S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5299--A
     Cal. No. 762
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                               March 1, 2021
                                ___________
 
 Introduced  by  Sens.  RIVERA, ADDABBO, AKSHAR, BROOKS, COONEY, HOYLMAN,
   JACKSON, KENNEDY, KRUEGER, SALAZAR, SKOUFIS -- read twice and  ordered
   printed,  and  when printed to be committed to the Committee on Insur-
   ance -- recommitted to the Committee on Insurance in  accordance  with
   Senate  Rule  6,  sec.  8  --  reported favorably from said committee,
   ordered to first and  second  report,  ordered  to  a  third  reading,
   amended  and  ordered  reprinted,  retaining its place in the order of
   third reading
 
 AN ACT to amend the insurance law, in relation to calculating an insured
   individual's overall contribution to any out-of-pocket maximum or  any
   cost-sharing requirement
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
 amended by adding a new paragraph 37 to read as follows:
   (37)  ANY  POLICY  THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
 APPLY ANY THIRD-PARTY PAYMENTS, FINANCIAL ASSISTANCE, DISCOUNT,  VOUCHER
 OR  OTHER  PRICE REDUCTION INSTRUMENT FOR OUT-OF-POCKET EXPENSES MADE ON
 BEHALF OF AN INSURED INDIVIDUAL FOR THE COST OF  PRESCRIPTION  DRUGS  TO
 THE INSURED'S DEDUCTIBLE, COPAYMENT, COINSURANCE, OUT-OF-POCKET MAXIMUM,
 OR  ANY  OTHER  COST-SHARING  REQUIREMENT  WHEN CALCULATING SUCH INSURED
 INDIVIDUAL'S OVERALL CONTRIBUTION TO ANY OUT-OF-POCKET  MAXIMUM  OR  ANY
 COST-SHARING  REQUIREMENT.    IF  UNDER FEDERAL LAW, APPLICATION OF THIS
 REQUIREMENT WOULD RESULT IN HEALTH SAVINGS ACCOUNT  INELIGIBILITY  UNDER
 26 USC 223, THIS REQUIREMENT SHALL APPLY FOR HEALTH SAVINGS ACCOUNT-QUA-
 LIFIED  HIGH  DEDUCTIBLE  HEALTH PLANS WITH RESPECT TO THE DEDUCTIBLE OF
 SUCH A PLAN AFTER THE ENROLLEE  HAS  SATISFIED  THE  MINIMUM  DEDUCTIBLE
 UNDER  26 USC 223, EXCEPT FOR WITH RESPECT TO ITEMS OR SERVICES THAT ARE
 PREVENTIVE CARE PURSUANT TO 26  USC  223(C)(2)(C),  IN  WHICH  CASE  THE
 REQUIREMENTS  OF  THIS  PARAGRAPH  SHALL APPLY REGARDLESS OF WHETHER THE
 MINIMUM DEDUCTIBLE UNDER 26 USC 223 HAS BEEN SATISFIED.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD00472-02-2
 S. 5299--A                          2
 
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 21 to read as follows:
   (21) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
 THIS STATE THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL APPLY ANY
 THIRD-PARTY  PAYMENTS,  FINANCIAL ASSISTANCE, DISCOUNT, VOUCHER OR OTHER
 PRICE REDUCTION INSTRUMENT FOR OUT-OF-POCKET EXPENSES MADE ON BEHALF  OF
 AN  INSURED  INDIVIDUAL  FOR  THE  COST  OF  PRESCRIPTION  DRUGS  TO THE
 INSURED'S DEDUCTIBLE, COPAYMENT, COINSURANCE, OUT-OF-POCKET MAXIMUM,  OR
 ANY  OTHER  COST-SHARING REQUIREMENT WHEN CALCULATING SUCH INSURED INDI-
 VIDUAL'S OVERALL CONTRIBUTION TO ANY OUT-OF-POCKET MAXIMUM OR ANY  COST-
 SHARING REQUIREMENT.  IF UNDER FEDERAL LAW, APPLICATION OF THIS REQUIRE-
 MENT  WOULD  RESULT IN HEALTH SAVINGS ACCOUNT INELIGIBILITY UNDER 26 USC
 223, THIS REQUIREMENT SHALL APPLY FOR HEALTH  SAVINGS  ACCOUNT-QUALIFIED
 HIGH  DEDUCTIBLE  HEALTH  PLANS WITH RESPECT TO THE DEDUCTIBLE OF SUCH A
 PLAN AFTER THE ENROLLEE HAS SATISFIED THE MINIMUM  DEDUCTIBLE  UNDER  26
 USC  223,  EXCEPT FOR WITH RESPECT TO ITEMS OR SERVICES THAT ARE PREVEN-
 TIVE CARE PURSUANT TO 26 USC 223(C)(2)(C), IN WHICH  CASE  THE  REQUIRE-
 MENTS  OF  THIS  PARAGRAPH SHALL APPLY REGARDLESS OF WHETHER THE MINIMUM
 DEDUCTIBLE UNDER 26 USC 223 HAS BEEN SATISFIED.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (tt) to read as follows:
   (TT) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,
 HOSPITAL   SERVICE  CORPORATION,  OR  HEALTH  SERVICE  CORPORATION  THAT
 PROVIDES COVERAGE FOR PRESCRIPTION DRUGS  SHALL  APPLY  ANY  THIRD-PARTY
 PAYMENTS,   FINANCIAL  ASSISTANCE,  DISCOUNT,  VOUCHER  OR  OTHER  PRICE
 REDUCTION INSTRUMENT FOR OUT-OF-POCKET EXPENSES MADE  ON  BEHALF  OF  AN
 INSURED  INDIVIDUAL FOR THE COST OF PRESCRIPTION DRUGS TO  THE INSURED'S
 DEDUCTIBLE,  COPAYMENT, COINSURANCE, OUT-OF-POCKET MAXIMUM, OR ANY OTHER
 COST-SHARING REQUIREMENT  WHEN  CALCULATING  SUCH  INSURED  INDIVIDUAL'S
 OVERALL  CONTRIBUTION  TO  ANY OUT-OF-POCKET MAXIMUM OR ANY COST-SHARING
 REQUIREMENT. IF UNDER FEDERAL LAW, APPLICATION OF THIS REQUIREMENT WOULD
 RESULT  IN  HEALTH  SAVINGS ACCOUNT INELIGIBILITY UNDER 26 USC 223, THIS
 REQUIREMENT SHALL APPLY FOR HEALTH SAVINGS ACCOUNT-QUALIFIED HIGH DEDUC-
 TIBLE HEALTH PLANS WITH RESPECT TO THE DEDUCTIBLE OF SUCH A  PLAN  AFTER
 THE  ENROLLEE  HAS  SATISFIED  THE  MINIMUM DEDUCTIBLE UNDER 26 USC 223,
 EXCEPT FOR WITH RESPECT TO ITEMS OR SERVICES THAT  ARE  PREVENTIVE  CARE
 PURSUANT  TO 26 USC 223(C)(2)(C), IN WHICH CASE THE REQUIREMENTS OF THIS
 PARAGRAPH SHALL APPLY REGARDLESS OF WHETHER THE MINIMUM DEDUCTIBLE UNDER
 26 USC 223 HAS BEEN SATISFIED.
   § 4. This act shall take effect on the first of January next  succeed-
 ing  the date on which it shall have become a law and shall apply to all
 policies and contracts issued, renewed, modified, altered or amended  on
 or after such date.