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S06740 Summary:

S06740 Actions:

S06740 Floor Votes:

S06740 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         6740--B
            Cal. No. 568
 
                    IN SENATE
 
                                     March 15, 2012
                                       ___________
 
        Introduced by Sens. ROBACH, RANZENHOFER -- read twice and ordered print-
          ed,  and when printed to be committed to the Committee on Insurance --
          reported favorably from said committee, ordered to  first  and  second
          report,  ordered to a third reading, passed by Senate and delivered to
          the Assembly, recalled, vote reconsidered, restored to third  reading,

          amended  and  ordered  reprinted,  retaining its place in the order of
          third reading -- again amended and ordered  reprinted,  retaining  its
          place in the order of third reading
 
        AN  ACT  to  amend  the insurance law, in relation to a health insurance
          demonstration program for early retirees; and providing for the repeal
          of such provisions upon expiration thereof
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section 1. The insurance law is amended by adding a new section 1123-a
     2  to read as follows:
     3    §  1123-a.   Health insurance demonstration program for former employ-
     4  ees.  (a) Definitions. In this section:
     5    (1) "Eligible association" means an entity that: (A)  is  exempt  from

     6  federal  taxation  under  section  501(c)(3)  or  (c)(4) of the internal
     7  revenue code; (B) was incorporated on or before January first, two thou-
     8  sand ten; (C) meets the criteria set forth in subparagraph (K) of  para-
     9  graph  one  of subsection (c) of section four thousand two hundred thir-
    10  ty-five of this chapter; and (D) has been established for the benefit of
    11  former employees of a company in this state.
    12    (2) "Eligible insurer"  means  any  health  maintenance  organization,
    13  certified  pursuant  to  article forty-four of the public health law, an
    14  insurer licensed to write accident and health  insurance,  or  a  corpo-
    15  ration organized pursuant to article forty-three of this chapter.

    16    (3)  "Former  employee"  means  an  individual:  (A)  who was formerly
    17  employed by a company headquartered in this state and which has been  in
    18  operation  for  over  one hundred years; (B) who has heretofore received
    19  health insurance coverage through the former employer, (C) whose  former
    20  employer  filed  for  chapter  eleven bankruptcy in January two thousand
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15057-07-2
        S. 6740--B                          2
 
     1  twelve, and (D) who is not eligible for Medicare  or  for  group  health
     2  insurance coverage through another employer.

     3    (4)  "Group  health  insurance"  means  insurance  providing hospital,
     4  surgical or medical expense  coverage  or  other  similar  comprehensive
     5  health insurance coverage.
     6    (b)  Demonstration program for former employees.  (1) Both the insurer
     7  and the group health insurance policies issued to the  eligible  associ-
     8  ation  shall  be subject to the provisions of this chapter and any regu-
     9  lations promulgated thereunder, except  that  the  eligible  association
    10  shall not be considered a small group under this chapter.
    11    (2)  Subject to paragraph three of this subsection, the superintendent
    12  may issue an approval to an eligible insurer if: (A) the eligible insur-
    13  er demonstrates that it satisfies all financial, operational  and  other

    14  requirements  of  this  chapter  and regulations promulgated thereunder,
    15  other than any requirements expressly waived by this section, and  shall
    16  operate the demonstration program in accordance with the requirements of
    17  this  section;  and  (B)  the  superintendent determines that the demon-
    18  stration program furthers the public policy goals of this section.
    19    (3) Any eligible insurer seeking the superintendent's  approval  under
    20  paragraph  two  of this subsection shall submit a written request to the
    21  superintendent within thirty days of the effective date of this section.
    22  The eligible insurer's  application  shall:  specify  the  identity  and
    23  composition  of  the  eligible  association,  the eligible association's

    24  membership rules, and the terms under which the eligible  insurer  shall
    25  provide  group health insurance to the eligible association; demonstrate
    26  that the eligible insurer and the eligible association meet the require-
    27  ments set forth in this section; and identify the group health insurance
    28  policy forms that the eligible insurer will issue to the eligible  asso-
    29  ciation.  The  superintendent  shall make a determination on any request
    30  within ninety days of receipt of all necessary information.  The  super-
    31  intendent shall issue an approval to only one eligible insurer.
    32    (4)  The  superintendent may revoke an approval issued under paragraph
    33  two of this subsection if: the insurer that received  such  approval  no

    34  longer  qualifies  as an eligible insurer or is otherwise operating in a
    35  manner inconsistent with the provisions of this chapter  or  regulations
    36  promulgated thereunder; or the association to which the eligible insurer
    37  issued  the  group  health  insurance  policy  no longer qualifies as an
    38  eligible association. An eligible insurer that receives  approval  under
    39  paragraph  two  of  this subsection shall submit periodic reports to the
    40  superintendent sufficient to enable the superintendent to  evaluate  the
    41  effectiveness of the demonstration program. Such reports shall include a
    42  comparison of the cost of health insurance obtained under the program to
    43  other  available  insurance  options,  including  group health insurance

    44  policies delivered or issued for delivery in this state, demographic and
    45  geographic analysis of the enrolled population and any other information
    46  required by the superintendent.
    47    § 2. This act shall take effect immediately and shall expire  December
    48  31,  2013 when upon such date the provisions of this act shall be deemed
    49  repealed.