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

                                  4902

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 9, 2015
                               ___________

Introduced by M. of A. WALTER -- 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
SAME CONTRACT OR CERTIFICATE WOULD CAUSE THE AGGREGATE RATE INCREASE FOR

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08264-01-5
              

A. 4902                             2

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.