S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    40
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 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 blanket group accident
   and health insurance coverage
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subsection (a)  of  section  4237  of  the  insurance  law,
 subparagraph (C) of paragraph 3 as amended by chapter 461 of the laws of
 2015,  subparagraph  (F) of paragraph 3 as amended by chapter 369 of the
 laws of 1985, is amended to read as follows:
   (a) (1) Any policy or contract of insurance against  death  or  injury
 resulting  from  accident which insures a group of persons conforming to
 the requirements of one of the subparagraphs (A) through  [(F)]  (M)  of
 paragraph three hereof shall be deemed a blanket accident policy.
   (2) Any policy or contract which insures a group of persons conforming
 to  the  requirements of subparagraph (C), (E) or [(F)] (M) of paragraph
 three hereof against total or partial disability, excluding  such  disa-
 bility from accident, shall be deemed a blanket health insurance policy.
   (3) Any policy or contract of insurance which combines the coverage of
 blanket  accident  insurance  and  of blanket health insurance on such a
 group of persons shall be deemed a blanket accident and health insurance
 policy:
   (A) Under a policy or contract  issued  to  any  railroad,  steamship,
 motorbus  or airplane carrier of passengers OR OWNER, OPERATOR OR LESSEE
 OF ANY MEANS OF TRANSPORTATION, which shall be deemed the  policyholder,
 a  group  defined  as  all persons who may become such passengers may be
 insured against death or bodily injury either while, or as a result  of,
 being such passengers.
   (B)  Under  a  policy  or contract issued to an employer, who shall be
 deemed the policyholder, covering any  group  of  employees  defined  by

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD01896-01-9

 A. 40                               2
 
 reference  to  [exceptional]  hazards  incident  to [such employment] AN
 ACTIVITY, ACTIVITIES, OR OPERATIONS OF THE POLICYHOLDER,  insuring  such
 employee  against death or bodily injury resulting while, or from, being
 exposed  to  such [exceptional] hazards.  DEPENDENTS OF THE EMPLOYEE AND
 GUESTS OF THE EMPLOYER OR EMPLOYEES MAY ALSO BE INCLUDED  WHERE  EXPOSED
 TO THE SAME HAZARDS.
   (C)  Under  a  policy  or  contract issued to an institution of higher
 education, as defined in the higher education act of 1965, 20  U.S.C.  §
 1001,  other  school, or other institution of learning or to the head or
 principal thereof, who  or  which  shall  be  deemed  the  policyholder,
 provided,  with respect to a policy or contract issued to an institution
 of higher education, the  policy  or  contract  shall  be  a  policy  or
 contract:
   (i) of hospital, medical, or surgical expense insurance that meets the
 requirements  of  section three thousand two hundred forty of this chap-
 ter;
   (ii) that provides limited scope dental or vision 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); or
   (iii)  as  described in item (ii) of subparagraph (B) of paragraph one
 of subsection (a) of section three thousand two hundred  forty  of  this
 chapter.
   (D) Under a policy or contract issued in the name of
   (i) any county, city, town, village or fire district,
   (ii)  any duly organized fire department, or fire company, of any such
 municipal corporation or fire district, FIRST  AID,  CIVIL  DEFENSE,  OR
 OTHER  SUCH  GROUP whether or not any such corporation has been incorpo-
 rated under any general or special law,
   (iii) any fire  corporation  incorporated  under  or  subject  to  the
 provisions  of section one thousand four hundred two of the not-for-pro-
 fit corporation law, or any general or special law, if such  corporation
 is  by  law under the general control of, or recognized as a fire corpo-
 ration by, the  governing  board  of  a  city,  town,  village  or  fire
 district,  which  municipal corporation, fire district, fire department,
 fire company or fire corporation, as the case may be,  shall  be  deemed
 the policyholder, covering all, but not less than twenty-five, volunteer
 members  of  such  department, company or corporation. A district corpo-
 ration which has the general powers of and operates as a  fire  district
 shall  be considered a fire district for the purposes of this paragraph.
 A volunteer fireman whose services are offered and accepted pursuant  to
 the  provisions  of  section two hundred nine-i of the general municipal
 law shall be deemed a volunteer member of any such fire department, fire
 company or fire corporation except for the purpose  of  determining  the
 minimum number of twenty-five volunteer members for which any such poli-
 cy or contract must provide coverage. Any such policy or contract issued
 to  a  municipal  corporation or a fire district shall be subject to any
 limitations on the amount, coverage or benefits as are set forth in  any
 applicable general, special or local law or city or village charter.
   (E)  Under a policy or contract issued to and in the name of an incor-
 porated or unincorporated association of persons having a common  inter-
 est  or  calling,  which  association  shall be deemed the policyholder,
 having not less than fifty members, covering all OR  ANY  GROUP  OF  the
 members  of  such  association or if part or all of the premium is to be
 derived from funds contributed by the insured members and if the  oppor-
 tunity  to  take such insurance is offered to all eligible members, then
 such policy must cover not less than seventy-five percent of  any  class

 A. 40                               3
 
 or  classes of members determined by conditions pertaining to membership
 in the association.
   (F) UNDER A POLICY OR CONTRACT ISSUED TO A SPORTS TEAM OR TO A CAMP OR
 SPONSOR THEREOF, WHICH TEAM, CAMP OR SPONSOR SHALL BE DEEMED THE POLICY-
 HOLDER, COVERING MEMBERS, CAMPERS, EMPLOYEES, VOLUNTEERS, SUPERVISORS OR
 OFFICIALS.
   (G)  UNDER A POLICY OR CONTRACT ISSUED TO ANY INCORPORATED OR UNINCOR-
 PORATED RELIGIOUS, CHARITABLE, RECREATIONAL, EDUCATIONAL OR CIVIC ORGAN-
 IZATION, OR BRANCH THEREOF, WHICH ORGANIZATION SHALL BE DEEMED THE POLI-
 CYHOLDER, COVERING ANY GROUP OF  MEMBERS,  PARTICIPANTS,  OR  VOLUNTEERS
 DEFINED  BY  REFERENCE TO HAZARDS INCIDENT TO ANY ACTIVITY OR ACTIVITIES
 OR OPERATIONS SPONSORED OR SUPERVISED BY OR  ON  THE  PREMISES  OF  SUCH
 POLICYHOLDER.
   (H)  UNDER  A POLICY OR CONTRACT ISSUED TO A RESTAURANT, HOTEL, MOTEL,
 RESORT, OR INNKEEPER, WHICH SHALL BE DEEMED THE  POLICYHOLDER,  COVERING
 PATRONS OR GUESTS.
   (I)  UNDER  A POLICY OR CONTRACT ISSUED TO A BANK, ASSOCIATION, FINAN-
 CIAL OR OTHER INSTITUTION, VENDOR, OR TO A PARENT HOLDING COMPANY, OR TO
 THE TRUSTEE, TRUSTEES OR AGENT DESIGNATED BY ONE OR MORE BANKS,  ASSOCI-
 ATIONS,  FINANCIAL  OR  OTHER  INSTITUTIONS,  OR VENDORS, WHICH SHALL BE
 DEEMED THE POLICYHOLDER, COVERING ACCOUNTHOLDERS, DEBTORS, GUARANTORS OR
 PURCHASERS.
   (J) UNDER A POLICY OR CONTRACT ISSUED TO  A  TRAVEL  AGENCY  OR  OTHER
 ORGANIZATION  THAT  PROVIDES  TRAVEL  RELATED  SERVICES, WHICH AGENCY OR
 ORGANIZATION SHALL BE DEEMED THE POLICYHOLDER, TO COVER ALL OR ANY GROUP
 OF PERSONS FOR WHOM TRAVEL RELATED SERVICES ARE PROVIDED.
   (K) AN ENTERTAINMENT, THEATER, ARTS OR  EVENT  PRODUCTION  COMPANY  OR
 ORGANIZATION,  WHICH  SHALL  BE DEEMED THE POLICYHOLDER, COVERING ALL OR
 ANY GROUP OF PARTICIPANTS, VOLUNTEERS,  AUDIENCE  MEMBERS,  CONTESTANTS,
 EMPLOYEES  OR WORKERS ENGAGED IN ANY ACTIVITY, ACTIVITIES, OR OPERATIONS
 OF THE POLICYHOLDER.
   (L) UNDER A POLICY OR CONTRACT ISSUED TO AN  ESTABLISHED  ORGANIZATION
 WHETHER  INCORPORATED  OR NOT, HAVING COMMUNITY RECOGNITION AND OPERATED
 FOR THE WELFARE OF THE COMMUNITY AND ITS MEMBERS  AND  NOT  FOR  PROFIT,
 WHICH  SHALL BE DEEMED THE POLICYHOLDER AND COVERING ALL VOLUNTEER WORK-
 ERS WHO SERVE WITHOUT PECUNIARY COMPENSATION  AND  THE  MEMBERS  OF  THE
 ORGANIZATION AGAINST LOSS FROM ACCIDENTS THAT OCCUR WHILE ENGAGED IN THE
 ACTUAL PERFORMANCE OF DUTIES ON BEHALF OF SUCH ORGANIZATION OR IN ACTIV-
 ITIES THEREOF.
   (M)  Under  a  policy  or  contract  issued  to  insure; (i) any other
 [substantially similar group] RISK OR CLASS OF  RISKS  approved  by  the
 superintendent  as  eligible  for insurance under a blanket accident and
 health insurance policy or contract; THE DISCRETION OF  THE  SUPERINTEN-
 DENT  MAY BE EXERCISED ON AN INDIVIDUAL RISK BASIS OR CLASS OF RISKS, OR
 BOTH; or (ii) any other group approved  by  the  superintendent  upon  a
 finding  that:  (I)  there  is a common enterprise or economic or social
 affinity or relationship; (II) the premiums charged  are  reasonable  in
 relation  to the benefits provided; and (III) the issuance of the policy
 would result in economies of acquisition  or  administration,  would  be
 actuarially sound, and would not be contrary to the best interest of the
 public.  The  superintendent  shall promulgate regulations setting forth
 any such groups that have been accepted as qualifying pursuant  to  this
 subparagraph.
   § 2. This act shall take effect immediately.