Bill Text: NY S01960 | 2017-2018 | General Assembly | Introduced

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Bill Title: Requires insurance companies to disclose claims information to municipalities employing 400 or more employees to determine how their benefits are used; provides for imposition of a fine for failure to disclose such information in a timely manner.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2017-01-11 - REFERRED TO INSURANCE [S01960 Detail]

Download: New_York-2017-S01960-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          1960
                               2017-2018 Regular Sessions
                    IN SENATE
                                    January 11, 2017
                                       ___________
        Introduced  by  Sen. LATIMER -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance
        AN ACT to amend the insurance law, in relation  to  requiring  insurance
          companies to disclose claims information to municipalities
          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 3217-i
     2  to read as follows:
     3    § 3217-i. Disclosure  of  information  to  municipalities.  (a)  Every
     4  insurer  contracting  with municipalities employing four hundred or more
     5  employees, including municipal cooperative health benefit  plans  certi-
     6  fied pursuant to article forty-seven of this chapter, shall provide upon
     7  request the following information to the insured municipality:
     8    (1) specific claims experience covered by the insurer under a communi-
     9  ty  rated  or  experienced  rated policy.   For purposes of this section
    10  "experience ratings" shall mean and include  all  quantitative  measures
    11  used  by  the  insurance  carrier  such  as  expenses per member and any
    12  historical data;
    13    (2) average annual per member cost of claims reimbursement;
    14    (3) number of members who did not file a claim within a  twelve  month
    15  period;
    16    (4)  a comparison of emergency services used by members to out-patient
    17  services;
    18    (5) a loss ratio report;
    19    (6) claims history for the last twelve  months  for  experience  rated
    20  plans separated by medical and prescription;
    21    (7)  information  regarding  cost  on the top twenty-five prescription
    22  drugs being used by member employees;
    23    (8) large loss claims report indicating diagnosis  and  prognosis  for
    24  claims greater than thirty thousand dollars;
    25    (9) medical loss ratio report; and
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00913-01-7
        S. 1960                             2
     1    (10)  any  other  statistical information the municipality requests to
     2  determine use of benefits by members.
     3    (b)  The  superintendent shall impose a fine of three hundred thousand
     4  dollars for failure to provide within thirty days of a  written  request
     5  by the insured municipality the information required by paragraph one of
     6  subsection  (a) of this section relating to how funding was spent by the
     7  insurance carrier regarding the insured employees. A fine of  ten  thou-
     8  sand  dollars per day shall be imposed for each day such failure contin-
     9  ues.   Any fines imposed shall  be  paid  to  the  insured  municipality
    10  requesting such information.
    11    (c)  Notwithstanding  the  foregoing provisions, in releasing any such
    12  information the insurer shall comply with the federal  health  insurance
    13  portability and accountability act (HIPAA) of 1996, as amended.
    14    § 2. This act shall take effect immediately.