NY State Senate Bill 2017-S8983A

Senate Bill S8983A

2017-2018 Legislative Session

Relates to policies or contracts which are not included in the definition of student accident and health insurance

download bill text pdf

Archive: Last Bill Status - In Senate Committee Rules Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 18, 2018	print number 8983a
Jun 18, 2018	amend (t) and recommit to rules
Jun 11, 2018	referred to rules

Bill Amendments

Original

A (Active)

2017-S8983 - Details

See Assembly Version of this Bill:: A11192
Current Committee:: Senate Rules
Law Section:: Insurance Law
Laws Affected:: Amd §3240, Ins L
Versions Introduced in 2019-2020 Legislative Session:: S1884, S6197, A492

2017-S8983 - Summary

Relates to policies or contracts which are not included in the definition of student accident and health insurance.

2017-S8983 - Sponsor Memo

2017-S8983 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8983
 
                             I N  S E N A T E
 
                               June 11, 2018
                                ___________
 
 Introduced  by  Sen.  O'MARA -- read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 AN ACT to amend the insurance law, in  relation  to  the  definition  of
   student accident and health insurance
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Items (i) and (ii) of subparagraph (B) of paragraph (1)  of
 subsection (a) of section 3240 of the insurance law are relettered items
 (ii) and (iii) and a new item (i) is added to read as follows:
   (I)  AN ACCIDENT POLICY OR CONTRACT THAT PROVIDES BENEFITS MEETING THE
 DEFINITION OF "EXPECTED BENEFITS" SET  FORTH  IN  SECTION  2791  OF  THE
 PUBLIC  HEALTH  SERVICE  ACT,  42  U.S.C. §300GG-91(C), IF THE POLICY OR
 CONTRACT IS LIMITED IN COVERAGE FOR  TRAVEL  BASED  SICKNESS,  ACCIDENT,
 DISABILITY  OR  DEATH  OCCURRING DURING TRAVEL, WITH ANY HEALTH BENEFITS
 INCIDENTAL TO OTHER COVERAGE;
   § 2. Item (iii) of subparagraph (C) of paragraph 3 of  subsection  (a)
 of  section  4237 of the insurance law, as amended by chapter 461 of the
 laws of 2015, is amended to read as follows:
   (iii) as described in item [(ii)] (III) of subparagraph (B)  of  para-
 graph  one of subsection (a) of section three thousand two hundred forty
 of this chapter.
   § 3. This act shall take effect January 1, 2019, and  shall  apply  to
 all policies and contracts issued, renewed, modified, altered or amended
 on or after such date.
 
 
 
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD16024-01-8

2017-S8983A (ACTIVE) - Details

See Assembly Version of this Bill:: A11192
Current Committee:: Senate Rules
Law Section:: Insurance Law
Laws Affected:: Amd §3240, Ins L
Versions Introduced in 2019-2020 Legislative Session:: S1884, S6197, A492

2017-S8983A (ACTIVE) - Summary

Relates to policies or contracts which are not included in the definition of student accident and health insurance.

2017-S8983A (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S8983A

SPONSOR: O'MARA
 
TITLE OF BILL:  An act to amend the insurance law, in relation to
policies or contracts which are not included in the definition of
student accident and health insurance

 
PURPOSE:

This bill will clarify that New York State law does not prohibit the
issuance of policies offering certain "excepted benefits," such as
dental, vision, intercollegiate sports injury coverage, and travel
insurance to institutions, of higher learning.

 
SUMMARY OF PROVISIONS:

Section 1 amends clause (ii) of subparagraph (B) of paragraph 1 of
subsection (a) of § 3240 of the insurance law to clarify that New York
law does not prohibit the issuance of policies offering certain
"excepted benefits," such as dental, vision, or intercollegiate sports
injury coverage, and travel insurance to institutions of higher learn-

ing.

§ 2 establishes the effective date.

 
JUSTIFICATION:

New York has enacted law to conform its requirements for student health
insurance to the requirements set forth in the Affordable Care Act
("ACA"), including the ACA requirement that student health insurance
policies include a comprehensive set of "essential health benefits"
which are not subject to annual or lifetime dollar limitations. New
York's laws are aimed at traditional student health insurance policies
subject to ACA requirements. Such policies are typically offered by
institutions of higher education as a comprehensive health insurance
option for students that do not have access to health insurance through
a parent's plan. However, New York's laws do not distinguish between
traditional student health insurance policies and "excepted benefits"
policies such as accident, dental, and vision policies, which are
purchased by institutions of higher learning to address potential gaps
in coverage.

New York has interpreted its ACA compliance obligations to require all
policies issued to students of institutions of higher education to
include comprehensive essential health benefits without annual or life-
time dollar limitations. This interpretation has raised questions
regarding whether it is permissible to issue student policies in the
college market providing dental coverage, vision coverage, and other
intercollegiate sports injury coverage recognized by the ACA as
"excepted benefits." Such policies do not offer "essential health bene-
fits" without limitation. Dental policies, for example, do not typically
include maternity or mammography benefits because it falls outside of
the intended scope of the policy. However, dental policies do provide
students with important health coverage that may not be included in
their comprehensive medical plan.

Relating to travel insurance, many institutions have in the past
purchased coverage to take care of gaps in health insurance policies,
such as high out-of-network deductibles for care received outside the
United States or medical evacuation to transport a student home after
they are stabilized, but still require hospital care.

New York has interpreted its ACA conforming law to prohibit insurers
from issuing travel accident policies, as they do not provide all
comprehensive essential health benefits. These are allowable in 49 other
states.

The Department of Financial Services has directed companies to stop
selling medical evacuation polices to institutions of higher education,
making this needed coverage unavailable in NYS. DFS informed colleges
and universities that this amendment is necessary to make such policies
allowable.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

None to the state.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2017-S8983A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8983--A
 
                             I N  S E N A T E
 
                               June 11, 2018
                                ___________
 
 Introduced  by  Sen.  O'MARA -- read twice and ordered printed, and when
   printed to be  committed  to  the  Committee  on  Rules  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 AN  ACT to amend the insurance law, in relation to policies or contracts
   which are not included in  the  definition  of  student  accident  and
   health insurance

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Clause  (ii)  of  subparagraph  (B)  of  paragraph  1  of
 subsection (a) of section 3240 of the insurance law, as amended by chap-
 ter 461 of the laws of 2015, is amended to read as follows:
   (ii) [an accident] A policy or contract that provides benefits meeting
 the  definition  of "excepted benefits" set forth in section 2791 of the
 public health service act, 42 U.S.C. § 300gg-91(c),  if  the  policy  or
 contract IS LIMITED TO INSURANCE COVERAGE FOR PERSONAL RISKS INCIDENT TO
 PLANNED  TRAVEL,  INCLUDING  SICKNESS,  ACCIDENT,  DISABILITY,  OR DEATH
 OCCURRING DURING TRAVEL, PROVIDED THAT  SUCH  HEALTH  BENEFITS  ARE  NOT
 OFFERED ON A STAND-ALONE BASIS AND ARE INCIDENTAL TO OTHER COVERAGE.
   (III)  AN  ACCIDENT  POLICY OR CONTRACT THAT PROVIDES BENEFITS MEETING
 THE DEFINITION OF "EXCEPTED BENEFITS" SET FORTH IN SECTION 2791  OF  THE
 PUBLIC  HEALTH  SERVICE  ACT,  42 U.S.C. § 300GG-91(C), IF THE POLICY OR
 CONTRACT:
   (I) is limited to coverage for intercollegiate sports injuries only;
   (II) provides benefits  to  diagnose  and  treat  any  intercollegiate
 sports  injury  and does not include a benefit dollar maximum amount per
 injury that is less than the overall benefit dollar maximum  amount  per
 student under the intercollegiate sports injury policy or contract;
   (III) provides benefits on an expense incurred basis;
   (IV)  provides  that  premiums  are paid in full by the institution of
 higher education;
   (V) includes prominent disclosure to the  student  that  the  accident
 policy is not a substitute for comprehensive hospital and medical cover-
 age;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                       [ ] is old law to be omitted.
                                                            LBD16024-02-8

 S. 8983--A                          2
 
   (VI)  provides coverage for intercollegiate sports injuries primary to
 any student accident and health insurance  policy  or  contract  or  any
 student  health plan issued pursuant to section one thousand one hundred
 twenty-four of this chapter; except that a policy  or  contract  meeting
 the  requirements  of  this item may be excess or secondary to any other
 policy or contract of accident and health insurance; and
   (VII) includes a maximum benefit amount  that  is  no  less  than  the
 deductible under the separate athletic association policy or contract if
 designed  to  coordinate with a separate policy or contract issued to an
 athletic association that extends coverage  for  intercollegiate  sports
 injuries.
   § 2. This act shall take effect immediately.

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