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

                                  9980

                          I N  A S S E M B L Y

                              June 5, 2014
                               ___________

Introduced  by  COMMITTEE ON RULES -- (at request of M. of A. Cahill) --
  read once and referred to the Committee on Insurance

AN ACT to amend the insurance law, in relation to rating  of  individual
  and small group health insurance contracts and policies

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

  Section 1. Paragraph 1 of subsection (a) of section 3231 of the insur-
ance law, as amended by section 69 of part D of chapter 56 of  the  laws
of 2013, is amended to read as follows:
  (1)  No  individual health insurance policy and no group health insur-
ance policy covering between one and fifty employees or members  of  the
groupr,  EXCEPT  AS  SET  FORTH  IN  SUBSECTION  (H) OF THIS SECTION, or
between one and one hundred employees or members of the group for  poli-
cies  issued  or renewed on or after January first, two thousand sixteen
exclusive of spouses and dependents, hereinafter referred to as a  small
group,  providing  hospital  and/or medical benefits, including medicare
supplemental insurance, shall be issued in this state unless such policy
is community rated and, notwithstanding any other provisions of law, the
underwriting of such policy involves no more than the  imposition  of  a
pre-existing  condition  limitation if otherwise permitted by this arti-
cle.
  S 2. Paragraph 1 of subsection (h) of section 3231  of  the  insurance
law,  as added by chapter 501 of the laws of 1992, is amended to read as
follows:
  (1) Notwithstanding any other provision of this chapter,  no  insurer,
subsidiary  of  an  insurer,  or  controlled person of a holding company
system may act as an administrator or claims paying agent, as opposed to
an insurer, on behalf of small groups which, if  they  purchased  insur-
ance,  would  be  subject  to this section. No insurer, subsidiary of an
insurer, or controlled person of a  holding  company  may  provide  stop
loss,  catastrophic  or  reinsurance  coverage to small groups which, if
they purchased insurance, would be subject to this section. FOR PURPOSES
OF THIS SUBSECTION, "SMALL  GROUP"  SHALL  MEAN  A  GROUP  COMPRISED  OF

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD14480-01-4
              

A. 9980                             2

BETWEEN  ONE  AND  FIFTY  EMPLOYEES OR MEMBERS, EXCLUSIVE OF SPOUSES AND
DEPENDENTS.
  S  3.  Paragraph  1 of subsection (a) of section 4317 of the insurance
law, as amended by section 72 of part D of chapter 56  of  the  laws  of
2013, is amended to read as follows:
  (1) No individual health insurance contract and no group health insur-
ance contract covering between one and fifty employees or members of the
group, EXCEPT AS SET FORTH IN SUBSECTION (E) OF THIS SECTION, or between
one  and  one  hundred  employees  or  members of the group for policies
issued or renewed on or after January first, two thousand sixteen exclu-
sive of spouses and dependents, including contracts for which the premi-
ums are paid by a remitting agent for a group, hereinafter  referred  to
as  a small group, providing hospital and/or medical benefits, including
Medicare supplemental insurance, shall be issued in  this  state  unless
such   contract  is  community  rated  and,  notwithstanding  any  other
provisions of law, the underwriting of such contract  involves  no  more
than  the imposition of a pre-existing condition limitation if otherwise
permitted by this article.
  S 4. Paragraph 1 of subsection (e) of section 4317  of  the  insurance
law,  as  amended  by  section 72 of part D of chapter 56 of the laws of
2013, is amended to read as follows:
  (1) Notwithstanding any other provision of this chapter,  no  insurer,
subsidiary  of  an  insurer,  or  controlled person of a holding company
system may act as an administrator or claims paying agent, as opposed to
an insurer, on behalf of small groups which, if  they  purchased  insur-
ance,  would  be  subject  to this section. No insurer, subsidiary of an
insurer, or controlled person of a  holding  company  may  provide  stop
loss,  catastrophic  or  reinsurance  coverage to small groups which, if
they purchased insurance,  would  be  subject  to  this  section.    FOR
PURPOSES  OF THIS SUBSECTION, "SMALL GROUP" SHALL MEAN A GROUP COMPRISED
OF BETWEEN ONE AND FIFTY EMPLOYEES OR MEMBERS, EXCLUSIVE OF SPOUSES  AND
DEPENDENTS.
  S 5. This act shall take effect immediately.