Bill Text: NY A10133 | 2017-2018 | General Assembly | Introduced
Bill Title: Authorizes municipalities and districts to enter into cooperative agreements for the provision of centralized public employee administrative and personnel services; provides for health insurance coverage of municipal employees pursuant to standardized health insurance contracts; and authorizes the provision of reduced premiums for municipal health insurance plans which offer wellness programs.
Spectrum: Slight Partisan Bill (Democrat 2-1)
Status: (Introduced - Dead) 2018-03-16 - referred to local governments [A10133 Detail]
Download: New_York-2017-A10133-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 10133 IN ASSEMBLY March 16, 2018 ___________ Introduced by M. of A. ZEBROWSKI, SCHIMMINGER, NORRIS -- read once and referred to the Committee on Local Governments AN ACT to amend the general municipal law, in relation to authorizing cities, towns, villages, school districts, boards of cooperative educational services, library districts, fire districts, improvement districts and special districts to enter into cooperative agreements for the provision of centralized public employee administrative and personnel services; and to amend the insurance law, in relation to authorizing reduction of premiums for municipal cooperative health benefit plans which offer employee wellness programs The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 92-a of the general municipal law is amended by 2 adding a new subdivision 8 to read as follows: 3 8. The provisions of this section shall not apply to any public corpo- 4 ration which provides health insurance benefits to its officers and 5 employees pursuant to article forty-seven of the insurance law. 6 § 2. Subdivision a of section 119-n of the general municipal law, as 7 amended by chapter 413 of the laws of 1991, is amended to read as 8 follows: 9 a. The term "municipal corporation" means a county outside the city of 10 New York, a city, a town, a village, a board of cooperative educational 11 services, a public library as defined in section two hundred fifty-three 12 of the education law, a fire district or a school district. 13 § 3. Subdivision 2 of section 119-o of the general municipal law is 14 amended by adding a new paragraph b-1 to read as follows: 15 b-1. The establishment of a centralized office to collectively 16 provide: 17 (i) employee payroll, time, attendance and personnel administration 18 services; 19 (ii) participation in the New York state health insurance program; 20 (iii) a personnel office to provide information on employee health 21 insurance and other employee benefits; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01961-01-7A. 10133 2 1 (iv) employee health insurance benefits from more than one health 2 insurance carrier or organization, which grants each employee the choice 3 of which health insurance plan which will provide coverage; 4 (v) employee participation in tax deferred retirement plans, health 5 care plans and child care plans; 6 (vi) municipal cooperative health benefit plans pursuant to article 7 forty-seven of the insurance law; 8 (vii) adequate and ongoing financial controls and security arrange- 9 ments to ensure that the participating municipal corporations and 10 districts remain solvent; 11 (viii) the preparation and dissemination of informational and solic- 12 itation materials to facilitate comparison of the various employee 13 health insurance plans offered by the participating municipal corpo- 14 rations and districts; 15 (ix) for the enrollment, billing, premium collection, premium 16 disbursement and reconciliation, commission disbursement, and other 17 processing services for health insurance benefits provided to municipal 18 employees; 19 (x) contracting with qualified third parties for the provision of any 20 service necessary to carry out such office's powers and duties; and 21 (xi) negotiation with participating health insurers and health mainte- 22 nance organizations with regard to the administrative expenses portion 23 of premium rates charged for health care coverage offered to municipal 24 employees by such office. 25 § 4. Subsections (a) and (f) of section 4702 of the insurance law, as 26 added by chapter 689 of the laws of 1994, are amended and a new 27 subsection (i-1) is added to read as follows: 28 (a) "Community rating" means a rating methodology in which the premium 29 equivalent rate for all persons covered under a municipal cooperative 30 health benefit plan is the same, based upon the experience of the entire 31 pool of risks covered under the plan, without regard to age, sex, health 32 status or occupation and such that refunds, rebates, credits or divi- 33 dends based upon age, sex, health status or occupation are not 34 permitted; provided, however, that, subject to the approval of the 35 superintendent, such plan may provide an actuarially appropriate 36 reduction in premium rates in return for an enrollee's or insured's 37 adherence to a bona fide wellness program. A bona fide wellness program 38 is either a risk management system that identifies at-risk populations 39 or any other systematic program or course of medical conduct which helps 40 to promote good health, helps to prevent or mitigate acute or chronic 41 sickness or disease, or which minimizes adverse health consequences due 42 to lifestyle. Such wellness program shall demonstrate actuarially that 43 it encourages the general good health and well-being of the covered 44 population. Such plan shall not require specific outcomes as a result of 45 an enrollee's or insured's adherence to the approved wellness program. 46 (f) "Municipal corporation" means within the state of New York, a city 47 [with a population of less than one million or], a county outside the 48 city of New York, town, village, board of cooperative educational 49 services, school district, a fire district, a public library, as defined 50 in section two hundred fifty-three of the education law, or district, as 51 defined in section one hundred nineteen-n of the general municipal law. 52 (i-1) "Stop-loss insurance" means an insurance policy whereby the 53 insurer agrees to pay claims or indemnify a municipal corporation for 54 losses incurred under a municipal cooperative health benefit plan in 55 excess of specified loss limits for individual claims and/or for all 56 claims combined, or any similar arrangement.A. 10133 3 1 § 5. Paragraphs 2 and 3 of subsection (a) of section 4704 of the 2 insurance law, paragraph 2 as amended by section 3 of part A of chapter 3 494 of the laws of 2009 and paragraph 3 as added by chapter 689 of the 4 laws of 1994, are amended to read as follows: 5 (2) except for any plan that provided medical, surgical and hospital 6 services on or before January first, nineteen hundred ninety-three 7 pursuant to a municipal cooperation agreement, the number of municipal 8 corporations participating in the municipal cooperative health benefit 9 plan shall be at least [three] two; 10 (3) except for any plan that provided medical, surgical and hospital 11 services to at least three hundred fifty covered employees (including 12 retirees and not including dependents) on or before January first, nine- 13 teen hundred ninety-three pursuant to a municipal cooperation agreement, 14 the number of covered employees (including retirees and not including 15 dependents) of municipal corporations participating in the municipal 16 cooperative health benefit plan shall be at least [two thousand] five 17 hundred; 18 § 6. Subsection (b) of section 4704 of the insurance law, as added by 19 chapter 689 of the laws of 1994, is amended to read as follows: 20 (b) The superintendent shall refuse to grant a certificate of authori- 21 ty to an applicant that fails to meet the requirements of this section. 22 Notice of refusal shall be in writing and shall set forth the basis for 23 the refusal. If the applicant submits a written request within [thirty] 24 sixty days after receipt of the notice of refusal, the superintendent 25 shall promptly conduct a hearing to give the applicant the opportunity 26 to show cause why the refusal should not be made final. 27 § 7. Paragraphs 1, 2 and 5 of subsection (d) of section 4705 of the 28 insurance law, paragraphs 1 and 5 as added by chapter 689 of the laws of 29 1994 and paragraph 2 as amended by chapter 681 of the laws of 2002, are 30 amended to read as follows: 31 (1) shall design the plan or plans of benefits provided or offered by 32 the municipal cooperative health benefit plan and prepare the plan docu- 33 ment and summary plan description in accordance with section four thou- 34 sand seven hundred nine of this article, and shall include a wellness 35 program option; 36 (2) may enter into an agreement with a contract administrator or other 37 service provider, determined by the governing board to be qualified, to 38 receive, investigate, recommend, audit, approve or make payment of 39 claims under the municipal cooperative health benefit plan or plans, 40 provided that: 41 (A) the charges, fees and other compensation for any contracted 42 services shall be clearly stated in written administrative services 43 contracts as required in subdivision six of section ninety-two-a of the 44 general municipal law; 45 (B) payment for contracted services shall be made only after such 46 services are rendered; and 47 (C) no member of the plan's governing board or any member of such 48 member's immediate family shall be an owner, officer, director, partner, 49 or employee of any contract administrator retained by the plan[; and50(D) all such agreements shall comply with the requirements of subdivi-51sion six of section ninety-two-a of the general municipal law]. 52 (5) shall prepare an annual budget for the municipal cooperative 53 health benefit plan to determine the premium equivalent rates for 54 participating municipal corporations to be deposited in the plan's joint 55 fund or funds during the fiscal year, provided that:A. 10133 4 1 (A) the governing board shall designate the bank or trust company in 2 which joint funds, including reserve funds, are to be deposited and 3 which shall be located in this state, duly chartered under federal law 4 or the laws of this state; and 5 (B) the governing board shall establish premium equivalent rates for 6 participating municipal corporations on the [bases] basis of a community 7 rating methodology filed with and approved by the superintendent and, in 8 determining the annual premium equivalent rates, the governing board: 9 (i) may contract for necessary actuarial services to estimate expected 10 plan expenditures during the fiscal year; 11 (ii) shall maintain reserves in amounts equal to or exceeding the 12 minimum amounts required by section four thousand seven hundred six of 13 this article; and 14 (iii) shall maintain a stop-loss policy or policies, to the extent 15 required by section four thousand seven hundred seven of this article; 16 § 8. Subparagraphs (A) and (B) of paragraph 5 of subsection (a) of 17 section 4706 of the insurance law, as added by chapter 689 of the laws 18 of 1994, are amended to read as follows: 19 (A) five percent of the annualized earned premium equivalents during 20 the current fiscal year of a municipal cooperative health benefit plan 21 which consists of [five] two or more participating municipal corpo- 22 rations and covers [two thousand] five hundred or more employees and 23 retirees; or 24 (B) seven percent of the annualized earned premium equivalents during 25 the current fiscal year of the municipal cooperative health benefit plan 26 which consists of [four] two or fewer participating municipal corpo- 27 rations or covers fewer than [two thousand] five hundred employees and 28 retirees. 29 § 9. This act shall take effect on the first of January next succeed- 30 ing the date on which it shall have become a law.
