S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8995
 
                           I N  A S S E M B L Y
 
                              January 8, 2020
                                ___________
 
 Introduced by M. of A. LIFTON -- read once and referred to the Committee
   on Insurance
 
 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. Subparagraph (B)  of  paragraph  1  of  subsection  (a)  of
 section 3240 of the insurance law, as amended by chapter 461 of the laws
 of 2015, clause (ii) as amended by a chapter of the laws of 2019, amend-
 ing  the  insurance  law relating to policies or contracts which are not
 included in the definition of student accident and health insurance,  as
 proposed  in legislative bills numbers S. 6197 and A. 492, is amended to
 read as follows:
   (B) "Student accident and health insurance" shall not include:
   (i) a policy or contract 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]
   (ii) [a] 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  [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;
              

 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05103-02-0

 A. 8995                             2
 
   (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;
   (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;
   (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)(1)(A), IF THE  POLICY
 OR CONTRACT:
   (I)  IS  LIMITED  TO  TRANSPORTATION  EXPENSES IN THE EVENT AN INSURED
 STUDENT INCURS A COVERED SICKNESS OR ACCIDENT, INCLUDING  TRANSPORTATION
 EXPENSES FOR A MEDICAL ESCORT TO TRAVEL WITH THE STUDENT AND TRANSPORTA-
 TION EXPENSES FOR RETURNING THE STUDENT TO THE STUDENT'S DOMICILE;
   (II)  PROVIDES  THAT  PREMIUMS  ARE PAID IN FULL BY THE INSTITUTION OF
 HIGHER EDUCATION;
   (III) COVERS STUDENTS ENROLLED IN THE INSTITUTION OF HIGHER EDUCATION;
   (IV) INCLUDES PROMINENT DISCLOSURE TO THE STUDENT  THAT  THE  ACCIDENT
 POLICY IS NOT A SUBSTITUTE FOR COMPREHENSIVE HOSPITAL AND MEDICAL COVER-
 AGE; AND
   (V) PROVIDES COVERAGE FOR A PERIOD OF TWELVE MONTHS; OR
   (IV)  AN  INSURANCE  POLICY,  CONTRACT,  OR  CERTIFICATE THAT PROVIDES
 HOSPITAL, MEDICAL, OR SURGICAL EXPENSE  COVERAGE  FOR  A  STUDENT  WHILE
 STUDYING OUTSIDE THE UNITED STATES FOR A PERIOD OF TWELVE MONTHS OR LESS
 THAT  IS  ISSUED TO A STUDENT, PROVIDED THAT THE STUDENT IS ALSO COVERED
 BY COMPREHENSIVE HOSPITAL AND MEDICAL COVERAGE WITHIN THE UNITED  STATES
 AND THE INSURANCE POLICY, CONTRACT, OR CERTIFICATE:
   (I)  IS SUBJECT TO THE REQUIREMENTS OF SUBSECTIONS (B), (C), (D), (E),
 (H), AND (I) OF THIS SECTION;
   (II) MEETS THE DEFINITION OF "EXPATRIATE HEALTH PLAN" SET FORTH IN  42
 U.S.C. § 18014(D)(2);
   (III) EXCLUDES COVERAGE WITHIN THE UNITED STATES;
   (IV)  MAY OFFER COVERAGE FOR GLOBAL EVACUATION AND REPATRIATION IN THE
 EVENT OF THE INSURED STUDENT'S SICKNESS OR ACCIDENT; AND
   (V) MAY OFFER  COVERAGE  FOR  TRIP  CANCELLATION,  TRIP  INTERRUPTION,
 BAGGAGE,  PERSONAL  EFFECTS,  OR  GLOBAL  EVACUATION  AND  REPATRIATION,
 INCLUDING EVACUATION IN THE EVENT OF A  NATURAL  OR  MAN-MADE  DISASTER,
 SUCH AS AN EPIDEMIC, POLITICAL EVENT, WAR, TERRORIST ACT, RIOT, OR CIVIL
 INSURRECTION,  PURSUANT TO SECTION THREE THOUSAND FOUR HUNDRED FIFTY-TWO
 OF THIS CHAPTER.
   § 2. Clause (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) OR (IV) of subparagraph (B) of
 paragraph one of subsection (a) of section three  thousand  two  hundred
 forty of this chapter.

 A. 8995                             3
 
   §  3.  Paragraphs  3, 4 and 5 of subsection (a) of section 3452 of the
 insurance law, as added by chapter 318 of the laws of 2008, are  amended
 to read as follows:
   (3) The policy may be issued to:
   (A)  any  railroad  company, steamship company, carrier by air, public
 bus carrier, or other common  carrier  of  passengers,  which  shall  be
 deemed the policyholder, where the policy insures its passengers; [or]
   (B) AN INSTITUTION OF HIGHER EDUCATION AS PROVIDED IN PARAGRAPH TWO OF
 SUBSECTION (A) OF SECTION THREE THOUSAND TWO HUNDRED FORTY OF THIS CHAP-
 TER; OR
   (C) any other group where the superintendent has determined in a regu-
 lation  that  the members are engaged in a common enterprise, or have an
 economic or social affinity or relationship, and that  the  issuance  of
 the policy would not be contrary to the best interests of the public.
   (4)  [The] (A) EXCEPT AS PROVIDED IN SUBPARAGRAPH (B) OF PARAGRAPH ONE
 OF SUBSECTION (A) OF SECTION THREE THOUSAND TWO HUNDRED  FORTY  OF  THIS
 CHAPTER,  THE  policy  may  provide coverage for trip cancellation, trip
 interruption, baggage, and personal effects when limited to  a  specific
 trip.  The  policy  shall  be  sold  in  connection  with transportation
 provided by the common carrier or,  with  respect  to  other  groups  as
 permitted  by  the  superintendent in accordance with subparagraph [(B)]
 (C) of paragraph three of this subsection, subject to  such  limitations
 provided in the regulation promulgated by the superintendent.
   (B) A POLICY ISSUED TO AN INSTITUTION OF HIGHER EDUCATION SHALL COMPLY
 WITH  CLAUSE  (V)  OF  ITEM (IV) OF SUBPARAGRAPH (B) OF PARAGRAPH ONE OF
 SUBSECTION (A) OF SECTION THREE THOUSAND TWO HUNDRED FORTY OF THIS CHAP-
 TER.
   (5) Coverage under the policy shall be limited to the  group  member's
 risks  with  respect  to a particular trip, EXCEPT A POLICY ISSUED TO AN
 INSTITUTION OF HIGHER EDUCATION SHALL COMPLY WITH ITEM (IV) OF  SUBPARA-
 GRAPH  (B)  OF PARAGRAPH ONE OF SUBSECTION (A) OF SECTION THREE THOUSAND
 TWO HUNDRED FORTY OF THIS CHAPTER.
   § 4. Paragraph 1 of subsection (c) of section 3452  of  the  insurance
 law,  as added by chapter 318 of the laws of 2008, is amended to read as
 follows:
   (1) Unless the group policy provides for a longer policy  period,  the
 policy shall be issued or renewed for a one-year policy period, EXCEPT A
 POLICY  ISSUED  TO AN INSTITUTION OF HIGHER EDUCATION SHALL BE ISSUED OR
 RENEWED FOR A PERIOD CONSISTENT WITH ITEM (IV) OF  SUBPARAGRAPH  (B)  OF
 PARAGRAPH  ONE  OF  SUBSECTION (A) OF SECTION THREE THOUSAND TWO HUNDRED
 FORTY OF THIS CHAPTER.
   § 5. Subparagraph (B) of paragraph 7 of subsection (c) of section 3452
 of the insurance law, as added by chapter 318 of the laws  of  2008,  is
 amended to read as follows:
   (B) The coverage shall terminate as provided in the certificate, which
 shall  in  no  event  be  later  than the conclusion of the trip, EXCEPT
 COVERAGE UNDER A POLICY ISSUED TO AN INSTITUTION OF HIGHER EDUCATION  AS
 PROVIDED IN ITEM (IV) OF SUBPARAGRAPH (B) OF PARAGRAPH ONE OF SUBSECTION
 (A)  OF  SECTION  THREE THOUSAND TWO HUNDRED FORTY OF THIS CHAPTER SHALL
 TERMINATE IN ACCORDANCE WITH THE PROVISIONS OF THAT SECTION.
   § 6. This act shall take effect on the  same  date  and  in  the  same
 manner  as  a  chapter  of  the laws of 2019, amending the insurance law
 relating to policies or contracts which are not included  in  the  defi-
 nition of student accident and health insurance, as proposed in legisla-
 tive bills numbers S. 6197 and A. 492, takes effect.