NY State Senate Bill 2021-S4058

Senate Bill S4058

2021-2022 Legislative Session

Relates to life, accident and health insurance; discrimination and rebating; prohibited inducements and independent sales

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance Committee

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
Jan 05, 2022	referred to insurance
Feb 02, 2021	referred to insurance

2021-S4058 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §4224, Ins L
Versions Introduced in Other Legislative Sessions:: 2013-2014: S7299
2015-2016: S1672
2017-2018: S4546
2019-2020: S3624
2023-2024: S3555

2021-S4058 (ACTIVE) - Summary

Relates to life, accident and health insurance; relates to discrimination and rebating; relates to prohibited inducements and independent sales.

2021-S4058 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S4058

SPONSOR: BRESLIN
 
TITLE OF BILL:

An act to amend the insurance law, in relation to life, accident and
health insurance; discriminating and rebating; prohibited inducements
and independent sales

 
PURPOSE:

To modernize the insurance law to allow licensed brokers, agents and
benefit consultants to assist insurers and employers in the interpreta-
tion, management and communication of the insurance policy and its
resulting costs, and to assist insurers and employers in the development
and implementation of care coordination services and other incidental or
ancillary programs and services.

 
SUMMARY OF PROVISIONS:

Section 1 of the bill would amend subsection (f) of § 4224 of the insur-

ance law by adding a new paragraph (3) thereto, to allow licensed insur-
ance producers without charging a service fee, or in the case of
licensed insurance brokers for a separate service fee, to provide
certain services to assist insurers and policyholders in the interpreta-
tion, management and communication of health insurance policies and
plans and their costs, including risk assessment, insurance consultation
and advice, insurance-related regulatory & legislative updates, claims
assistance services, tax preparations services related to IRS Form 5500
Schedule A (Annual Return/Report of Employee Benefit Plan) , insurance
plan information, forms, administration, employee & subscriber enroll-
ment services, websize links/employee benefit portals, answers to FAQs,
COBRA administration services, and HIPAA compliance services.

Section 2 of the bill would provide for an immediate effective date.

 
JUSTIFICATION:

The fast-paced and competitive insurance marketplace continues to
evolve, and insurance producers must change with it. Integral to this is
the modernization of certain statutory restrictions that are old and
outmoded. Chief amongst these are the anti-rebating and inducement laws
that were originally designed to protect insurance producers and consum-
ers alike from offering and accepting illegal inducements for the sale
of insurance products. In today's sophisticated health insurance market,
licensed insurance producers, including brokers, agents and benefits
consultants, must be able to offer a full value-added services platform,
such as providing benefits concierge, employee communications, 'benefits
web sites and help desks, benefits statements, compliance support, in
order to attract business and close the sale. Employer groups of all
sizes are increasingly looking not only for traditional advice in
selecting health plan benefits design and coverage options, underwriting
to reduce claims losses, and claims servicing and policyholder advocacy,
but are also demanding back-office human resources support.  The statu-
tory exceptions and allowanced prescribed in this bill would modernize
the insurance law with respect to health insurance, and allow insurance
producers to keep abreast of the market by lawfully providing such
services within the scope of their licensure and practice, without

charging a service fee, or in the case of licensed insurance brokers for
a separate service fee.

Moreover, this bill would codify the incidental services excepted from
the insurance anti-rebating and inducement laws listed in NYS Insurance
Department Circular Letter No. 9 (2009)
http://www.ins.state.ny.us/circltr/ 2009/0109 09 .htm

 
LEGISLATIVE HISTORY:

S.3624 of 2019-20;

S.4546 of 2017-18;

S.1672 of 2015-16;

S.7299 of 2014

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
Immediately.

2021-S4058 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4058
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             February 2, 2021
                                ___________
 
 Introduced  by  Sen. BRESLIN -- 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  life,  accident  and
   health  insurance; discriminating and rebating; prohibited inducements
   and independent sales

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection  (f)  of  section 4224 of the insurance law is
 amended by adding a new paragraph 3 to read as follows:
   (3) NOTWITHSTANDING SUBSECTION (C) OF THIS SECTION, A  LICENSED  AGENT
 OR  INSURANCE BROKER MAY PROVIDE THE FOLLOWING SERVICES WITHOUT CHARGING
 A SERVICE FEE OR, IN THE CASE OF A  LICENSED  INSURANCE  BROKER,  FOR  A
 SEPARATE SERVICE FEE PURSUANT TO A WRITTEN MEMORANDUM MADE IN ACCORDANCE
 WITH SUBSECTION (C) OF SECTION TWO THOUSAND ONE HUNDRED NINETEEN OF THIS
 CHAPTER,  IF  SUCH SERVICES ARE PROVIDED IN A FAIR AND NONDISCRIMINATORY
 MANNER AND INCIDENTAL TO A GROUP OR BLANKET POLICY OR CONTRACT  SOLD  BY
 THE INSURANCE AGENT OR INSURANCE BROKER:
   (I)  RISK ASSESSMENT, INCLUDING IDENTIFYING SOURCES OF RISK AND DEVEL-
 OPING STRATEGIES FOR ELIMINATING OR LIMITING THOSE RISKS;
   (II) INSURANCE CONSULTING SERVICES OR OTHER INSURANCE-RELATED ADVICE;
   (III) INSURANCE-RELATED REGULATORY AND LEGISLATIVE UPDATES;
   (IV) CERTAIN CLAIMS ASSISTANCE SERVICES (INCLUDING THE PREPARATION  OF
 CLAIMS FORMS), BUT EXCLUDING ADJUSTMENT, UNLESS THE EXCEPTIONS SET FORTH
 IN  SUBSECTION (G) OF SECTION TWO THOUSAND ONE HUNDRED ONE OF THIS CHAP-
 TER ARE SATISFIED;
   (V) TAX PREPARATION ON BEHALF OF AN EMPLOYER  OF  SCHEDULE  A  OF  THE
 INTERNAL REVENUE SERVICE FORM FIFTY-FIVE HUNDRED ANNUAL RETURN/REPORT OF
 EMPLOYEE  BENEFIT  PLAN,  WHICH REQUESTS INFORMATION REGARDING INSURANCE
 CONTRACT  COVERAGE,  FEES,  AND  COMMISSIONS,  INVESTMENT  AND   ANNUITY
 CONTRACTS, AND WELFARE BENEFIT CONTRACTS;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07472-01-1

 S. 4058                             2
 
   (VI) INFORMATION TO GROUP POLICY OR CONTRACT HOLDERS AND MEMBERS UNDER
 GROUP INSURANCE POLICIES CURRENTLY IN PLACE, AS WELL AS FORMS NEEDED FOR
 PLAN  ADMINISTRATION,  ENROLLMENT  IN A PLAN, INSURER WEBSITE LINKS, AND
 ANSWERS TO FREQUENTLY ASKED QUESTIONS RELATED TO THE INSURANCE  (INCLUD-
 ING,  FOR  EXAMPLE,  ACCESS  THROUGH A WEBSITE, CREATED BY THE INSURANCE
 PRODUCER, TO AN EMPLOYEE BENEFIT PORTAL THAT CONTAINS SUCH INFORMATION);
   (VII) CERTAIN SERVICES PERFORMED PURSUANT TO THE FEDERAL  CONSOLIDATED
 OMNIBUS  BUDGET  RECONCILIATION  ACT  (COBRA),  SUCH  AS  BILLING FORMER
 EMPLOYEES, COLLECTING THE INSURANCE PREMIUMS, AND FORWARDING THE  AGGRE-
 GATE PREMIUMS TO THE EMPLOYER POLICY OR CONTRACT HOLDER OR TO THE INSUR-
 ER, WHEN OFFERED IN CONNECTION WITH THE PROVISION OF ACCIDENT AND HEALTH
 INSURANCE; AND
   (VIII) CERTAIN SERVICES PROVIDED IN ACCORDANCE WITH THE FEDERAL HEALTH
 INSURANCE  PORTABILITY  AND ACCOUNTABILITY ACT, SUCH AS THOSE PERTAINING
 TO HEALTH CARE ACCESS, PORTABILITY, AND RENEWABILITY,  WHEN  OFFERED  IN
 CONNECTION WITH THE PROVISION OF ACCIDENT AND HEALTH INSURANCE.
   § 2. This act shall take effect immediately.

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