S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    310
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced  by  M.  of  A. STECK, PEOPLES-STOKES, FAHY, ARROYO, GUNTHER,
   MOSLEY, MONTESANO, RAIA, PALMESANO, STIRPE, HAWLEY, GOTTFRIED,  BRABE-
   NEC,  FRIEND, ZEBROWSKI, GALEF, ENGLEBRIGHT, BARRETT, GIGLIO, BLANKEN-
   BUSH, BUCHWALD, BLAKE, LIFTON, WOERNER, LUPARDO, HEVESI -- Multi-Spon-
   sored by -- M. of A.  BARCLAY,  CROUCH,  LAVINE,  SCHIMMINGER,  SIMON,
   THIELE -- read once and referred to the Committee on Insurance
 
 AN  ACT authorizing municipalities to join a county self-funded or self-
   insured health plan
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Notwithstanding articles 44 or 47 of the insurance law or
 any other provision of law to the contrary, and subject to the  require-
 ments  set  forth in this section, a municipality is permitted, with the
 consent of the county and the governing body of  such  municipality,  to
 join  a  county self-funded or self-insured health plan in any county in
 which such municipality is located in whole or in part. Municipality  is
 defined as any city, town, village or any other municipal corporation, a
 school  district  or  any governmental entity operating a public school,
 college or university, a  public  improvement  or  special  district,  a
 public  authority,  commission,  or  public  benefit corporation, or any
 other public corporation, agency or instrumentality or unit  of  govern-
 ment which exercises governmental powers under the laws of the state but
 is  not  a  part of, nor a department of, nor an agency of the state. In
 order for a municipality to join the county self-funded or  self-insured
 health  plan, the county shall file with the superintendent of financial
 services certification that, with inclusion of the lives to  be  covered
 in  the  plan  following admission of the municipality, the county self-
 funded or self-insured health plan meets  the  following  four  require-
 ments:

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

                                                            LBD03515-01-9

 A. 310                              2
 
   (a)  That  it  maintain  a reserve fund, calculated as a percentage of
 total annual incurred claims, of a minimum of 13% and a maximum  of  15%
 of medical claims and a minimum of 4% of prescription claims.
   (b)  It  has in effect a specific stop loss per individual claim only,
 no aggregate, and with a minimum deductible of $200,000 to $250,000.
   (c) It has a minimum of 1,000 covered lives  including  retirees,  but
 not including dependents.
   (d) The plan has in effect an agreement between itself and any munici-
 palities  that  have  joined  the  plan such that the plan satisfies the
 contingent liability provisions set forth in section 4708 of the  insur-
 ance law.
   The  superintendent  of financial services shall have the authority to
 review such certification to  determine  that  the  four  aforementioned
 requirements  have been met; provided, however, that in the absence of a
 finding of the superintendent to the contrary within a six-month  period
 following the filing of such certification, the admission of the munici-
 pality  to the county self-funded or self-insured health plan shall take
 effect. In January of every year following the initial  filing  of  such
 certification, the county shall file a subsequent certification that the
 four aforementioned requirements remain in full force and effect.
   § 2. This act shall take effect immediately.

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  310--A
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced  by  M.  of  A. STECK, PEOPLES-STOKES, FAHY, ARROYO, GUNTHER,
   MOSLEY, MONTESANO, RAIA, PALMESANO, STIRPE, HAWLEY, GOTTFRIED,  BRABE-
   NEC,  FRIEND, ZEBROWSKI, GALEF, ENGLEBRIGHT, BARRETT, GIGLIO, BLANKEN-
   BUSH, BUCHWALD, BLAKE, LIFTON, WOERNER, LUPARDO, HEVESI -- Multi-Spon-
   sored by -- M. of A.  BARCLAY,  CROUCH,  LAVINE,  SCHIMMINGER,  SIMON,
   THIELE  --  read  once  and  referred to the Committee on Insurance --
   committee discharged, bill amended, ordered reprinted as  amended  and
   recommitted to said committee
 
 AN  ACT authorizing municipalities to join a county self-funded or self-
   insured health plan
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Notwithstanding  article 44 or 47 of the insurance law or
 any other provision of law to the contrary, and subject to the  require-
 ments  set  forth in this section, a municipality is permitted, with the
 consent of the county and the governing body of  such  municipality,  to
 join  a  county self-funded or self-insured health plan in any county in
 which such municipality is located in whole or in part. Municipality  is
 defined as any city, town, village or any other municipal corporation, a
 school  district  or  any governmental entity operating a public school,
 college or university, a  public  improvement  or  special  district,  a
 public  authority,  commission,  or  public  benefit corporation, or any
 other public corporation, agency or instrumentality or unit  of  govern-
 ment which exercises governmental powers under the laws of the state but
 is  not  a  part of, nor a department of, nor an agency of the state. In
 order for a municipality or municipalities to join the county self-fund-
 ed or self-insured health plan, the county shall file  with  the  super-
 intendent  of  financial  services certification that, with inclusion of
 the lives to be covered in the plan following admission of  the  munici-

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

                                                            LBD03515-02-9

 A. 310--A                           2
 
 pality  or municipalities, the county self-funded or self-insured health
 plan meets the following six requirements:
   (a)  That  the  county  and any municipality or municipalities joining
 such plan have mutually consented to join such plan.
   (b) That it maintain a reserve fund, calculated  as  a  percentage  of
 total annual incurred claims, of a minimum of 12% of claims.
   (c)  That it has a surplus account, established and maintained for the
 sole purpose of satisfying unexpected obligations of the benefit plan in
 the event of termination or abandonment of the plan, which shall not  be
 less  than  5%  of  the annualized earned premium equivalents during the
 current fiscal year of the plan.
   (d) That it has in effect a specific stop loss  per  individual  claim
 only,  no  aggregate,  and  with  a  minimum  deductible  of $200,000 to
 $250,000.
   (e) That it has a minimum of 1,000 covered lives  including  retirees,
 but not including dependents.
   (f)  That  joint and several liability of participating municipalities
 for the obligations of the plan is hereby abolished, and such  liability
 shall be governed as follows:
   1.  If  the  plan does not have admitted assets, as defined in section
 107 of the insurance law, at least equal to the aggregate of its liabil-
 ities and reserves and minimum surplus as provided in subdivision (b) of
 this section, the governing board of such plan  shall,  within  30  days
 thereafter,  order an assessment for the amount that will provide suffi-
 cient funds to remove such impairment and collect  from  each  municipal
 corporation a pro rata share of such assessed amount.
   2.  Every  municipal  corporation that participated in the plan at any
 time during the two-year period prior to the issuing  of  an  assessment
 order  by  the plan's governing board shall, if notified of such assess-
 ment, pay its pro rata share of such assessment within 90 days after the
 issuance of that assessment order.
   3. A municipal corporation's pro rata share of any assessment shall be
 determined by applying the ratio of (i)  the  total  assessment  to  the
 total  contributions  or  premium  equivalents  earned during the period
 covered by the assessment  on  all  municipal  corporations  subject  to
 assessment  to (ii) the contribution or premium equivalent earned during
 such period attributable to such municipal corporation.
   4. The contingent liability of municipal corporations  for  additional
 premium  equivalents or assessments shall not be included as an asset in
 the financial statements of the self-funded or self-insured health plan.
   The superintendent of financial services shall have the  authority  to
 review  such  certification  to  determine  that  the six aforementioned
 requirements have been met; provided, however, that in the absence of  a
 finding  of the superintendent to the contrary within a six-month period
 following the filing of such certification, the admission of the munici-
 pality to the county self-funded or self-insured health plan shall  take
 effect.  In  January  of every year following the initial filing of such
 certification, the county shall file a subsequent certification that the
 six aforementioned requirements remain in full force and effect.
   § 2. This act shall take effect immediately.