S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5130
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 2, 2023
                                ___________
 
 Introduced by M. of A. DINOWITZ -- read once and referred to the Commit-
   tee on Insurance
 
 AN  ACT to amend the insurance law, in relation to the designation of an
   independent consumer assistance program
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. The insurance law is amended by adding a new section 211 to
 read as follows:
   § 211. INDEPENDENT CONSUMER ASSISTANCE PROGRAM. THE SUPERINTENDENT, IN
 CONSULTATION  WITH  THE COMMISSIONER OF HEALTH, SHALL DESIGNATE AN INDE-
 PENDENT CONSUMER ASSISTANCE PROGRAM THAT WILL HAVE THE FOLLOWING DUTIES:
   (A) THE INDEPENDENT CONSUMER ASSISTANCE PROGRAM SHALL:
   (1) ASSIST CONSUMERS  WITH  THE  FILING  OF  COMPLAINTS  AND  APPEALS,
 INCLUDING  FILING  APPEALS WITH THE INTERNAL APPEAL OR GRIEVANCE PROCESS
 OF THE GROUP HEALTH PLANS  OR  HEALTH  INSURANCE  ISSUERS  INVOLVED  AND
 PROVIDING  INFORMATION  ABOUT  AND ASSISTING CONSUMERS WITH THE EXTERNAL
 APPEALS AND ADMINISTRATIVE HEARING PROCESS;
   (2) COLLECT, TRACK, AND QUANTIFY PROBLEMS AND INQUIRIES ENCOUNTERED BY
 CONSUMERS;
   (3) EDUCATE  CONSUMERS  ON  THEIR  RIGHTS  AND  RESPONSIBILITIES  WITH
 RESPECT TO GROUP HEALTH PLANS AND HEALTH INSURANCE COVERAGE;
   (4)  ASSIST CONSUMERS WITH ENROLLMENT IN A GROUP HEALTH PLAN OR HEALTH
 INSURANCE COVERAGE BY PROVIDING INFORMATION, REFERRAL, AND ASSISTANCE;
   (5) RESOLVE PROBLEMS WITH OBTAINING PREMIUM TAX CREDITS UNDER  SECTION
 36B OF THE INTERNAL REVENUE CODE OF 1986;
   (6) ASSIST CONSUMERS WITH DISPUTES ELIGIBLE FOR RESOLUTION UNDER ARTI-
 CLE SIX OF THE FINANCIAL SERVICES LAW;
   (7)  ASSIST UNINSURED, INSURED, OR UNDERINSURED CONSUMERS IN ACCESSING
 APPROPRIATE HEALTH CARE SERVICES, HOSPITAL FINANCIAL ASSISTANCE  OR  THE
 RESOLUTION OF THEIR HEALTH CARE BILLS; AND
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07668-01-3
 A. 5130                             2
              

 
   (8)  PROVIDE  ASSISTANCE TO HEALTH CONSUMERS ON ANY ADDITIONAL MATTERS
 RELATED TO ACCESSING HEALTH INSURANCE COVERAGE AND HEALTH CARE SERVICES.
   (B)  ALL  NEW  YORK  STATE REGULATED HEALTH PLANS SHALL BE REQUIRED TO
 LIST THE NAME, PHONE NUMBER, ADDRESS AND EMAIL OF THE STATE  INDEPENDENT
 CONSUMER ASSISTANCE PROGRAMS ON NOTICES TO CONSUMERS OF ADVERSE DETERMI-
 NATIONS  AND  EXPLANATION  OF  BENEFITS AND IN THE SUBSCRIBER AGREEMENT,
 MEMBER HANDBOOK AND ANY ADDITIONAL CONSUMER FACING MATERIALS  AS  DETER-
 MINED BY THE SUPERINTENDENT AND THE COMMISSIONER OF HEALTH.
   § 2. This act shall take effect immediately.