Requires insurers providing family health insurance coverage to offer coverage for the domestic partner of an insured person according to qualification standards to be adopted by the superintendent.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A2224
SPONSOR: O'Donnell (MS)
 
TITLE OF BILL: An act to amend the insurance law, in relation to
health insurance benefits for domestic partners
 
PURPOSE OR GENERAL IDEA OF BILL:
When requested by an employer group or individual purchasing health
coverage, a health plan shall provide health insurance coverage for
domestic partners.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section one of the bill amends section 3 of subsection (a) of section
3216 to revise the definition of the term "family" and adds a definition
of the term "domestic partner." Section two requires the superintendent
of insurance to promulgate regulations for the qualification of domestic
partners under commercial health insurance policies issued to individ-
uals. Such regulations shall include provisions to limit coverage to one
domestic partner, provide coverage for children of domestic partners of
the insured, and provide coverage for individuals who submit legal
proofs of domestic partnership or similar relationships. It shall also
provide for: allowing affidavits attesting to a domestic partnership to
be submitted as proof of relationship, notification procedures for the
termination of domestic partnerships, requirements for prior cohabi-
tation, and acceptance of documents which are commonly accepted from
married persons as proof of residence and financial interdependence.
Sections three, four, and five make similar changes to health coverage
issued by commercial insurers to groups, and to individual a1d group
coverage issued by non-profit insurers and HMOs. Section six sets out
the effective date.
 
JUSTIFICATION:
Current law and regulations permit insurers, non-profit health plans and
HMOs to offer health insurance coverage for domestic partners. Many
insurers and health plans, however, refuse to provide domestic partner
coverage to individuals and smaller employer groups. This legislation
would allow employer groups and individuals to successfully request that
their health plan provide benefits to qualified domestic partners. This
legislation also puts in several safeguards to prevent abuse of the new
domestic partnership provisions by requiring the New York State Super-
intendent of Insurance to devise specific qualification standards for
domestic partners. These standards include the types of proof required
to demonstrate that a person is a qualified domestic partner and limit
of one domestic partner per policy holder.
 
PRIOR LEGISLATIVE HISTORY:
2004 - a.11464 - Referred to Rules
 
FISCAL IMPLICATIONS: None
 
EFFECTIVE DATE: Immediately, and requires the superintendent to
promulgate the necessary regulations within 180 days.
STATE OF NEW YORK
________________________________________________________________________
2224
2005-2006 Regular Sessions
IN ASSEMBLY
January 25, 2005
___________
Introduced by M. of A. O'DONNELL, STRINGER -- read once and referred to
the Committee on Insurance
AN ACT to amend the insurance law, in relation to health insurance bene-
fits for domestic partners
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 (a) of section 3216 of the insur-
2 ance law is amended and a new paragraph 5 is added to read as follows:
3 (3) "Family" may include husband, wife, domestic partner or dependent
4 children, or any other person dependent upon the policyholder.
5 (5) "Domestic partner" shall mean a person who with respect to another
6 person:
7 (A) is formally a party in a domestic partnership or similar relation-
8 ship with the other person, entered into pursuant to the laws of the
9 United States or of any state, local or foreign jurisdiction, or regis-
10 tered as the domestic partner of the other person with any registry
11 maintained by the employer of either party or any state, municipality,
12 or foreign jurisdiction; or
13 (B) is dependent or mutually interdependent on the other person for
14 support, as evidenced by the totality of the circumstances indicating a
15 mutual intent to be domestic partners including but not limited to:
16 common ownership or joint leasing of real or personal property; common
17 householding, shared income or shared expenses; children in common;
18 signs of intent to marry or become domestic partners; or the length of
19 the personal relationship of the persons.
20 § 2. Paragraph 4 of subsection (c) of section 3216 of the insurance
21 law is amended by adding a new subparagraph (D) to read as follows:
22 (D) The superintendent shall, within one hundred eighty days of the
23 effective date of this subparagraph, provide for qualification standards
24 for domestic partner benefits by regulation. Such regulations:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD04691-01-5
A. 2224 2
1 (i) shall prohibit the coverage of more than one domestic partner at
2 the same time under a family contract, or coverage of a domestic partner
3 of an insured or certificate holder who is also married, or coverage as
4 a domestic partner of anyone less than eighteen years of age or any
5 person who is related to the other person by blood in a manner that
6 would bar marriage to the other person in New York state;
7 (ii) shall provide for the coverage of a dependent child of a domestic
8 partner under the same terms and conditions as would apply to a depend-
9 ent child of the insured or certificate holder or spouse of such insured
10 or certificate holder;
11 (iii) shall include a provision which deems as qualified any person
12 who submits proof that he or she is formally a party to a domestic part-
13 nership, or similar relationship, entered into with the insured or
14 certificate holder pursuant to the laws of the United States or of any
15 state, local or foreign jurisdiction;
16 (iv) shall, as an alternative to clause (iii) of this subparagraph,
17 provide for other means of demonstrating a domestic partner relation-
18 ship, including but not limited to, an affidavit attesting to the
19 relationship;
20 (v) shall provide for reasonable procedures for notification of the
21 corporation by the insured or certificate holder of the end of the
22 domestic partner relationship;
23 (vi) may, for persons who are not deemed as qualified pursuant to
24 clause (iii) or (iv) of this subparagraph, include provisions requiring
25 prior cohabitation of the insured or certificate holder and the domestic
26 partner, provided that such period of required cohabitation may not
27 exceed six months; and
28 (vii) may, for persons who are not deemed as qualified pursuant to
29 clause (iii) or (iv) of this subparagraph, require the submission of
30 reasonable documentation of residence and financial interdependence of
31 the kind commonly available to married persons including, but not limit-
32 ed to, income tax returns, passports, drivers' licenses, utility bills,
33 leases, deeds, joint banking and credit card accounts, retirement
34 accounts and insurance policies and benefit statements.
35 § 3. Section 3221 of the insurance law is amended by adding two new
36 subsections (r) and (s) to read as follows:
37 (r) A group policy providing hospital, surgical or medical expense
38 insurance other than accident only to a family member of the policy or
39 certificate holder must, if requested by the policyholder, make avail-
40 able and, if requested by the insured or certificate holder, provide
41 coverage for the domestic partner of the insured or certificate holder.
42 For the purposes of this section, "domestic partner" shall mean a person
43 who with respect to another person:
44 (1) is formally a party in a domestic partnership or similar relation-
45 ship with the other person, entered into pursuant to the laws of the
46 United States or of any state, local or foreign jurisdiction, or regis-
47 tered as the domestic partner of the other person with any registry
48 maintained by the employer of either party or any state, municipality,
49 or foreign jurisdiction; or
50 (2) is dependent or mutually interdependent on the other person for
51 support, as evidenced by the totality of the circumstances indicating a
52 mutual intent to be domestic partners including but not limited to:
53 common ownership or joint leasing of real or personal property; common
54 householding, shared income or shared expenses; children in common;
55 signs of intent to marry or become domestic partners or the length of
56 the personal relationship of the persons.
A. 2224 3
1 (s) The superintendent shall, within one hundred eighty days of the
2 effective date of this subsection, provide for qualification standards
3 for domestic partner benefits by regulation. Such regulations:
4 (1) shall prohibit the coverage of more than one domestic partner at
5 the same time under a family contract, or coverage of a domestic partner
6 of an insured or certificate holder who is also married, or coverage as
7 a domestic partner of anyone less than eighteen years of age or any
8 person who is related to the other person by blood in a manner that
9 would bar marriage to the other person in New York state;
10 (2) shall provide for the coverage of a dependent child of a domestic
11 partner under the same terms and conditions as would apply to a depend-
12 ent child of the insured or certificate holder or spouse of such insured
13 or certificate holder;
14 (3) shall include a provision which deems as qualified any person who
15 submits proof that he or she is formally a party to a domestic partner-
16 ship, or similar relationship, entered into with the insured or certif-
17 icate holder pursuant to the laws of the United States, or of any state,
18 local or foreign jurisdiction;
19 (4) shall, as an alternative to paragraph three of this subsection,
20 provide for other means of demonstrating a domestic partner relation-
21 ship, including but not limited to, an affidavit attesting to the
22 relationship;
23 (5) shall provide for reasonable procedures for notification of the
24 insurer by the insured or certificate holder of the end of the domestic
25 partner relationship;
26 (6) may, for persons not deemed as qualified pursuant to paragraph
27 three or four of this subsection, include provisions requiring prior
28 cohabitation of the insured or certificate holder and the domestic part-
29 ner, provided that such period of required cohabitation may not exceed
30 six months; and
31 (7) may, for persons not deemed as qualified pursuant to paragraph
32 three or four of this subsection, require the submission of reasonable
33 documentation of residence and financial interdependence of the kind
34 commonly available to married persons including, but not limited to,
35 income tax returns, passports, drivers' licenses, utility bills, leases,
36 deeds, joint banking and credit card accounts, retirement accounts and
37 insurance policies and benefit statements.
38 § 4. Paragraph 1 of subsection (d) of section 4304 of the insurance
39 law, as amended by chapter 312 of the laws of 2002, is amended and two
40 new paragraphs 4 and 5 are added to read as follows:
41 (1) No contract issued pursuant to this section shall entitle more
42 than one person to benefits except that a contract issued and marked as
43 a "family contract" may provide that benefits will be furnished to a
44 husband and wife, or husband, wife or domestic partner and their depend-
45 ent child or children, or any child or children not over nineteen years
46 of age, provided that an unmarried student at an accredited institution
47 of learning may be considered a dependent until he or she becomes twen-
48 ty-three years of age, and provided also that the coverage of any such
49 "family contract" shall include any other unmarried child, regardless of
50 age, who is incapable of self-sustaining employment by reason of mental
51 illness, developmental disability, mental retardation, as defined in the
52 mental hygiene law, or physical handicap and who became so incapable
53 prior to attainment of the age at which dependent coverage would other-
54 wise terminate, so that such child may be considered a dependent.
55 Notwithstanding any rule, regulation or law to the contrary, any "family
56 contract" shall provide that coverage of newborn infants, including
A. 2224 4
1 newly born infants adopted by the insured or subscriber if such insured
2 or subscriber takes physical custody of the infant upon such infant's
3 release from the hospital and files a petition pursuant to section one
4 hundred fifteen-c of the domestic relations law within thirty days of
5 birth; and provided further that no notice of revocation to the adoption
6 has been filed pursuant to section one hundred fifteen-b of the domestic
7 relations law and consent to the adoption has not been revoked, shall be
8 effective from the moment of birth for injury or sickness including the
9 necessary care and treatment of medically diagnosed congenital defects
10 and birth abnormalities including premature birth, except that in cases
11 of adoption, coverage of the initial hospital stay shall not be required
12 where a birth parent has insurance coverage available for the infant's
13 care. This provision regarding coverage of newborn infants shall not
14 apply to two person coverage. In the case of individual or two person
15 coverages the corporation must also permit the person to whom the policy
16 is issued to elect such coverage of newborn infants from the moment of
17 birth. If notification and/or payment of an additional premium or
18 contribution is required to make coverage effective for a newborn
19 infant, the coverage may provide that such notice and/or payment be made
20 within no less than thirty days of the day of birth to make coverage
21 effective from the moment of birth. This election shall not be required
22 in the case of student insurance or where the group remitting agent's
23 plan does not provide coverage for dependent children.
24 (4) A hospital service corporation or health service corporation which
25 provides a "family contract" to an individual or a group must, if
26 requested by the policyholder, make available and, if requested by the
27 insured or certificate holder, provide coverage for the domestic partner
28 of the insured or certificate holder. For the purposes of this section,
29 "domestic partner" shall mean a person who with respect to another
30 person:
31 (A) is formally a party in a domestic partnership or similar relation-
32 ship with the other person, entered into pursuant to the laws of the
33 United States or of any state, local or foreign jurisdiction, or regis-
34 tered as the domestic partner of the other person with any registry
35 maintained by the employer of either party or any state, municipality,
36 or foreign jurisdiction; or
37 (B) is dependent or mutually interdependent on the other person for
38 support, as evidenced by the totality of the circumstances indicating a
39 mutual intent to be domestic partners including but not limited to:
40 common ownership or joint leasing of real or personal property; common
41 householding, shared income or shared expenses; children in common;
42 signs of intent to marry or become domestic partners; or the length of
43 the personal relationship of the persons.
44 (5) The superintendent shall, within one hundred eighty days of the
45 effective date of this paragraph, provide for qualification standards
46 for domestic partner benefits by regulation. Such regulation:
47 (A) shall prohibit the coverage of more than one domestic partner at
48 the same time under a family contract, or coverage of a domestic partner
49 of an insured or certificate holder who is also married, or coverage as
50 a domestic partner of anyone less than eighteen years of age or any
51 person who is related to the other person by blood in a manner that
52 would bar marriage to the other person in New York state;
53 (B) shall provide for the coverage of a dependent child of a domestic
54 partner under the same terms and conditions as would apply to a depend-
55 ent child of the insured or certificate holder or spouse of such insured
56 or certificate holder;
A. 2224 5
1 (C) shall include a provision which deems as qualified any person who
2 submits proof that he or she is formally a party to a domestic partner-
3 ship, or similar relationship, entered into with the insured or certif-
4 icate holder pursuant to the laws of the United States or of any state,
5 local or foreign jurisdiction;
6 (D) shall, as an alternative to subparagraph (C) of this paragraph,
7 provide for other means of demonstrating a domestic partner relationship
8 including, but not limited to, an affidavit attesting to the relation-
9 ship;
10 (E) shall provide for reasonable procedures for notification of the
11 corporation by the insured or certificate holder of the end of the
12 domestic partner relationship;
13 (F) may, for persons not deemed as qualified pursuant to subparagraph
14 (C) or (D) of this paragraph, include provisions requiring prior cohabi-
15 tation of the insured or certificate holder and the domestic partner,
16 provided that such period of required cohabitation may not exceed six
17 months; and
18 (G) may, for persons not deemed as qualified pursuant to subparagraph
19 (C) or (D) of this paragraph, require the submission of reasonable
20 documentation of residence and financial interdependence of the kind
21 commonly available to married persons including, but not limited to,
22 income tax returns, passports, drivers' licenses, utility bills, leases,
23 deeds, joint banking and credit card accounts, retirement accounts and
24 insurance policies and benefit statements.
25 § 5. Paragraph 1 of subsection (c) of section 4305 of the insurance
26 law, as amended by chapter 312 of the laws of 2002, is amended and two
27 new paragraphs 3 and 4 are added to read as follows:
28 (1) Any such contract may provide that benefits will be furnished to a
29 member of a covered group, for [himself, his spouse, his] such member
30 and the spouse, domestic partner, child or children of such member, or
31 other persons chiefly dependent upon him or her for support and mainte-
32 nance; provided that a contract under which coverage of a dependent of a
33 member terminates at a specified age shall, with respect to an unmarried
34 child who is incapable of self-sustaining employment by reason of mental
35 illness, developmental disability, mental retardation, as defined in the
36 mental hygiene law, or physical handicap and who became so incapable
37 prior to attainment of the age at which dependent coverage would other-
38 wise terminate and who is chiefly dependent upon such member for support
39 and maintenance, not so terminate while the contract remains in force
40 and the dependent remains in such condition, if the member has within
41 thirty-one days of such dependent's attainment of the termination age
42 submitted proof of such dependent's incapacity as described herein.
43 Notwithstanding any rule, regulation or law to the contrary, any
44 contract under which a member elects coverage for [himself, his spouse,
45 his] such member and the spouse, domestic partner, children or other
46 persons chiefly dependent upon him or her for support and maintenance
47 shall provide that coverage of newborn infants, including newly born
48 infants adopted by the insured or subscriber if such insured or
49 subscriber takes physical custody of the infant upon such infant's
50 release from the hospital and files a petition pursuant to section one
51 hundred fifteen-c of the domestic relations law within thirty days of
52 birth; and provided further that no notice of revocation to the adoption
53 has been filed pursuant to section one hundred fifteen-b of the domestic
54 relations law and consent to the adoption has not been revoked, shall be
55 effective from the moment of birth for injury or sickness including the
56 necessary care and treatment of medically diagnosed congenital defects
A. 2224 6
1 and birth abnormalities including premature birth, except that in cases
2 of adoption, coverage of the initial hospital stay shall not be required
3 where a birth parent has insurance coverage available for the infant's
4 care. This provision regarding coverage of newborn infants shall not
5 apply to two person coverage. In the case of individual or two person
6 coverages the corporation must also permit the person to whom the
7 certificate is issued to elect such coverage of newborn infants from the
8 moment of birth. If notification and/or payment of an additional premium
9 or contribution is required to make coverage effective for a newborn
10 infant, the coverage may provide that such notice and/or payment be made
11 within no less than thirty days of the day of birth to make coverage
12 effective from the moment of birth. This election shall not be required
13 in the case of student insurance or where the group's plan does not
14 provide coverage for dependent children.
15 (3) A hospital service corporation or health service corporation which
16 provides a "family contract" to an individual or a group must, if
17 requested by the policyholder, make available and, if requested by the
18 insured or certificate holder, provide coverage for the domestic partner
19 of the insured or certificate holder. For the purposes of this section,
20 "domestic partner" shall mean a person who with respect to another
21 person:
22 (A) is formally a party in a domestic partnership or similar relation-
23 ship with the other person, entered into pursuant to the laws of the
24 United States or of any state, local or foreign jurisdiction, or regis-
25 tered as the domestic partner of the other person with any registry
26 maintained by the employer of either party or any state, municipality,
27 or foreign jurisdiction; or
28 (B) is dependent or mutually interdependent on the other person for
29 support, as evidenced by the totality of the circumstances indicating a
30 mutual intent to be domestic partners including but not limited to:
31 common ownership or joint leasing of real or personal property; common
32 householding, shared income or shared expenses; children in common;
33 signs of intent to marry or become domestic partners; or the length of
34 the personal relationship of the persons.
35 (4) The superintendent shall, within one hundred eighty days of the
36 effective date of this paragraph, provide for qualification standards
37 for domestic partner benefits by regulation. Such regulations:
38 (A) shall prohibit the coverage of more than one domestic partner at
39 the same time under a family contract, or coverage of a domestic partner
40 of an insured or certificate holder who is also married, or coverage as
41 a domestic partner of anyone less than eighteen years of age or any
42 person who is related to the other person by blood in a manner that
43 would bar marriage to the other person in New York state;
44 (B) shall provide for the coverage of a dependent child of a domestic
45 partner under the same terms and conditions as would apply to a depend-
46 ent child of the insured or certificate holder or spouse of such insured
47 or certificate holder;
48 (C) shall include a provision which deems as qualified any person who
49 submits proof that he or she is formally a party to a domestic partner-
50 ship, or similar relationship, entered into with the insured or certif-
51 icate holder pursuant to the laws of the United States, or of any state,
52 local or foreign jurisdiction;
53 (D) shall, as an alternative to subparagraph (C) of this paragraph,
54 provide for other means of demonstrating a domestic partner relation-
55 ship, including but not limited to, an affidavit attesting to the
56 relationship;
A. 2224 7
1 (E) shall provide for reasonable procedures for notification of the
2 corporation by the insured or certificate holder of the end of the
3 domestic partner relationship;
4 (F) may, for persons not deemed as qualified pursuant to subparagraph
5 (C) or (D) of this paragraph, include provisions requiring prior cohabi-
6 tation of the insured or certificate holder and the domestic partner,
7 provided that such period of required cohabitation may not exceed six
8 months; and
9 (G) may, for persons not deemed as qualified pursuant to subparagraph
10 (C) or (D) of this paragraph, require the submission of reasonable
11 documentation of residence and financial interdependence of the kind
12 commonly available to married persons including, but not limited to,
13 income tax returns, passports, drivers' licenses, utility bills, leases,
14 deeds, joint banking and credit care accounts, retirement accounts and
15 insurance policies and benefit statements.
16 § 6. This act shall take effect immediately.