Relates to gender indication on insurance claim forms; provides policies shall not exclude coverage if gender indication is different from sex assigned at birth or gender otherwise recorded.
STATE OF NEW YORK
________________________________________________________________________
5556
2025-2026 Regular Sessions
IN SENATE
February 25, 2025
___________
Introduced by Sens. HOYLMAN-SIGAL, WEBB -- read twice and ordered print-
ed, and when printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to prohibiting the exclu-
sion of coverage based upon gender indication on claim forms
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subsection (i) of section 3216 of the insurance law is
2 amended by adding a new paragraph 41 to read as follows:
3 (41) Every policy that provides coverage for hospital, surgical or
4 medical care shall not exclude coverage for screening, diagnosis and
5 treatment of medical conditions, or services otherwise covered by the
6 policy solely on the basis of the gender indicated on a claim form, or
7 that the gender indicated on a claim form is different from the
8 insured's sex assigned at birth or gender otherwise recorded, or that
9 the insured is not of the gender to whom a service is provided. Nothing
10 herein shall limit the insurer's ability to take reasonable steps,
11 including requesting additional information, to determine whether the
12 insured is eligible for the services, to review the claim for potential
13 fraud, or to review the claim for clinical appropriateness.
14 § 2. Subsection (l) of section 3221 of the insurance law is amended by
15 adding a new paragraph 24 to read as follows:
16 (24) Every policy that provides coverage for hospital, surgical or
17 medical care shall not exclude coverage for screening, diagnosis and
18 treatment of medical conditions, or services otherwise covered by the
19 policy solely on the basis of the gender indicated on a claim form, or
20 that the gender indicated on a claim form is different from the
21 insured's sex assigned at birth or gender otherwise recorded, or that
22 the insured is not of the gender to whom a service is provided. Nothing
23 herein shall limit the insurer's ability to take reasonable steps,
24 including requesting additional information, to determine whether the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07854-02-5
S. 5556 2
1 insured is eligible for the services, to review the claim for potential
2 fraud, or to review the claim for clinical appropriateness.
3 § 3. Section 4303 of the insurance law is amended by adding a new
4 subsection (ww) to read as follows:
5 (ww) Every contract that provides coverage for hospital, surgical or
6 medical care shall not exclude coverage for screening, diagnosis and
7 treatment of medical conditions, or services otherwise covered by the
8 contract solely on the basis of the gender indicated on a claim form, or
9 that the gender indicated on a claim form is different from the
10 insured's sex assigned at birth or gender otherwise recorded, or that
11 the insured is not of the gender to whom a service is provided. Nothing
12 herein shall limit the insurer's ability to take reasonable steps,
13 including requesting additional information, to determine whether the
14 insured is eligible for the services, to review the claim for potential
15 fraud, or to review the claim for clinical appropriateness.
16 § 4. This act shall take effect on the first of January next succeed-
17 ing the date on which it shall have become a law and shall apply to
18 policies and contracts issued, renewed, modified, altered or amended on
19 or after such effective date.
