S T A T E   O F   N E W   Y O R K
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                                  1154

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                             January 8, 2015
                               ___________

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 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
group, EXCEPT AS SET FORTH IN SUBSECTION (H) 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,  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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06335-01-5
              

A. 1154                             2

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  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.