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S02268 Summary:

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S02268 Committee Votes:

S02268 Floor Votes:

S02268 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2268
 
                               2015-2016 Regular Sessions
 
                    IN SENATE
 
                                    January 22, 2015
                                       ___________
 
        Introduced  by  Sen.  GOLDEN -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance
 
        AN ACT to amend the insurance law, in relation  to  the  designation  of
          third parties to receive notification of cancellation
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraph 6 of subsection (b) of section 1117 of the insur-
     2  ance law, as added by chapter 572 of the laws of  2008,  is  amended  to
     3  read as follows:
     4    (6)  prior  to the earlier of the execution of a policy or certificate
     5  in connection with a plan providing a home care benefit and/or a nursing
     6  home benefit, or the payment of any premium or fee  related  to  such  a
     7  policy or certificate, the authorized insurer, corporation, health main-
     8  tenance  organization  or  fraternal  benefit  society shall provide the
     9  prospective insured or his  or  her  representative  with  a  disclosure
    10  statement, which contains the following:
    11    (A)  The  maximum  daily  and  lifetime benefit levels, if applicable,
    12  provided by the policy or certificate for home care services and nursing
    13  home services;
    14    (B) The percentage of coverage provided for  home  care  services  and
    15  nursing  home services, if applicable, and an explanation of the method-
    16  ology on which the reasonable  charge  used  in  conjunction  with  such
    17  percentage amount is based;
    18    (C)  A  description of any inflation protection feature included in or
    19  available for purchase under the policy or  certificate  and  the  addi-
    20  tional premium required to purchase such option or options;
    21    (D)  (i)  If  available  and accessible by the insurer or other entity
    22  from the department of  health,  the  most  recently-published  average,
    23  statewide  rate for care in a nursing home, as well as the average rates
    24  for care in nursing homes for both the New  York  city-metropolitan  and
    25  upstate regions of the state; or
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00936-01-5
        S. 2268                             2
 
     1    (ii)  If  available and accessible by the insurer or other entity from
     2  the department of health, the most recently-published map of  the  esti-
     3  mated  average  regional  rates in New York state for nursing home care;
     4  [and]
     5    (E)  A graphic demonstration of the maximum daily nursing home benefit
     6  level provided by the policy or certificate, and  the  impact  that  the
     7  selection of any inflation protection options would have on such maximum
     8  daily nursing home benefit level[.]; and
     9    (F)  The  right  of the prospective insured, upon attaining the age of
    10  sixty-five years, to designate a third party who will receive a copy  of
    11  any  notices of nonpayment of premiums due or notice of cancellation for
    12  nonpayment of premiums that is sent to the prospective insured.
    13  For the purpose of this paragraph, "home care services" shall  have  the
    14  same meaning as defined in subdivision one of section thirty-six hundred
    15  two  of  the  public  health law. The prospective insured, or his or her
    16  representative, shall acknowledge that the required disclosure has  been
    17  made  by  signing the disclosure statement prior to or contemporaneously
    18  with the effective date of the policy or certificate.
    19  Failure to provide information required  by  subparagraph  (D)  of  this
    20  paragraph  shall not be construed as a violation of this section if such
    21  information has not been made available by the department of health.
    22    § 2. Subsection (e) of section 3111 of the insurance law, as added  by
    23  section  30  of  part B of chapter 58 of the laws of 2004, is amended to
    24  read as follows:
    25    (e) Every insurer that has in force a long-term care insurance  policy
    26  as defined in section one thousand one hundred seventeen of this chapter
    27  the  premiums  for  which are paid directly to the insurer by the senior
    28  citizen insured, except a policy that  qualifies  as  a  long-term  care
    29  insurance  contract  as defined in Section 7702B of the Internal Revenue
    30  Code, shall permit senior citizen insureds to designate a third party to
    31  whom the insurer shall transmit notices of nonpayment of premiums due or
    32  notice of cancellation for nonpayment of premiums[, as determined by the
    33  insurer]; provided that notice of cancellation for nonpayment of premium
    34  shall be sent no later than thirty days before  the  effective  date  of
    35  such  cancellation.   The senior [citizens] citizen insured shall notify
    36  the insurer that a third party has been so designated. Such notification
    37  shall be delivered to the insurer either in the  same  envelope  as  the
    38  senior  citizen  insured's  premium payment or by certified mail, return
    39  receipt requested, and shall be effective not later  than  ten  business
    40  days  from  the  date  of  receipt by the insurer. The notification must
    41  contain, in writing, an  acceptance  by  the  third  party  designee  to
    42  receive  such  notices  of cancellation. Should the third party designee
    43  desire to terminate his or her status as a third  party  designee,  such
    44  designee shall provide written notice to both the insurer and the senior
    45  citizen  insured.  Should the senior citizen insured desire to terminate
    46  the third party designation, the insured shall provide written notice to
    47  the insurer. The transmission to the third party designee  of  any  such
    48  notice  of  cancellation shall be in addition to a copy of such document
    49  transmitted to the senior citizen insured and when a third party  is  so
    50  designated  all  such  notices  shall  be  mailed in an envelope clearly
    51  marked on its face with the  following:    "IMPORTANT  INSURANCE  POLICY
    52  INFORMATION:  OPEN  IMMEDIATELY". Designation as a third party shall not
    53  constitute acceptance of any liability on the third party  for  services
    54  provided  to  such  senior  citizen. The insurer shall notify its senior
    55  citizen insureds not less than annually in writing of  the  availability
    56  of  the third party designee notice procedure and provide information on
        S. 2268                             3
 
     1  how the insured can commence this procedure[; however, such notice  need
     2  not  be  provided  once  a senior citizen has made a designation].  If a
     3  senior citizen insured has not  made  a  third  party  designation,  the
     4  insurer  shall  include  a copy of the third party designation form with
     5  each premium statement sent to the senior citizen insured. If  a  senior
     6  citizen  insured  has made a designation, the insurer shall confirm with
     7  the senior citizen insured  that  the  third  party  designee's  contact
     8  information  is correct. Upon receipt of a designation or termination of
     9  a designation, the insurer shall verify the designation or  cancellation
    10  of  designation  with the senior citizen insured. Such verification may,
    11  but is not required to be, written and the insurer may use telephony  to
    12  obtain  an  oral confirmation from the senior citizen insured so long as
    13  the insurer provides the senior citizen insured with  written  confirma-
    14  tion of the oral verification.
    15    §  3.  This  act  shall take effect on the sixtieth day after it shall
    16  have become a law.