S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4412
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 14, 2023
                                ___________
 
 Introduced  by  M.  of  A.  STECK, BARRETT, BLANKENBUSH, BRABENEC, COOK,
   DeSTEFANO, FAHY, FRIEND, J. M. GIGLIO, GUNTHER, HAWLEY, HEVESI, JONES,
   LUPARDO, McMAHON, PALMESANO, PEOPLES-STOKES, REYES,  STIRPE,  WALLACE,
   WOERNER,  ZEBROWSKI  --  read  once  and  referred to the Committee on
   Insurance

 AN ACT authorizing municipalities to join a county self-funded or  self-
   insured health plan
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Notwithstanding article 44 or 47 of the  insurance  law  or
 any  other provision of law to the contrary, and subject to the require-
 ments set forth in this section, a municipality is permitted,  with  the
 consent  of  the  county and the governing body of such municipality, to
 join a county self-funded or self-insured health plan in any  county  in
 which  such municipality is located in whole or in part. Municipality is
 defined as any city, town, village or any other municipal corporation, a
 school district or any governmental entity operating  a  public  school,
 college  or  university,  a  public  improvement  or special district, a
 public authority, commission, or  public  benefit  corporation,  or  any
 other  public  corporation, agency or instrumentality or unit of govern-
 ment which exercises governmental powers under the laws of the state but
 is not a part of, nor a department of, nor an agency of  the  state.  In
 order for a municipality or municipalities to join the county self-fund-
 ed  or  self-insured  health plan, the county shall file with the super-
 intendent of financial services certification that,  with  inclusion  of
 the  lives  to be covered in the plan following admission of the munici-
 pality or municipalities, the county self-funded or self-insured  health
 plan meets the following six requirements:
   (a)  That  the  county  and any municipality or municipalities joining
 such plan have mutually consented to join such plan.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04801-01-3
 A. 4412                             2
              

 
   (b) That it maintain a reserve fund, calculated  as  a  percentage  of
 total annual incurred claims, of a minimum of 12% of claims.
   (c)  That it has a surplus account, established and maintained for the
 sole purpose of satisfying unexpected obligations of the benefit plan in
 the event of termination or abandonment of the plan, which shall not  be
 less  than  5%  of  the annualized earned premium equivalents during the
 current fiscal year of the plan.
   (d) That it has in effect a specific stop loss  per  individual  claim
 only,  no  aggregate,  and  with  a  minimum  deductible  of $200,000 to
 $250,000.
   (e) That it has a minimum of 1,000 covered lives  including  retirees,
 but not including dependents.
   (f)  That  joint and several liability of participating municipalities
 for the obligations of the plan is hereby abolished, and such  liability
 shall be governed as follows:
   1.  If  the  plan does not have admitted assets, as defined in section
 107 of the insurance law, at least equal to the aggregate of its liabil-
 ities and reserves and minimum surplus as provided in subdivision (b) of
 this section, the governing board of such plan  shall,  within  30  days
 thereafter,  order an assessment for the amount that will provide suffi-
 cient funds to remove such impairment and collect  from  each  municipal
 corporation a pro rata share of such assessed amount.
   2.  Every  municipal  corporation that participated in the plan at any
 time during the two-year period prior to the issuing  of  an  assessment
 order  by  the plan's governing board shall, if notified of such assess-
 ment, pay its pro rata share of such assessment within 90 days after the
 issuance of that assessment order.
   3. A municipal corporation's pro rata share of any assessment shall be
 determined by applying the ratio of (i)  the  total  assessment  to  the
 total  contributions  or  premium  equivalents  earned during the period
 covered by the assessment  on  all  municipal  corporations  subject  to
 assessment  to (ii) the contribution or premium equivalent earned during
 such period attributable to such municipal corporation.
   4. The contingent liability of municipal corporations  for  additional
 premium  equivalents or assessments shall not be included as an asset in
 the financial statements of the self-funded or self-insured health plan.
   The superintendent of financial services shall have the  authority  to
 review  such  certification  to  determine  that  the six aforementioned
 requirements have been met; provided, however, that in the absence of  a
 finding  of the superintendent to the contrary within a six-month period
 following the filing of such certification, the admission of the munici-
 pality to the county self-funded or self-insured health plan shall  take
 effect.  In  January  of every year following the initial filing of such
 certification, the county shall file a subsequent certification that the
 six aforementioned requirements remain in full force and effect.
   § 2. This act shall take effect immediately.