NY State Senate Bill 2019-S1884

Senate Bill S1884

2019-2020 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 - Stricken

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
May 21, 2019	recommit, enacting clause stricken
Jan 17, 2019	referred to insurance

co-Sponsors

2019-S1884 (ACTIVE) - Details

See Assembly Version of this Bill:: A492
Law Section:: Insurance Law
Laws Affected:: Amd §3240, Ins L
Versions Introduced in 2017-2018 Legislative Session:: S8983, A11192

2019-S1884 (ACTIVE) - Summary

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

2019-S1884 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S1884

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 f 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.

2019-S1884 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1884
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                             January 17, 2019
                                ___________
 
 Introduced  by  Sen.  O'MARA -- read twice and ordered printed, and when
   printed to be committed 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.  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;

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05103-01-9

 S. 1884                             2
 
   (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.
   § 2. This act shall take effect immediately.

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Senate Bill S1884

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Sponsored By

Thomas F. O'Mara