STATE OF NEW YORK
________________________________________________________________________
6193
2015-2016 Regular Sessions
IN ASSEMBLY
March 16, 2015
___________
Introduced by M. of A. ROBERTS, PEOPLES-STOKES, BARRETT, COOK -- Multi-
Sponsored by -- M. of A. CROUCH, GOTTFRIED -- read once and referred
to the Committee on Insurance
AN ACT to amend the insurance law, in relation to health insurance plans
for long term care
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 (f) of section 1117 of the insur-
2 ance law, as added by chapter 245 of the laws of 1986, is amended to
3 read as follows:
4 (3) the premium rates for the long term care plan are reasonably
5 related to the benefits provided, and are self-supporting, as determined
6 by the superintendent pursuant to subsection (h) of this section; and
7 § 2. Section 1117 of the insurance law is amended by adding a new
8 subsection (h) to read as follows:
9 (h)(1) An insurer desiring to set, increase, or decrease premiums for
10 any plan subject to this section shall submit a rate filing or applica-
11 tion to the superintendent.
12 (2) An insurer shall send written notice of the proposed rate adjust-
13 ment, including the specific change requested, to each policy holder and
14 certificate holder affected by the adjustment before the date the rate
15 filing or application is submitted to the superintendent. The notice
16 shall prominently include mailing and website addresses for both the
17 department and the insurer through which a person may, within thirty
18 days from the date the rate filing or application is submitted to the
19 superintendent, contact the department or insurer to receive additional
20 information or to submit written comments to the department on the rate
21 filing or application.
22 (3) The superintendent shall establish a process to post on the
23 department's website, in a timely manner, all relevant written comments
24 received pertaining to rate filings or applications.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09464-01-5
A. 6193 2
1 (4) The insurer shall provide a copy of the notice to the superinten-
2 dent with the rate filing or application. The superintendent shall imme-
3 diately cause the notice to be posted on the department's website.
4 (5) The superintendent shall determine whether the filing or applica-
5 tion shall become effective as filed, shall become effective as modi-
6 fied, or shall be disapproved. The superintendent may modify or disap-
7 prove the rate filing or application if the superintendent finds that
8 the premiums are unreasonable, excessive, inadequate, unfairly discrimi-
9 natory, or not self-supporting and may consider the financial condition
10 of the insurer when approving, modifying or disapproving any premium
11 adjustment.
12 (6) The determination of the superintendent shall be supported by
13 sound actuarial assumptions and methods, and shall be rendered in writ-
14 ing between thirty and sixty days from the date the rate filing or
15 application is submitted to the superintendent.
16 (7) Should the superintendent require additional information from the
17 insurer in order to make a determination, the superintendent shall
18 require the insurer to furnish such information, and in such event, the
19 sixty days shall be tolled and shall resume as of the date the insurer
20 furnishes the information to the superintendent. If the superintendent
21 requests additional information less than ten days from the expiration
22 of the sixty days (exclusive of tolling), the superintendent may extend
23 the sixty day period an additional twenty days to make a determination.
24 (8) The application or rate filing will be deemed approved if a deter-
25 mination is not rendered within the time allotted under this subsection.
26 (9) An insurer shall not implement a rate adjustment unless the insur-
27 er provides at least sixty days advance written notice of the premium
28 rate adjustment approved by the superintendent to each policy holder and
29 certificate holder affected by the rate adjustment.
30 § 3. If any clause, sentence, paragraph, section or part of this act
31 shall be adjudged by any court of competent jurisdiction to be invalid,
32 the judgment shall not affect, impair or invalidate the remainder there-
33 of, but shall be confined in its operation to the clause, sentence,
34 paragraph, section or part thereof directly involved in the controversy
35 in which such judgment shall have been rendered.
36 § 4. This act shall take effect immediately.
