S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7109
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               May 11, 2023
                                ___________
 
 Introduced  by  M.  of  A.  STECK,  FAHY,  SANTABARBARA -- read once and
   referred to the Committee on Local Governments
 
 AN ACT in relation to establishing a pilot program for  a  county  self-
   funded or self-insured health plan in Albany and Schenectady counties;
   and providing for the repeal of such provisions upon expiration there-
   of

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. (a) The superintendent of financial services shall  author-
 ize a pilot program for a county self-funded or self-insured health plan
 in  Albany and Schenectady counties. Notwithstanding article 44 or 47 of
 the insurance law or any other provision of law  to  the  contrary,  and
 subject  to  the  requirements set forth in this section, a municipality
 located in such counties is permitted, with the consent  of  the  county
 and  the  governing body of such municipality, to join such county self-
 funded or self-insured health plan in the county in which  such  munici-
 pality  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  government
 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 such county self-funded  or
 self-insured  health plan, the county shall file with the superintendent
 of financial services certification that, with inclusion of the lives to
 be covered in the plan following admission of the municipality or  muni-
 cipalities, such plan meets the following six requirements:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09395-02-3
 A. 7109                             2
 
              

   1.  That the county and any municipality or municipalities joining the
 county self-funded or self-insured health plan have  mutually  consented
 to join such plan.
   2. That the county self-funded or self-insured health plan maintains a
 reserve  fund,  calculated  as  a  percentage  of  total annual incurred
 claims, of a minimum of 12% of claims.
   3. That the county self-funded  or  self-insured  health  plan  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 such plan, which shall not be less than 5%
 of  the  annualized earned premium equivalents during the current fiscal
 year of such plan.
   4. That the county self-funded or  self-insured  health  plan  has  in
 effect  a  specific  stop  loss per individual claim only, no aggregate,
 with a minimum deductible of $200,000 to $250,000.
   5. That the county self-funded or self-insured health plan has a mini-
 mum of 1,000 covered lives including retirees, but not including  depen-
 dents.
   6.  That  joint  and several liability of participating municipalities
 for the obligations of the county  self-funded  or  self-insured  health
 plan  is  hereby  abolished,  and  such  liability  shall be governed as
 follows:
   (i) 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 paragraph 2 of
 this subdivision, 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.
   (ii) 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.
   (iii) A municipal corporation's pro rata share of any assessment shall
 be  determined  by applying the ratio of (A) 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 (B) the contribution or premium equivalent  earned  during
 such period attributable to such municipal corporation.
   (iv) 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 plan.
   (b) 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.
   (c) The duration of a county self-funded or self-insured  health  plan
 undertaken  by  participating municipalities shall be at least two years
 and shall be allowed to become permanent should either county  determine
 the plan to be successful.
 A. 7109                             3
 
   (d) Thirty months after the effective date of this section, the super-
 intendent  of  financial services shall submit a report to the governor,
 the temporary president of the senate, and the speaker of the  assembly,
 analyzing  the data provided by participating municipalities, as well as
 recommendations based on the data collected from the pilot program.
   §  2.  This  act shall take effect on the ninetieth day after it shall
 have become a law.