Bill Text: NY A03001 | 2009-2010 | General Assembly | Introduced
Bill Title: An act to amend the insurance law, in relation to the establishment of freedom health insurance plans
Spectrum: Partisan Bill (Republican 19-0)
Status: (Introduced - Dead) 2010-01-06 - referred to insurance [A03001 Detail]
Download: New_York-2009-A03001-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
3001
2009-2010 Regular Sessions
I N A S S E M B L Y
January 22, 2009
___________
Introduced by M. of A. BARCLAY, KOLB, OAKS, GIGLIO, REILICH, MOLINARO --
Multi-Sponsored by -- M. of A. BACALLES, BURLING, CALHOUN, CONTE,
CROUCH, ERRIGO, FINCH, HAWLEY, SAYWARD, TEDISCO, TOWNSEND -- read once
and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to the establishment of
freedom health insurance plans
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Subsection (l) of section 3216 of the insurance law, as
2 added by chapter 504 of the laws of 1995, is amended to read as follows:
3 (l) On and after January first, nineteen hundred ninety-seven, no
4 insurer shall offer major medical, comprehensive or other comparable
5 individual contracts, other than for purposes of conversion, unless the
6 benefits of such contracts, including deductibles and coinsurance, are
7 identical to the out-of-plan benefits of the contracts described in
8 section four thousand three hundred twenty-two of this chapter. Such
9 contracts must include a prescription drug benefit complying with the
10 requirements of that section. THE REQUIREMENTS OF THIS SUBSECTION SHALL
11 NOT APPLY TO A POLICY INTENDED TO QUALIFY FOR USE IN A HEALTH SAVINGS
12 ACCOUNT PURSUANT TO SECTION 1201 OF THE FEDERAL MEDICARE PRESCRIPTION
13 DRUG, IMPROVEMENT AND MODERNIZATION ACT OF 2003. SUCH POLICIES SHALL BE
14 KNOWN AS "FREEDOM POLICIES".
15 S 2. Section 3221 of the insurance law is amended by adding a new
16 subsection (r) to read as follows:
17 (R) NO GROUP OR BLANKET ACCIDENT AND HEALTH INSURANCE POLICY ISSUED OR
18 ISSUED FOR DELIVERY IN THIS STATE FOR USE IN A HEALTH SAVINGS ACCOUNT
19 PURSUANT TO SECTION 1201 OF THE FEDERAL MEDICARE PRESCRIPTION DRUG,
20 IMPROVEMENT, AND MODERNIZATION ACT OF 2003 SHALL BE REQUIRED TO MEET THE
21 REQUIREMENTS OF THIS SECTION, OR REGULATIONS ISSUED BY THE SUPERINTEN-
22 DENT, WITH REGARD TO COVERED HEALTH CARE SERVICES WHICH MUST BE INCLUDED
23 IN THE POLICY. SUCH POLICIES SHALL BE KNOWN AS "FREEDOM POLICIES".
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02808-01-9
A. 3001 2
1 S 3. Subsection (l) of section 4304 of the insurance law, as added by
2 chapter 504 of the laws of 1995, is amended to read as follows:
3 (l) On and after January first, nineteen hundred ninety-seven, no
4 insurer shall offer major medical, comprehensive or other comparable
5 individual contracts on a direct payment basis, other than for purposes
6 of conversion, unless the benefits of such contracts, including deduct-
7 ibles and coinsurance, are identical to the out-of-plan benefits of the
8 contracts described in section four thousand three hundred twenty-two of
9 this article. Such contracts must include a prescription drug benefit
10 complying with the requirements of such section. THE REQUIREMENTS OF
11 THIS SUBSECTION SHALL NOT APPLY TO A POLICY INTENDED TO QUALIFY FOR USE
12 IN A HEALTH SAVINGS ACCOUNT PURSUANT TO SECTION 1201 OF THE FEDERAL
13 MEDICARE PRESCRIPTION DRUG, IMPROVEMENT AND MODERNIZATION ACT OF 2003.
14 SUCH POLICIES SHALL BE KNOWN AS "FREEDOM POLICIES".
15 S 4. Section 4304 of the insurance law is amended by adding a new
16 subsection (m) to read as follows:
17 (M) NO POLICY ISSUED TO A REMITTING AGENT ON BEHALF OF A GROUP PURSU-
18 ANT TO SUBSECTION (A) OF THIS SECTION, AND NO POLICY ISSUED TO A GROUP
19 PURSUANT TO SECTION FOUR THOUSAND THREE HUNDRED FIVE OF THIS ARTICLE,
20 FOR USE IN A HEALTH SAVINGS ACCOUNT PURSUANT TO SECTION 1201 OF THE
21 FEDERAL MEDICARE PRESCRIPTION DRUG, IMPROVEMENT, AND MODERNIZATION ACT
22 OF 2003 SHALL BE REQUIRED TO MEET THE REQUIREMENTS OF THIS SECTION OR
23 SECTION FOUR THOUSAND THREE HUNDRED FIVE OF THIS ARTICLE, OR REGULATIONS
24 ISSUED BY THE SUPERINTENDENT, WITH REGARD TO COVERED HEALTH CARE
25 SERVICES WHICH MUST BE INCLUDED IN THE POLICY. SUCH POLICIES SHALL BE
26 KNOWN AS "FREEDOM POLICIES".
27 S 5. Subsection (a) of section 4322 of the insurance law, as amended
28 by chapter 342 of the laws of 2004, is amended to read as follows:
29 (a) On and after January first, nineteen hundred ninety-six, all
30 health maintenance organizations issued a certificate of authority under
31 article forty-four of the public health law or licensed under this arti-
32 cle shall offer to individuals, in addition to the standardized contract
33 required by section four thousand three hundred twenty-one of this arti-
34 cle, a standardized individual enrollee direct payment contract on an
35 open enrollment basis as prescribed by section four thousand three
36 hundred seventeen of this article and section four thousand four hundred
37 six of the public health law, and regulations promulgated thereunder,
38 with an out-of-plan benefit system, provided, however, that such
39 requirements shall not apply to a health maintenance organization exclu-
40 sively serving individuals enrolled pursuant to title eleven of article
41 five of the social services law, title eleven-D of article five of the
42 social services law, title one-A of article twenty-five of the public
43 health law or title eighteen of the federal Social Security Act, and,
44 further provided, that such health maintenance organization shall not
45 discontinue a contract for an individual receiving comprehensive-type
46 coverage in effect prior to January first, two thousand four who is
47 ineligible to purchase policies offered after such date pursuant to this
48 section or section four thousand three hundred twenty-two of this arti-
49 cle due to the provision of 42 U.S.C. 1395ss in effect prior to January
50 first, two thousand four. The out-of-plan benefit system shall either be
51 provided by the health maintenance organization pursuant to subdivision
52 two of section four thousand four hundred six of the public health law
53 or through an accompanying insurance contract providing out-of-plan
54 benefits offered by a company appropriately licensed pursuant to this
55 chapter. On and after January first, nineteen hundred ninety-six, the
56 contracts issued pursuant to this section and section four thousand
A. 3001 3
1 three hundred twenty-one of this article shall be the only contracts
2 offered by health maintenance organizations to individuals; PROVIDED,
3 HOWEVER, THIS LIMITATION SHALL NOT APPLY TO ONE OR MORE POLICIES
4 INTENDED TO QUALIFY FOR USE IN A HEALTH SAVINGS ACCOUNT PURSUANT TO
5 SECTION 1201 OF THE FEDERAL MEDICARE PRESCRIPTION DRUG, IMPROVEMENT, AND
6 MODERNIZATION ACT OF 2003. SUCH POLICIES SHALL BE KNOWN AS "FREEDOM
7 POLICIES". The enrollee contracts issued by a health maintenance organ-
8 ization under this section and section four thousand three hundred twen-
9 ty-one of this article shall also be the only contracts issued by the
10 health maintenance organization for purposes of conversion pursuant to
11 sections four thousand three hundred four and four thousand three
12 hundred five of this article. However, nothing in this section shall be
13 deemed to require health maintenance organizations to terminate individ-
14 ual direct payment contracts issued prior to January first, nineteen
15 hundred ninety-six or prohibit health maintenance organizations from
16 terminating individual direct payment contracts issued prior to January
17 first, nineteen hundred ninety-six.
18 S 6. This act shall take effect immediately.
