STATE OF NEW YORK
________________________________________________________________________
6931
IN SENATE
January 6, 2020
___________
Introduced by Sen. BRESLIN -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
AN ACT to amend the insurance law, in relation to policies or contracts
which are not included in the definition of student accident and
health insurance
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subparagraph (B) of paragraph 1 of subsection (a) of
2 section 3240 of the insurance law, as amended by chapter 461 of the laws
3 of 2015, clause (ii) as amended by a chapter of the laws of 2019, amend-
4 ing the insurance law relating to policies or contracts which are not
5 included in the definition of student accident and health insurance, as
6 proposed in legislative bills numbers S. 6197 and A. 492, is amended to
7 read as follows:
8 (B) "Student accident and health insurance" shall not include:
9 (i) a policy or contract that provides limited scope dental or vision
10 benefits meeting the definition of "excepted benefits" set forth in
11 section 2791 of the public health service act, 42 U.S.C. § 300gg-91(c);
12 [or]
13 (ii) [a] an accident policy or contract that provides benefits meeting
14 the definition of "excepted benefits" set forth in section 2791 of the
15 public health service act, 42 U.S.C. § 300gg-91(c), if the policy or
16 contract [is limited to insurance coverage for personal risks incident
17 to planned travel, including sickness, accident, disability, or death
18 occurring during travel, provided that such health benefits are not
19 offered on a stand-alone basis and are incidental to other coverage.
20 (iii) an accident policy or contract that provides benefits meeting
21 the definition of "excepted benefits" set forth in section 2791 of the
22 public health service act, 42 U.S.C. § 300gg-91(c), if the policy or
23 contract]:
24 (I) is limited to coverage for intercollegiate sports injuries only;
25 (II) provides benefits to diagnose and treat any intercollegiate
26 sports injury and does not include a benefit dollar maximum amount per
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05103-02-0
S. 6931 2
1 injury that is less than the overall benefit dollar maximum amount per
2 student under the intercollegiate sports injury policy or contract;
3 (III) provides benefits on an expense incurred basis;
4 (IV) provides that premiums are paid in full by the institution of
5 higher education;
6 (V) includes prominent disclosure to the student that the accident
7 policy is not a substitute for comprehensive hospital and medical cover-
8 age;
9 (VI) provides coverage for intercollegiate sports injuries primary to
10 any student accident and health insurance policy or contract or any
11 student health plan issued pursuant to section one thousand one hundred
12 twenty-four of this chapter; except that a policy or contract meeting
13 the requirements of this item may be excess or secondary to any other
14 policy or contract of accident and health insurance; and
15 (VII) includes a maximum benefit amount that is no less than the
16 deductible under the separate athletic association policy or contract if
17 designed to coordinate with a separate policy or contract issued to an
18 athletic association that extends coverage for intercollegiate sports
19 injuries;
20 (iii) an accident policy or contract that provides benefits meeting
21 the definition of "excepted benefits" set forth in section 2791 of the
22 public health service act, 42 U.S.C. § 300gg-91(c)(1)(A), if the policy
23 or contract:
24 (I) is limited to transportation expenses in the event an insured
25 student incurs a covered sickness or accident, including transportation
26 expenses for a medical escort to travel with the student and transporta-
27 tion expenses for returning the student to the student's domicile;
28 (II) provides that premiums are paid in full by the institution of
29 higher education;
30 (III) covers students enrolled in the institution of higher education;
31 (IV) includes prominent disclosure to the student that the accident
32 policy is not a substitute for comprehensive hospital and medical cover-
33 age; and
34 (V) provides coverage for a period of twelve months; or
35 (iv) an insurance policy, contract, or certificate that provides
36 hospital, medical, or surgical expense coverage for a student while
37 studying outside the United States for a period of twelve months or less
38 that is issued to a student, provided that the student is also covered
39 by comprehensive hospital and medical coverage within the United States
40 and the insurance policy, contract, or certificate:
41 (I) is subject to the requirements of subsections (b), (c), (d), (e),
42 (h), and (i) of this section;
43 (II) meets the definition of "expatriate health plan" set forth in 42
44 U.S.C. § 18014(d)(2);
45 (III) excludes coverage within the United States;
46 (IV) may offer coverage for global evacuation and repatriation in the
47 event of the insured student's sickness or accident; and
48 (V) may offer coverage for trip cancellation, trip interruption,
49 baggage, personal effects, or global evacuation and repatriation,
50 including evacuation in the event of a natural or man-made disaster,
51 such as an epidemic, political event, war, terrorist act, riot, or civil
52 insurrection, pursuant to section three thousand four hundred fifty-two
53 of this chapter.
54 § 2. Clause (iii) of subparagraph (C) of paragraph 3 of subsection (a)
55 of section 4237 of the insurance law, as amended by chapter 461 of the
56 laws of 2015, is amended to read as follows:
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1 (iii) as described in item (ii), (iii) or (iv) of subparagraph (B) of
2 paragraph one of subsection (a) of section three thousand two hundred
3 forty of this chapter.
4 § 3. Paragraphs 3, 4 and 5 of subsection (a) of section 3452 of the
5 insurance law, as added by chapter 318 of the laws of 2008, are amended
6 to read as follows:
7 (3) The policy may be issued to:
8 (A) any railroad company, steamship company, carrier by air, public
9 bus carrier, or other common carrier of passengers, which shall be
10 deemed the policyholder, where the policy insures its passengers; [or]
11 (B) an institution of higher education as provided in paragraph two of
12 subsection (a) of section three thousand two hundred forty of this chap-
13 ter; or
14 (C) any other group where the superintendent has determined in a regu-
15 lation that the members are engaged in a common enterprise, or have an
16 economic or social affinity or relationship, and that the issuance of
17 the policy would not be contrary to the best interests of the public.
18 (4) [The] (A) Except as provided in subparagraph (B) of paragraph one
19 of subsection (a) of section three thousand two hundred forty of this
20 chapter, the policy may provide coverage for trip cancellation, trip
21 interruption, baggage, and personal effects when limited to a specific
22 trip. The policy shall be sold in connection with transportation
23 provided by the common carrier or, with respect to other groups as
24 permitted by the superintendent in accordance with subparagraph [(B)]
25 (C) of paragraph three of this subsection, subject to such limitations
26 provided in the regulation promulgated by the superintendent.
27 (B) A policy issued to an institution of higher education shall comply
28 with clause (V) of item (iv) of subparagraph (B) of paragraph one of
29 subsection (a) of section three thousand two hundred forty of this chap-
30 ter.
31 (5) Coverage under the policy shall be limited to the group member's
32 risks with respect to a particular trip, except a policy issued to an
33 institution of higher education shall comply with item (iv) of subpara-
34 graph (B) of paragraph one of subsection (a) of section three thousand
35 two hundred forty of this chapter.
36 § 4. Paragraph 1 of subsection (c) of section 3452 of the insurance
37 law, as added by chapter 318 of the laws of 2008, is amended to read as
38 follows:
39 (1) Unless the group policy provides for a longer policy period, the
40 policy shall be issued or renewed for a one-year policy period, except a
41 policy issued to an institution of higher education shall be issued or
42 renewed for a period consistent with item (iv) of subparagraph (B) of
43 paragraph one of subsection (a) of section three thousand two hundred
44 forty of this chapter.
45 § 5. Subparagraph (B) of paragraph 7 of subsection (c) of section 3452
46 of the insurance law, as added by chapter 318 of the laws of 2008, is
47 amended to read as follows:
48 (B) The coverage shall terminate as provided in the certificate, which
49 shall in no event be later than the conclusion of the trip, except
50 coverage under a policy issued to an institution of higher education as
51 provided in item (iv) of subparagraph (B) of paragraph one of subsection
52 (a) of section three thousand two hundred forty of this chapter shall
53 terminate in accordance with the provisions of that section.
54 § 6. This act shall take effect on the same date and in the same
55 manner as a chapter of the laws of 2019, amending the insurance law
56 relating to policies or contracts which are not included in the defi-
S. 6931 4
1 nition of student accident and health insurance, as proposed in legisla-
2 tive bills numbers S. 6197 and A. 492, takes effect.