S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  6967

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                             April 29, 2013
                               ___________

Introduced  by  M. of A. WALTER, RAIA, OAKS, FINCH -- Multi-Sponsored by
  -- M. of A. GABRYSZAK, McDONOUGH -- read  once  and  referred  to  the
  Committee on Aging

AN ACT to amend the elder law and the insurance law, in relation to long
  term  care insurance education, premiums and prohibition of exclusions
  for pre-existing conditions

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1.  Subdivision 8 of section 203 of the elder law, as added by
section  18  of  part B of chapter 58 of the laws of 2007, is amended to
read as follows:
  8. The director, in consultation  with  the  commissioner  of  health,
shall  establish  a  program to be known as the NY Connects: Choices for
Long Term Care. The purpose of this initiative is to provide consistent,
comprehensive, locally-based information and  assistance  on  long  term
care  services  to  consumers, caregivers and families to help them make
educated choices. This program shall  provide  individuals,  caregivers,
and  families  with  objective  information  and  assistance about home,
community-based and institutional long term care services,  AS  WELL  AS
INFORMATION  ABOUT  LONG TERM CARE INSURANCE PRODUCTS AND PROVIDERS.  NY
Connects will be available on a voluntary basis to consumers, caregivers
and their families. There shall be an on-going  education  and  outreach
campaign  to  educate the public about long term care services available
in their community and to assist consumers in preparing for  their  long
term care needs.
  S  2.  Section  1117 of the insurance law is amended by adding two new
subsections (c-1) and (c-2) to read as follows:
  (C-1) THE PREMIUM RATES FOR SUCH CONTRACTS  SHALL  BE  LEVEL  FOR  THE
DURATION  OF  THE  POLICY OR CERTIFICATE EXCEPT WHERE A RATE INCREASE IS
GRANTED BY THE SUPERINTENDENT. NO RATE INCREASE MAY BE  DEEMED  APPROVED
IF  THAT  INCREASE, TOGETHER WITH ANY OTHER RATE INCREASE IMPOSED ON THE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09995-01-3
              

A. 6967                             2

SAME CONTRACT OR CERTIFICATE WOULD CAUSE THE AGGREGATE RATE INCREASE FOR
THAT CONTRACT OR CERTIFICATE TO EXCEED THE LESSER OF  THREE  PERCENT  OR
THE  PERCENTAGE CHANGE IN THE CONSUMER PRICE INDEX FOR ALL URBAN CONSUM-
ERS  PUBLISHED  BY  THE  BUREAU OF LABOR STATISTICS OF THE UNITED STATES
DEPARTMENT OF LABOR DURING ANY CONTINUOUS TWELVE MONTH PERIOD.
  (C-2) THE SUPERINTENDENT SHALL NOT AUTHORIZE  SUCH  A  CONTRACT  WHICH
INCLUDES AN EXCLUSION FOR PRE-EXISTING CONDITIONS.
  S  3.  Subsection (d) of section 1117 of the insurance law, as amended
by chapter 446 of the laws of 1996,  is amended to read as follows:
  (d) Contracts issued pursuant to the provisions of this section  shall
be  subject  to all other provisions of this chapter and the regulations
promulgated thereunder applicable to  the  insurer,  health  maintenance
organization,  or  fraternal  benefit society which issues the contract,
provided however that in order to permit the development  of  long  term
care  plans, the superintendent may modify or suspend any such provision
or regulation upon making the determinations set forth in subsection (f)
of this section; AND PROVIDED  FURTHER  THAT  TO  THE  EXTENT  THAT  THE
PROVISIONS  OF THIS SECTION ARE INCONSISTENT WITH THE PROVISIONS OF THIS
CHAPTER, THE PROVISIONS OF THIS SECTION SHALL PREVAIL.
  S 4. Subsection (b) of section 3229 of the insurance law,  as  amended
by chapter 572 of the laws of 2008, is amended to read as follows:
  (b)  In  establishing  minimum  benefit  standards for insurance plans
pursuant to this section, the superintendent shall seek  to  ensure  the
cost  effectiveness of the partnership for long term care program estab-
lished pursuant to section three hundred  sixty-seven-f  of  the  social
services  law, and may establish minimum permissible payments under such
insurance plans. The superintendent shall not approve an insurance  plan
which  includes  an  exclusion for pre-existing conditions [that exceeds
six months], or which does not OTHERWISE comply with [paragraph  six  of
subsection  (b)  of]  section one thousand one hundred seventeen of this
chapter.
  S 5. This act shall take effect on the first of January next  succeed-
ing the date on which it shall have become a law.