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

                                  9208

                          I N  A S S E M B L Y

                             March 31, 2014
                               ___________

Introduced by M. of A. CAHILL -- read once and referred to the Committee
  on Insurance

AN  ACT  to amend the insurance law, in relation to allowing for the use
  of an affiliate company to meet certain obligations of an insurer

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

  Section  1.  Subparagraph  (A)  of  paragraph  5  of subsection (c) of
section 3216 of the insurance law, as amended by section 46-b of part  D
of chapter 56 of the laws of 2013, is amended to read as follows:
  (A) Any family policy providing hospital or surgical expense insurance
(but  not including such insurance against accidental injury only) shall
provide that, in the event such insurance on any person, other than  the
policyholder,  is  terminated because the person is no longer within the
definition of the family as set forth in  the  policy  but  before  such
person  has  attained  the  limiting age, if any, for coverage of adults
specified in the policy, such person shall be entitled to have issued to
that person by the  insurer,  without  evidence  of  insurability,  upon
application therefor and payment of the first premium, within sixty days
after  such  insurance  shall  have terminated, an individual conversion
policy  that  contains  the  benefits  described  in  paragraph  one  of
subsection  (b)  of  section four thousand three hundred twenty-eight of
this chapter. The insurer shall offer one policy at each level of cover-
age as defined in section 1302(d) of the affordable care act, 42  U.S.C.
S  18022(d).  The  individual  may choose any such policy offered by the
insurer.  PROVIDED, HOWEVER, THE SUPERINTENDENT MAY,  AFTER  GIVING  DUE
CONSIDERATION  TO  THE  PUBLIC  INTEREST,  APPROVE  A REQUEST MADE BY AN
INSURER FOR THE INSURER TO SATISFY THE REQUIREMENTS OF THIS SUBPARAGRAPH
THROUGH THE OFFERING OF POLICIES THAT COMPLY WITH THIS  SUBPARAGRAPH  BY
ANOTHER  INSURER,  CORPORATION OR HEALTH MAINTENANCE ORGANIZATION WITHIN
THE INSURER'S HOLDING COMPANY SYSTEM, AS DEFINED IN ARTICLE  FIFTEEN  OF
THIS  CHAPTER.  The  conversion  privilege afforded herein shall also be
available upon the divorce or annulment of the marriage of  the  policy-
holder to the former spouse of such policyholder.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD14588-01-4
              

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  S  2.  Paragraph  2 of subsection (g) of section 3216 of the insurance
law is amended by adding a new subparagraph (E) to read as follows:
  (E)  THE  SUPERINTENDENT  MAY,  AFTER  GIVING DUE CONSIDERATION TO THE
PUBLIC INTEREST, APPROVE A REQUEST MADE BY AN INSURER FOR THE INSURER TO
SATISFY THE REQUIREMENTS OF SUBPARAGRAPH (C) OF THIS  PARAGRAPH  THROUGH
THE OFFERING OF POLICIES AT EACH LEVEL OF COVERAGE AS DEFINED IN SECTION
1302(D)  OF  THE AFFORDABLE CARE ACT, 42 U.S.C. S 18022(D) THAT CONTAINS
THE BENEFITS DESCRIBED IN PARAGRAPH ONE OF  SUBSECTION  (B)  OF  SECTION
FOUR  THOUSAND  THREE  HUNDRED  TWENTY-EIGHT  OF THIS CHAPTER BY ANOTHER
INSURER, CORPORATION  OR  HEALTH  MAINTENANCE  ORGANIZATION  WITHIN  THE
INSURER'S  SAME HOLDING COMPANY SYSTEM, AS DEFINED IN ARTICLE FIFTEEN OF
THIS CHAPTER.
  S 3. Subsection (g) of section 3221 of the insurance law, as added  by
section  49  of  part D of chapter 56 of the laws of 2013, is amended to
read as follows:
  (g) For conversion purposes, an insurer shall offer to the employee or
member a policy at each level of coverage as defined in section  1302(d)
of the affordable care act, 42 U.S.C. S 18022(d) that contains the bene-
fits  described in paragraph one of subsection (b) of section four thou-
sand three hundred twenty-eight of this chapter.  PROVIDED, HOWEVER, THE
SUPERINTENDENT MAY, AFTER GIVING DUE CONSIDERATION TO THE PUBLIC  INTER-
EST, APPROVE A REQUEST MADE BY AN INSURER FOR THE INSURER TO SATISFY THE
REQUIREMENTS  OF  THIS  SUBSECTION  AND  SUBSECTIONS (E) AND (F) OF THIS
SECTION  THROUGH  THE  OFFERING  OF  POLICIES  THAT  COMPLY  WITH   THIS
SUBSECTION  BY ANOTHER INSURER, CORPORATION OR HEALTH MAINTENANCE ORGAN-
IZATION WITHIN THE INSURER'S HOLDING COMPANY SYSTEM, AS DEFINED IN ARTI-
CLE FIFTEEN OF THIS CHAPTER.
  S 4. Item (i) of subparagraph (C) of paragraph 2 of subsection (c)  of
section  4304 of the insurance law, as amended by section 43-a of part D
of chapter 56 of the laws of 2013, is amended to read as follows:
  (i) Discontinuance of a class of contract  upon  not  less  than  five
months'  prior  written  notice. In exercising the option to discontinue
coverage pursuant to this item, the corporation must act uniformly with-
out regard to any health status-related factor of  enrolled  individuals
or  individuals who may become eligible for such coverage and must offer
to subscribers or group remitting agents, as  may  be  appropriate,  the
option  to  purchase  all  other  individual  health  insurance coverage
currently being offered by the corporation to applicants in that market.
PROVIDED, HOWEVER, THE SUPERINTENDENT MAY, AFTER  GIVING  DUE  CONSIDER-
ATION  TO  THE  PUBLIC INTEREST, APPROVE A REQUEST MADE BY A CORPORATION
FOR THE CORPORATION TO SATISFY THE REQUIREMENTS OF THIS ITEM THROUGH THE
OFFERING OF CONTRACTS AT EACH LEVEL OF COVERAGE AS  DEFINED  IN  SECTION
1302(D)  OF  THE AFFORDABLE CARE ACT, 42 U.S.C. S 18022(D) THAT CONTAINS
THE BENEFITS DESCRIBED IN PARAGRAPH ONE OF  SUBSECTION  (B)  OF  SECTION
FOUR  THOUSAND  THREE  HUNDRED  TWENTY-EIGHT  OF THIS CHAPTER BY ANOTHER
CORPORATION, INSURER  OR  HEALTH  MAINTENANCE  ORGANIZATION  WITHIN  THE
CORPORATION'S SAME HOLDING COMPANY SYSTEM, AS DEFINED IN ARTICLE FIFTEEN
OF THIS CHAPTER.
  S  5.  Paragraph  1 of subsection (e) of section 4304 of the insurance
law, as amended by section 51 of part D of chapter 56  of  the  laws  of
2013, is amended to read as follows:
  (1)  If  any  such  contract  is  terminated  in  accordance  with the
provisions of paragraph one of subsection (c) of this  section,  or  any
such  contract is terminated because of a default by the remitting agent
in the payment of premiums not cured within the  grace  period  and  the
remitting  agent  has not replaced the contract with similar and contin-

A. 9208                             3

uous coverage for the same group whether insured or self-insured, or any
such contract is terminated in accordance with the provisions of subpar-
agraph (E) of paragraph two of subsection (c) of this section, or if  an
individual  other  than the contract holder is no longer covered under a
"family contract" because the individual is no longer within  the  defi-
nition set forth in the contract, or a spouse is no longer covered under
the contract because of divorce from the contract holder or annulment of
the marriage, or any such contract is terminated because of the death of
the contract holder, then such individual, former spouse, or in the case
of the death of the contract holder the surviving spouse or other depen-
dents of the deceased contract holder covered under the contract, as the
case  may  be, shall be entitled to convert, without evidence of insura-
bility, upon application therefor and the making of  the  first  payment
thereunder  within  sixty  days  after  the  date of termination of such
contract, to a contract that contains the benefits  described  in  para-
graph one of subsection (b) of section four thousand three hundred twen-
ty-eight  of  this  chapter. The corporation shall offer one contract at
each level of coverage as defined in section 1302(d) of  the  affordable
care  act,  42  U.S.C.  S  18022(d).  The individual may choose any such
contract offered by the corporation.  PROVIDED, HOWEVER, THE SUPERINTEN-
DENT MAY, AFTER GIVING DUE CONSIDERATION TO THE PUBLIC INTEREST, APPROVE
A REQUEST MADE BY A CORPORATION  FOR  THE  CORPORATION  TO  SATISFY  THE
REQUIREMENTS  OF  THIS  PARAGRAPH THROUGH THE OFFERING OF CONTRACTS THAT
COMPLY WITH THIS PARAGRAPH BY ANOTHER  CORPORATION,  INSURER  OR  HEALTH
MAINTENANCE  ORGANIZATION  WITHIN THE CORPORATION'S SAME HOLDING COMPANY
SYSTEM, AS DEFINED IN ARTICLE FIFTEEN OF  THIS  CHAPTER.  The  effective
date  of  the coverage provided by the converted direct payment contract
shall be the date of the termination of coverage under the contract from
which conversion was made.
  S 6. Subparagraph (A) of paragraph 1 of subsection (d) of section 4305
of the insurance law, as amended by section 52 of part D of  chapter  56
of the laws of 2013, is amended to read as follows:
  (A)  A  group contract issued pursuant to this section shall contain a
provision to the effect that in case of a termination of coverage  under
such  contract of any member of the group because of (i) termination for
any reason whatsoever of the member's employment or membership, or  (ii)
termination  for  any  reason  whatsoever  of  the group contract itself
unless the group contract holder has replaced the  group  contract  with
similar  and  continuous  coverage for the same group whether insured or
self-insured, the member shall be entitled to have issued to the  member
by  the  corporation, without evidence of insurability, upon application
therefor and payment of the first premium made to the corporation within
sixty days after termination  of  the  coverage,  an  individual  direct
payment  contract, covering such member and the member's eligible depen-
dents who were covered by the group contract,  which  provides  coverage
that  contains the benefits described in paragraph one of subsection (b)
of section four thousand three hundred twenty-eight of this chapter. The
corporation shall offer one  contract  at  each  level  of  coverage  as
defined  in  section  1302(d)  of  the  affordable care act, 42 U.S.C. S
18022(d). The member may choose any such contract offered by the  corpo-
ration.    PROVIDED,  HOWEVER,  THE SUPERINTENDENT MAY, AFTER GIVING DUE
CONSIDERATION TO THE PUBLIC INTEREST, APPROVE A REQUEST MADE BY A CORPO-
RATION FOR THE CORPORATION TO SATISFY THE REQUIREMENTS OF THIS  SUBPARA-
GRAPH  THROUGH  THE OFFERING OF CONTRACTS THAT COMPLY WITH THIS SUBPARA-
GRAPH BY ANOTHER CORPORATION, INSURER OR HEALTH MAINTENANCE ORGANIZATION

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WITHIN THE CORPORATION'S SAME HOLDING  COMPANY  SYSTEM,  AS  DEFINED  IN
ARTICLE FIFTEEN OF THIS CHAPTER.
  S 7. This act shall take effect immediately.