attesting to the relation-
27 ship;
28 (5) shall provide for reasonable procedures for notification of the
29 insurer by the insured or certificate holder of the end of the domestic
30 partner relationship;
31 (6) may, for persons not deemed as qualified pursuant to paragraph
32 three or four of this subsection, include provisions requiring prior
33 cohabitation of the insured or certificate holder and the domestic part-
34 ner, provided that such period of required cohabitation may not exceed
35 six months; and
36 (7) may, for persons not deemed as qualified pursuant to paragraph
37 three or four of this subsection, require the submission of reasonable
38 documentation of residence and financial interdependence of the kind
39 commonly available to married persons including, but not limited to,
40 income tax returns, passports, drivers' licenses, utility bills, leases,
41 deeds, joint banking and credit card accounts, retirement accounts and
42 insurance policies and benefit statements.
43 § 4. Subparagraph (A) of paragraph 1 of subsection (d) of section 4304
44 of the insurance law, as amended by chapter 240 of the laws of 2009, is
45 amended and two new paragraphs 4 and 5 are added to read as follows:
46 (A) No contract issued pursuant to this section shall entitle more
47 than one person to benefits except that a contract issued and marked as
48 a "family contract" may provide that benefits will be furnished to a
49 husband and wife, or husband, wife or domestic partner and their depend-
50 ent child or children, or any child or children not over nineteen years
51 of age, provided that an unmarried student at an accredited institution
52 of learning may be considered a dependent until he or she becomes twen-
53 ty-three years of age, provided that the coverage of any such "family
54 contract" may include, at the option of the insurer, any unmarried child
55 until attaining age twenty-five, and provided also that the coverage of
56 any such "family contract" shall include any other unmarried child,
A. 2368--B 4
1 regardless of age, who is incapable of self-sustaining employment by
2 reason of mental illness, developmental disability, mental retardation,
3 as defined in the mental hygiene law, or physical handicap and who
4 became so incapable prior to attainment of the age at which dependent
5 coverage would otherwise terminate, so that such child may be considered
6 a dependent.
7 (4) A hospital service corporation or health service corporation which
8 provides a "family contract" to an individual or a group must, if
9 requested by the policyholder, make available and, if requested by the
10 insured or certificate holder, provide coverage for the domestic partner
11 of the insured or certificate holder. For the purposes of this section,
12 "domestic partner" shall mean a person who with respect to another
13 person:
14 (A) is formally a party in a domestic partnership or similar relation-
15 ship with the other person, entered into pursuant to the laws of the
16 United States or of any state, local or foreign jurisdiction, or regis-
17 tered as the domestic partner of the other person with any registry
18 maintained by the employer of either party or any state, municipality,
19 or foreign jurisdiction; or
20 (B) is dependent or mutually interdependent on the other person for
21 support, as evidenced by the totality of the circumstances indicating a
22 mutual intent to be domestic partners including but not limited to:
23 common ownership or joint leasing of real or personal property; common
24 householding, shared income or shared expenses; children in common;
25 signs of intent to marry or become domestic partners; or the length of
26 the personal relationship of the persons.
27 (5) The superintendent shall, within one hundred eighty days of the
28 effective date of this paragraph, provide for qualification standards
29 for domestic partner benefits by regulation. Such regulation:
30 (A) shall prohibit the coverage of more than one domestic partner at
31 the same time under a family contract, or coverage of a domestic partner
32 of an insured or certificate holder who is also married, or coverage as
33 a domestic partner of anyone less than eighteen years of age or any
34 person who is related to the other person by blood in a manner that
35 would bar marriage to the other person in New York state;
36 (B) shall provide for the coverage of a dependent child of a domestic
37 partner under the same terms and conditions as would apply to a depend-
38 ent child of the insured or certificate holder or spouse of such insured
39 or certificate holder;
40 (C) shall include a provision which deems as qualified any person who
41 submits proof that he or she is formally a party to a domestic partner-
42 ship, or similar relationship, entered into with the insured or certif-
43 icate holder pursuant to the laws of the United States or of any state,
44 local or foreign jurisdiction;
45 (D) shall, as an alternative to subparagraph (C) of this paragraph,
46 provide for other means of demonstrating a domestic partner relationship
47 including, but not limited to, an affidavit attesting to the relation-
48 ship;
49 (E) shall provide for reasonable procedures for notification of the
50 corporation by the insured or certificate holder of the end of the
51 domestic partner relationship;
52 (F) may, for persons not deemed as qualified pursuant to subparagraph
53 (C) or (D) of this paragraph, include provisions requiring prior cohabi-
54 tation of the insured or certificate holder and the domestic partner,
55 provided that such period of required cohabitation may not exceed six
56 months; and
A. 2368--B 5
1 (G) may, for persons not deemed as qualified pursuant to subparagraph
2 (C) or (D) of this paragraph, require the submission of reasonable
3 documentation of residence and financial interdependence of the kind
4 commonly available to married persons including, but not limited to,
5 income tax returns, passports, drivers' licenses, utility bills, leases,
6 deeds, joint banking and credit card accounts, retirement accounts and
7 insurance policies and benefit statements.
8 § 5. Subparagraphs (A) and (C) of paragraph 1 of subsection (c) of
9 section 4305 of the insurance law, as amended by chapter 240 of the laws
10 of 2009, are amended and two new paragraphs 3 and 4 are added to read as
11 follows:
12 (A) Any such contract may provide that benefits will be furnished to a
13 member of a covered group, for [himself, his spouse, his] such member
14 and the spouse, domestic partner, child or children of such member, or
15 other persons chiefly dependent upon him or her for support and mainte-
16 nance; provided that a contract under which coverage of a dependent of a
17 member terminates at a specified age shall, with respect to an unmarried
18 child who is incapable of self-sustaining employment by reason of mental
19 illness, developmental disability, mental retardation, as defined in the
20 mental hygiene law, or physical handicap and who became so incapable
21 prior to attainment of the age at which dependent coverage would other-
22 wise terminate and who is chiefly dependent upon such member for support
23 and maintenance, not so terminate while the contract remains in force
24 and the dependent remains in such condition, if the member has within
25 thirty-one days of such dependent's attainment of the termination age
26 submitted proof of such dependent's incapacity as described herein.
27 (C) Notwithstanding any rule, regulation or law to the contrary, any
28 contract under which a member elects coverage for [himself, his spouse,
29 his] such member and the spouse, domestic partner, children or other
30 persons chiefly dependent upon him or her for support and maintenance
31 shall provide that coverage of newborn infants, including newly born
32 infants adopted by the insured or subscriber if such insured or
33 subscriber takes physical custody of the infant upon such infant's
34 release from the hospital and files a petition pursuant to section one
35 hundred fifteen-c of the domestic relations law within thirty days of
36 birth; and provided further that no notice of revocation to the adoption
37 has been filed pursuant to section one hundred fifteen-b of the domestic
38 relations law and consent to the adoption has not been revoked, shall be
39 effective from the moment of birth for injury or sickness including the
40 necessary care and treatment of medically diagnosed congenital defects
41 and birth abnormalities including premature birth, except that in cases
42 of adoption, coverage of the initial hospital stay shall not be required
43 where a birth parent has insurance coverage available for the infant's
44 care. This provision regarding coverage of newborn infants shall not
45 apply to two person coverage. In the case of individual or two person
46 coverages the corporation must also permit the person to whom the
47 certificate is issued to elect such coverage of newborn infants from the
48 moment of birth. If notification and/or payment of an additional premium
49 or contribution is required to make coverage effective for a newborn
50 infant, the coverage may provide that such notice and/or payment be made
51 within no less than thirty days of the day of birth to make coverage
52 effective from the moment of birth. This election shall not be required
53 in the case of student insurance or where the group's plan does not
54 provide coverage for dependent children.
55 (3) A hospital service corporation or health service corporation which
56 provides a "family contract" to an individual or a group must, if
A. 2368--B 6
1 requested by the policyholder, make available and, if requested by the
2 insured or certificate holder, provide coverage for the domestic partner
3 of the insured or certificate holder. For the purposes of this section,
4 "domestic partner" shall mean a person who with respect to another
5 person:
6 (A) is formally a party in a domestic partnership or similar relation-
7 ship with the other person, entered into pursuant to the laws of the
8 United States or of any state, local or foreign jurisdiction, or regis-
9 tered as the domestic partner of the other person with any registry
10 maintained by the employer of either party or any state, municipality,
11 or foreign jurisdiction; or
12 (B) is dependent or mutually interdependent on the other person for
13 support, as evidenced by the totality of the circumstances indicating a
14 mutual intent to be domestic partners including, but not limited to:
15 common ownership or joint leasing of real or personal property; common
16 householding, shared income or shared expenses; children in common;
17 signs of intent to marry or become domestic partners; or the length of
18 the personal relationship of the persons.
19 (4) The superintendent shall, within one hundred eighty days of the
20 effective date of this paragraph, provide for qualification standards
21 for domestic partner benefits by regulation. Such regulations:
22 (A) shall prohibit the coverage of more than one domestic partner at
23 the same time under a family contract, or coverage of a domestic partner
24 of an insured or certificate holder who is also married, or coverage as
25 a domestic partner of anyone less than eighteen years of age or any
26 person who is related to the other person by blood in a manner that
27 would bar marriage to the other person in New York state;
28 (B) shall provide for the coverage of a dependent child of a domestic
29 partner under the same terms and conditions as would apply to a depend-
30 ent child of the insured or certificate holder or spouse of such insured
31 or certificate holder;
32 (C) shall include a provision which deems as qualified any person who
33 submits proof that he or she is formally a party to a domestic partner-
34 ship, or similar relationship, entered into with the insured or certif-
35 icate holder pursuant to the laws of the United States, or of any state,
36 local or foreign jurisdiction;
37 (D) shall, as an alternative to subparagraph (C) of this paragraph,
38 provide for other means of demonstrating a domestic partner relationship
39 including, but not limited to, an affidavit attesting to the relation-
40 ship;
41 (E) shall provide for reasonable procedures for notification of the
42 corporation by the insured or certificate holder of the end of the
43 domestic partner relationship;
44 (F) may, for persons not deemed as qualified pursuant to subparagraph
45 (C) or (D) of this paragraph, include provisions requiring prior cohabi-
46 tation of the insured or certificate holder and the domestic partner,
47 provided that such period of required cohabitation may not exceed six
48 months; and
49 (G) may, for persons not deemed as qualified pursuant to subparagraph
50 (C) or (D) of this paragraph, require the submission of reasonable
51 documentation of residence and financial interdependence of the kind
52 commonly available to married persons including, but not limited to,
53 income tax returns, passports, drivers' licenses, utility bills, leases,
54 deeds, joint banking and credit card accounts, retirement accounts and
55 insurance policies and benefit statements.
56 § 6. This act shall take effect immediately.