S T A T E O F N E W Y O R K
________________________________________________________________________
6931
I N S E N A T E
January 6, 2020
___________
Introduced by Sen. BRESLIN -- 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 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
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05103-02-0
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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;
(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:
S. 6931 3
(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.
§ 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-
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nition of student accident and health insurance, as proposed in legisla-
tive bills numbers S. 6197 and A. 492, takes effect.