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A07725 Summary:

A07725 Actions:

A07725 Committee Votes:

A07725 Floor Votes:

A07725 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         7725--C
 
                               2015-2016 Regular Sessions
 
                   IN ASSEMBLY
 
                                      May 26, 2015
                                       ___________
 
        Introduced by M. of A. STIRPE, MORELLE, LIFTON -- read once and referred
          to  the  Committee on Insurance -- committee discharged, bill amended,
          ordered reprinted as amended and  recommitted  to  said  committee  --
          reported   and  referred  to  the  Committee  on  Rules  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee -- Rules Committee discharged, bill amended, ordered
          reprinted as amended and recommitted to the Committee on Rules
 
        AN ACT to amend the insurance law, in relation to authorizing the  issu-
          ance  of certain accident and health insurance policies to an institu-
          tion of higher education
 
          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 (a) of section 3240 of the insur-
     2  ance  law, as added by section 41 of part D of chapter 56 of the laws of
     3  2013, is amended and two new paragraphs 5 and 6 are  added  to  read  as
     4  follows:
     5    (1)(A)  "Student  accident  and  health  insurance"  means a policy or
     6  contract of hospital, medical, or surgical expense  insurance  delivered
     7  or  issued  for  delivery  in  this state on or after January first, two
     8  thousand fourteen, by an insurer or a corporation, to an institution  of
     9  higher  education  covering students enrolled in the institution and the
    10  students' dependents.
    11    (B) "Student accident and health insurance" shall not include:
    12    (i) a policy or contract that provides limited scope dental or  vision
    13  benefits  meeting  the  definition  of  "excepted benefits" set forth in
    14  section 2791 of the public health service act, 42 U.S.C. §  300gg-91(c);
    15  or
    16    (ii) an accident policy or contract that provides benefits meeting the
    17  definition  of  "excepted  benefits"  set  forth  in section 2791 of the
    18  public health service act, 42 U.S.C. § 300gg-91(c),  if  the  policy  or
    19  contract:
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10900-07-5
        A. 7725--C                          2
 
     1    (I) is limited to coverage for intercollegiate sports injuries only;
     2    (II)  provides  benefits  to  diagnose  and  treat any intercollegiate
     3  sports injury and does not include a benefit dollar maximum  amount  per
     4  injury  that  is less than the overall benefit dollar maximum amount per
     5  student under the intercollegiate sports injury policy or contract;
     6    (III) provides benefits on an expense incurred basis;
     7    (IV) provides that premiums are paid in full  by  the  institution  of
     8  higher education;
     9    (V)  includes  prominent  disclosure  to the student that the accident
    10  policy is not a substitute for comprehensive hospital and medical cover-
    11  age;
    12    (VI) provides coverage for intercollegiate sports injuries primary  to
    13  any  student  accident  and  health  insurance policy or contract or any
    14  student health plan issued pursuant to section one thousand one  hundred
    15  twenty-four  of  this  chapter; except that a policy or contract meeting
    16  the requirements of this item may be excess or secondary  to  any  other
    17  policy or contract of accident and health insurance; and
    18    (VII)  includes  a  maximum  benefit  amount  that is no less than the
    19  deductible under the separate athletic association policy or contract if
    20  designed to coordinate with a separate policy or contract issued  to  an
    21  athletic  association  that  extends coverage for intercollegiate sports
    22  injuries.
    23    (5) "Intercollegiate sport" means a sport that has been designated  as
    24  an intercollegiate sport by the institution of higher education in which
    25  a  student is enrolled and that is organized or sponsored by an institu-
    26  tion of higher education.
    27    (6) "Intercollegiate sports injury" means an  injury  sustained  by  a
    28  student member of an athletics team during participation in an intercol-
    29  legiate sport.
    30    § 2. Section 3240 of the insurance law, as added by section 41 of part
    31  D  of  chapter  56  of  the  laws  of  2013,  is amended by adding a new
    32  subsection (j) to read as follows:
    33    (j) With respect to benefits for treatment relating to an  intercolle-
    34  giate  sports  injury,  as defined in paragraph six of subsection (a) of
    35  this section, a policy or contract of student accident and health insur-
    36  ance or a student health plan issued pursuant to  section  one  thousand
    37  one hundred twenty-four of this chapter shall be secondary to a separate
    38  accident  policy  or  contract  meeting  the requirements of clauses (I)
    39  through (VII) of item (ii) of  subparagraph  (B)  of  paragraph  one  of
    40  subsection (a) of this section.
    41    § 3. Subparagraph (C) of paragraph 3 of subsection (a) of section 4237
    42  of the insurance law is amended to read as follows:
    43    (C)  Under  a policy or contract issued to [a college,] an institution
    44  of higher education, as defined in the higher education act of 1965,  20
    45  U.S.C.  § 1001, other school, or other institution of learning or to the
    46  head  or  principal  thereof,  who  or  which  shall   be   deemed   the
    47  policyholder,  provided,  with respect to a policy or contract issued to
    48  an institution of higher education, the policy or contract  shall  be  a
    49  policy or contract:
    50    (i) of hospital, medical, or surgical expense insurance that meets the
    51  requirements  of  section three thousand two hundred forty of this chap-
    52  ter;
    53    (ii) that provides limited scope dental or vision benefits meeting the
    54  definition of "excepted benefits" set  forth  in  section  2791  of  the
    55  public health service act, 42 U.S.C. § 300gg-91(c); or
        A. 7725--C                          3
 
     1    (iii)  as  described in item (ii) of subparagraph (B) of paragraph one
     2  of subsection (a) of section three thousand two hundred  forty  of  this
     3  chapter.
     4    §  4.  This  act  shall take effect immediately and shall be deemed to
     5  have been in full force and effect on the same  date  and  in  the  same
     6  manner  as  section  41 of part D of chapter 56 of the laws of 2013 took
     7  effect.